Women navigating the complexities of menopause might encounter unexpected health challenges, including the surprising onset of asthma. This is a condition that, traditionally, has been associated with childhood.
Karen Bowen, a 58-year-old skin clinic owner, can attest to this. After enduring years of agonizing pain from polycystic ovaries,she opted for a hysterectomy,a decision that brought immediate relief from her pain but triggered an unexpected result – severe asthma.
Within months, Karen was battling for every breath, experiencing frightening attacks that left her gasping for air and struggling to speak. “It felt like someone was sitting on my chest,” she recalls. Her heart hammered as her blood pressure skyrocketed, convinced it was her last moments.
Initially, her doctors attributed these attacks to a childhood asthma she had briefly experienced, prescribing standard inhalers. However, these failed to provide relief. It wasn’t untill fifteen years after her surgery,in 2021,that karen received a proper diagnosis of severe asthma,a condition brought on by the abrupt onset of menopause.Karen’s experience highlights a concerning trend. while asthma is frequently enough considered a childhood ailment, research reveals that menopause can be a potent trigger for asthma in women who have never experienced it before.Erika Kennington, head of research and innovation at Asthma & Lung UK, warns: “It is therefore possible that this delays diagnosis in older women, leaving their symptoms untreated.There is definitely a need to raise awareness of hormones as an asthma trigger.”
dr. Pujan Patel, a consultant respiratory clinician at Royal Brompton Hospital in London, echoes this sentiment. He observes a “peak in adult-onset asthma in women in their 40s and 50s every week,adding that both natural and surgical menopause can be significant triggers.
Recent research published in the journal Menopause supports this observation, finding that the peak age for adult-onset asthma is between 50 and 54. This study, which analyzed ten years of data from over 14,000 postmenopausal women who had no history of asthma before menopause, underscores the impact of hormonal shifts on respiratory health.
It’s crucial for women undergoing menopause to be aware of this potential link, and for healthcare professionals to consider it during diagnosis and treatment. The earlier asthma is recognized and treated, the better the outcomes for women navigating this phase of life.
Hormonal Shifts and Asthma: Understanding the menopause Connection
Asthma, a chronic respiratory condition characterized by inflammation and narrowing of the airways, often presents differently in women than in men. While childhood asthma is primarily linked to allergies, adult-onset asthma, often manifesting around menopause, can be triggered by a range of factors, including viruses, stress, and non-allergic irritants. But what’s the connection between hormonal changes during menopause and the progress of asthma?
Dr. Viki Male, a senior lecturer in reproductive immunology at Imperial College London, sheds light on this intriguing link. According to dr. Male, declining levels of estrogen, a key hormone predominantly produced by the ovaries, may play a role in increasing inflammation, a common denominator in asthma development. Oestrogen levels naturally decrease during menopause, a time when women experience a range of physical and emotional changes.
“Increased inflammation raises the risk of non-atopic asthma [asthma not caused by an allergic trigger],” explains Dr.Male.
Intriguingly, the relationship between estrogen and asthma appears to be a complex one. While declining estrogen levels may contribute to inflammation, high levels of synthetic estrogen, found in certain forms of hormone replacement therapy (HRT), have also been linked to an increased risk of asthma.
A 2021 study published in the journal *Chest* found that women using HRT had a 63% higher risk of developing asthma compared to those not using HRT. Even more striking, women who stopped HRT were twice as likely to see improvements in their asthma symptoms.
Based on these findings, Danish researchers recommend informing women prescribed HRT about the potential risk of developing asthma.
However, Dr. Male cautions against overstating the risks associated with HRT, stating, “If you take the right amount of estrogen – but not too much – then increased inflammation should not be a risk.”
The field of research is constantly evolving. Scientists are now exploring the potential role of “male hormones” such as testosterone in the development of asthma around menopause.
Dr. Patela notes that testosterone and other androgens, primarily associated with masculine traits, are generally linked to reduced inflammation in men. This may explain why menopausal women,with lower estrogen levels and possibly more influence from androgens,might experience increased airway inflammation.
“We don’t understand exactly what’s happening,” Dr. Patel acknowledges, “but the one thing that shouldn’t be ignored is that there is a hormonal influence on asthma, and that GPs and specialists should be aware that the risk is higher in women.”
While there’s still much to learn about this complex interplay between hormones and asthma, existing research highlights the importance of awareness and personalized healthcare approaches for women experiencing asthma symptoms, particularly during menopause.
Is Your Asthma Linked to Menopause?
For many women, the arrival of menopause brings a cascade of symptoms, from hot flashes and mood swings to sleep disturbances. While these are often discussed, there’s a less-talked-about potential consequence: adult-onset asthma.
erika Kennington, a specialist in the field, sheds light on this connection. “We see a lot of older women with asthma who don’t respond to asthma drugs,” she explains. This lack of response to conventional treatments can be a red flag, pointing towards a unique trigger for these women’s asthma.
Karen, a 69-year-old woman from Staffordshire, experienced this firsthand. After a hysterectomy, she began taking hormone replacement therapy (HRT).”Within months, the asthma kicked in,” she recalls.
Karen initially faced the same challenges countless women do when managing asthma. ”I started to catch chest infections and I’d find myself fighting for breath,” she describes. While doctors treated her symptoms with steroid inhalers and reliever inhalers,Karen often needed additional assistance at the hospital. Sadly, she felt her concerns weren’t always taken seriously. She was told her asthma was simply a recurrence from her childhood, dismissing the potential link to HRT.
in 2021, Karen was referred to a specialist center. There, she received a diagnosis of severe asthma and was prescribed a biologic treatment called tezepelumab, which targets a chemical messenger implicated in airway inflammation.
While tezepelumab has provided some relief, Karen’s journey highlights a crucial need for awareness.Dr.Male, a medical expert in the field, emphasizes the importance of “keeping an eye on any respiratory symptoms if you’ve recently started taking HRT.” She adds,”Given the evidence showing HRT can increase the rate of adult-onset asthma, it’s sensible to keep an eye on any respiratory symptoms if you’ve recently started taking it, and GPs shouldn’t dismiss those who have noticed changes with HRT or the menopause,”
Karen’s experience underscores the importance of understanding this connection. ”It’s so important that there’s more awareness of this connection – there coudl be women out there who have respiratory symptoms and might not even know it’s asthma,” she says.
What are the potential impacts of different types of hormone replacement therapy (HRT) on asthma risk in menopausal women?
Archyde Interview: Dr. Pujan Patel on Hormonal Shifts and Asthma in menopause
Archyde: Dr.Patel, thank you for joining us today to discuss the intriguing link between hormonal shifts during menopause and the onset or progression of asthma. Could you start by telling us about your expertise in this area?
Dr. Pujan Patel: Thank you for having me. I’m a consultant respiratory clinician at the Royal Brompton hospital in London, with a special interest in adult-onset asthma, including the impact of hormonal changes on the condition.
Archyde: We’ve been hearing about a concerning trend where menopause can trigger asthma in women who have never experienced it before. Can you shed some light on this?
Dr. Patel: Absolutely. Menopause is indeed a potent trigger for adult-onset asthma in women. We see a peak in new asthma cases in women in their 40s and 50s every week. Both natural and surgical menopause can be significant triggers, as the decline in estrogen levels can increase inflammation, a common denominator in asthma development.
Archyde: Estrogen has been in the spotlight regarding this connection.Can you elaborate on its role in asthma?
Dr. Patel: Estrogen plays a complex role in asthma. While declining estrogen levels during menopause can contribute to inflammation and thus increase the risk of non-atopic asthma,high levels of synthetic estrogen,as found in certain forms of hormone replacement therapy (HRT),have also been linked to an increased risk of asthma. A 2021 study published in the journal Chest supports this, showing that women using HRT had a 63% higher risk of developing asthma.
Archyde: That’s a significant increase. How should healthcare professionals approach this when diagnosing and treating asthma in menopausal women?
Dr. Patel: It’s crucial for healthcare professionals to consider hormonal changes during menopause when diagnosing and treating asthma. The earlier asthma is recognized and treated, the better the outcomes for women navigating this phase of life. We should be mindful of the potential impact of HRT on asthma risk, and discuss the benefits and risks with each individual patient.
Archyde: What about testosterone and other androgens? We’ve heard they might play a role in asthma around menopause.
Dr. Patel: That’s an area of active research. Testosterone and other androgens are generally linked to reduced inflammation in men, which might explain why menopausal women with lower estrogen levels and potentially more influence from androgens might experience different asthma patterns than men. However, more research is needed to fully understand this relationship.
Archyde: Thank you, Dr. Patel, for your insights. Your expertise has certainly helped our readers better understand the connection between hormonal shifts and asthma in menopause.
Dr.Patel: My pleasure. Raising awareness about this link is crucial to improve asthma outcomes in menopausal women.
