Association Between Asthma and Female Sex Hormones

Overview

Journal Sao Paulo Med J

Specialty General Medicine

Date 2017 Jan 12

PMID 28076614

Citations 16

Authors

Raquel Prudente de Carvalho Baldacara

Ivaldo Silva

Affiliations

Soon will be listed here.

Abstract

Context And Objective:: The relationship between sex hormones and asthma has been evaluated in several studies. The aim of this review article was to investigate the association between asthma and female sex hormones, under different conditions (premenstrual asthma, use of oral contraceptives, menopause, hormone replacement therapy and pregnancy).

Design And Setting:: Narrative review of the medical literature, Universidade Federal do Tocantins (UFT) and Universidade Federal de São Paulo (Unifesp).

Methods:: We searched the CAPES journal portal, a Brazilian platform that provides access to articles in the MEDLINE, PubMed, SciELO, and LILACS databases. The following keywords were used based on Medical Subject Headings: asthma, sex hormones, women and use of oral contraceptives.

Results:: The associations between sex hormones and asthma remain obscure. In adults, asthma is more common in women than in men. In addition, mortality due to asthma is significantly higher among females. The immune system is influenced by sex hormones: either because progesterone stimulates progesterone-induced blocking factor and Th2 cytokines or because contraceptives derived from progesterone and estrogen stimulate the transcription factor GATA-3.

Conclusions:: The associations between asthma and female sex hormones remain obscure. We speculate that estrogen fluctuations are responsible for asthma exacerbations that occur in women. Because of the anti-inflammatory action of estrogen, it decreases TNF-α production, interferon-γ expression and NK cell activity. We suggest that further studies that highlight the underlying physiopathological mechanisms contributing towards these interactions should be conducted.

Citing Articles

Relationship between prognostic nutritional index and asthma: a cross-sectional analysis.

Jiang Z, Zhu X, Jiang H, Zhao D, Tian J Front Nutr. 2025; 12:1467270.

PMID: 39980673 PMC: 11839445. DOI: 10.3389/fnut.2025.1467270.

Association of systemic immune-inflammation index with asthma and asthma-related events: a cross-sectional NHANES-based study.

Tian T, Xie M, Sun G Front Med (Lausanne). 2024; 11:1400484.

PMID: 38988356 PMC: 11233796. DOI: 10.3389/fmed.2024.1400484.

Age at menarche and idiopathic pulmonary fibrosis: a two-sample mendelian randomization study.

Cao J, Ma Y, Zhao W, Feng C BMC Pulm Med. 2024; 24(1):117.

PMID: 38448907 PMC: 10916238. DOI: 10.1186/s12890-024-02936-8.

Smoking, Urban Housing and Work-Aggravated Asthma are Associated with Asthma Severity in a Cross-Sectional Observational Study.

Chevereau-Choquet M, Thoreau B, Taille C, Marchand-Adam S, Morel H, Plantier L J Asthma Allergy. 2024; 17:69-79.

PMID: 38318088 PMC: 10840413. DOI: 10.2147/JAA.S424546.

Fertility Challenges in Asthmatic Women: Examining the Complexities of Pregnancy Loss, Infertility, and Assisted Reproductive Technologies.

Shaikh M, Shaikh M, Hirani S, Nanote A, Prasad R, Wanjari M Cureus. 2023; 15(8):e43104.

PMID: 37692593 PMC: 10483094. DOI: 10.7759/cureus.43104.

References

Tan K, McFarlane L, Lipworth B . Loss of normal cyclical beta 2 adrenoceptor regulation and increased premenstrual responsiveness to adenosine monophosphate in stable female asthmatic patients. Thorax. 1997; 52(7):608-11. PMC: 1758601. DOI: 10.1136/thx.52.7.608. View

Mandhane P, Hanna S, Inman M, Duncan J, Greene J, Wang H . Changes in exhaled nitric oxide related to estrogen and progesterone during the menstrual cycle. Chest. 2009; 136(5):1301-1307. DOI: 10.1378/chest.09-0604. View

Magnan A, Mely L, Camilla C, Badier M, Montero-Julian F, Guillot C . Assessment of the Th1/Th2 paradigm in whole blood in atopy and asthma. Increased IFN-gamma-producing CD8(+) T cells in asthma. Am J Respir Crit Care Med. 2000; 161(6):1790-6. DOI: 10.1164/ajrccm.161.6.9906130. View

Lange P, Parner J, Prescott E, Ulrik C, Vestbo J . Exogenous female sex steroid hormones and risk of asthma and asthma-like symptoms: a cross sectional study of the general population. Thorax. 2001; 56(8):613-6. PMC: 1746111. DOI: 10.1136/thorax.56.8.613. View

Jenkins M, Dharmage S, Flander L, Douglass J, Ugoni A, Carlin J . Parity and decreased use of oral contraceptives as predictors of asthma in young women. Clin Exp Allergy. 2006; 36(5):609-13. DOI: 10.1111/j.1365-2222.2006.02475.x. View

Carey M, Card J, Voltz J, Arbes Jr S, Germolec D, Korach K . It's all about sex: gender, lung development and lung disease. Trends Endocrinol Metab. 2007; 18(8):308-13. PMC: 2391086. DOI: 10.1016/j.tem.2007.08.003. View

Zein J, Erzurum S . Asthma is Different in Women. Curr Allergy Asthma Rep. 2015; 15(6):28. PMC: 4572514. DOI: 10.1007/s11882-015-0528-y. View

Gomez Real F, Svanes C, Bjornsson E, Franklin K, Franklin K, Gislason D . Hormone replacement therapy, body mass index and asthma in perimenopausal women: a cross sectional survey. Thorax. 2005; 61(1):34-40. PMC: 2080706. DOI: 10.1136/thx.2005.040881. View

Varraso R, Siroux V, Maccario J, Pin I, Kauffmann F . Asthma severity is associated with body mass index and early menarche in women. Am J Respir Crit Care Med. 2004; 171(4):334-9. DOI: 10.1164/rccm.200405-674OC. View

10.

Kynyk J, Mastronarde J, McCallister J . Asthma, the sex difference. Curr Opin Pulm Med. 2010; 17(1):6-11. DOI: 10.1097/MCP.0b013e3283410038. View

11.

Carlson C, Cushman M, Enright P, Cauley J, Newman A . Hormone replacement therapy is associated with higher FEV1 in elderly women. Am J Respir Crit Care Med. 2001; 163(2):423-8. DOI: 10.1164/ajrccm.163.2.2003040. View

12.

Macsali F, Real F, Omenaas E, Bjorge L, Janson C, Franklin K . Oral contraception, body mass index, and asthma: a cross-sectional Nordic-Baltic population survey. J Allergy Clin Immunol. 2009; 123(2):391-7. DOI: 10.1016/j.jaci.2008.10.041. View

13.

Townsend E, Meuchel L, Thompson M, Pabelick C, Prakash Y . Estrogen increases nitric-oxide production in human bronchial epithelium. J Pharmacol Exp Ther. 2011; 339(3):815-24. PMC: 3226369. DOI: 10.1124/jpet.111.184416. View

14.

Macsali F, Svanes C, Sothern R, Benediktsdottir B, Bjorge L, Dratva J . Menstrual cycle and respiratory symptoms in a general Nordic-Baltic population. Am J Respir Crit Care Med. 2012; 187(4):366-73. DOI: 10.1164/rccm.201206-1112OC. View

15.

Bateman E, Hurd S, Barnes P, Bousquet J, Drazen J, Fitzgerald J . Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008; 31(1):143-78. DOI: 10.1183/09031936.00138707. View

16.

Matsubara S, Swasey C, Loader J, Dakhama A, Joetham A, Ohnishi H . Estrogen determines sex differences in airway responsiveness after allergen exposure. Am J Respir Cell Mol Biol. 2007; 38(5):501-8. PMC: 2335333. DOI: 10.1165/rcmb.2007-0298OC. View

17.

Shore S, Fredberg J . Obesity, smooth muscle, and airway hyperresponsiveness. J Allergy Clin Immunol. 2005; 115(5):925-7. DOI: 10.1016/j.jaci.2005.01.064. View

18.

Matteis M, Polverino F, Spaziano G, Roviezzo F, Santoriello C, Sullo N . Effects of sex hormones on bronchial reactivity during the menstrual cycle. BMC Pulm Med. 2014; 14:108. PMC: 4106209. DOI: 10.1186/1471-2466-14-108. View

19.

Romieu I, Fabre A, Fournier A, Kauffmann F, Varraso R, Mesrine S . Postmenopausal hormone therapy and asthma onset in the E3N cohort. Thorax. 2010; 65(4):292-7. PMC: 2962872. DOI: 10.1136/thx.2009.116079. View

20.

Keselman A, Heller N . Estrogen Signaling Modulates Allergic Inflammation and Contributes to Sex Differences in Asthma. Front Immunol. 2015; 6:568. PMC: 4644929. DOI: 10.3389/fimmu.2015.00568. View