< Back to Newsletters

ASTHMA IN WOMEN

Women with asthma often go undiagnosed…are likely to have more severe episodes during the premenstrual phase of the cycle… and more…

Asthma has become a global health problem, especially among women.

A condition in which inflamed bronchial tubes are narrowed or constricted, asthma makes it harder to breathe. Typically, this takes the form of wheezing, but you may just cough. Public attention has focused mostly on asthma in children, especially boys. It is not that girls don't get asthma, but compared with boys, who have typical wheezing, girls often express their asthma by coughing, particularly at night, and are thus less likely to be diagnosed as asthmatic.

Asthma differs in women in another important way. The severity of symptoms may vary with the menstrual cycle! In fact, 40% of women with asthma become more symptomatic premenstrually. These cyclic variations translate into a 4-fold increase in emergency room visits. The reason is NOT because women get less treatment. Quite the contrary… more women than men see primary care doctors and do get treated for asthma. They are even more likely to get aggressive treatment for asthma. Despite this, women with asthma are more likely than men with asthma to require emergency room visits and once there, to get admitted to the hospital, stay longer, and even get re-admitted! So, what's different?

Most women are aware of variations in how they feel during the menstrual cycle. Variations are normal. Breathing and how the lungs function are a good example: the work of breathing normally increases 30% during the premenstrual phase, similar to changes normally seen during pregnancy. However, the bronchial tubes are also more sensitive during this time and more likely to constrict. Nature compensates by enhancing the bronchial tubes' ability to relax and dilate (through beta receptors). Women with asthma, however, don't have this compensation. In fact, their beta receptors get fewer in number and even less able to widen.

An important part of asthma treatment is getting beta receptors more activated to open the bronchial tubes-something that may be less effective in women during the premenstrual phase!

So what should you do?

First, if you think you may have asthma, based on difficulty breathing during exertion, wheezing or coughing (especially during sleep), see your doctor for proper diagnosis.

If you have already been diagnosed with asthma:

• Stay on your medications while you collect more information
• Keep a monthly diary of symptoms, need for inhalers, and measurements of "peak flow"
• If you notice that your symptoms are worse just before your menstrual period, please bring that to the doctor's attention.

Working with your doctor, you may be able to minimize the risks of asthma emergencies, even during the premenstrual period. New medications that target the inflamed bronchial tubes and are not dependent upon beta receptors may work better. Sometimes combinations of treatments can make the difference, like using the relaxation response to mindfully alter your breathing pattern.

< Back to Newsletters