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[Features of asthma in women: what is the relationship with hormonal status?]
C Taillé1, C Raherison2, A Sobaszek3
1Inserm U700, service de pneumologie, département hospitalo-universitaire FIRE, centre de compétence des maladies pulmonaires rares, hôpital Bichat, université Paris Diderot, AP-HP, 46, rue Henri-Huchard, 75877 Paris cedex, France.
Introduction:
The prevalence and control of asthma are modulated by hormonal changes in women, suggesting an influence of sex hormones on the airways.
Background:
The blood levels of both oestrogens and progesterone can modulate airway tone and inflammation. Asthma prevalence changes at puberty and the menopause, events also associated with modifications of adipose tissue and behaviour. Changes in lung function and asthma control are well documented during the menstrual cycle. However, an effect of hormone therapy on asthma control has not been demonstrated.
Perspective:
The effect of a targeted hormonal therapeutic intervention in menopausal asthma, a phenotype, which is frequently particularly severe, or in premenstrual asthma, should be evaluated by randomized trials.
Conclusion:
Involvement of sex hormones and their cyclical variations in the characteristics of asthma in women is probable, despite lack of convincing data. However, no definitive protective or deleterious effect can be assigned. Complex interactions with adipose tissue, airways anatomy and the domestic or working environment must be taken into account to explain these differences.
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