slideshow widget

Monday, February 3, 2014

Is asthma worse in women?

The following was originally published at by me.

Asthma Attacks in Women

Studies show that while boys are more likely to have asthma than girls, women are more likely to have it than men.  Likewise, the older women become, the greater risk of developing asthma.  Studies also show  women are more likely to be admitted to the hospital for asthma, and more likely to die of an asthma attack.

What is the evidence?

According to a September, 2012, report by the American Lung Association (ALA), in 2011,women were 14 percent more likely to be diagnosed with asthma than men.  For instance, 11.8 million women were diagnosed with asthma compared with 5.1 million men, and this rate has been significant since 1999.

The report showed that 15.2 million females had asthma, while 10.8 million men had it. Women had a 35 percent greater risk of developing asthma than men.

Among adults over 18, women were 62 percent more likely to have asthma than men. Women were also more likely to be admitted to the hospital for asthma.  For instance,in 2011, 278,000 women were admitted for asthma, compared with 163,000 men.

Between 1988 and 2010, asthma hospital admissions decreased 19 percent in females and 30 percent in men.  In 2009, women were 50 percent more likely to die of an asthma attack than men. In 2009, for instance, 3,388 people died of asthma, and 64% of those deaths were women.

National Jewish Health ( said that boys are more likely to have asthma than girls, although this trend begins to reversed at puberty.  By the age of 40, women are 50% more likely to have asthma than men.

About 30-40 percent of women experience increased asthma symptoms at specific times during the menstrual cycle, most commonly 4-5 days before the onset of menstruation.

Studies have suggested that, during pregnancy, about a third of women observe an increase in symptoms, a third observe no increase in symptoms, and a third observe fewer symptoms.

Why is asthma harder on women?

Why asthma affects more women than men remains a mystery. According to Partners Asthma Center ( and National Jewish Health, there are some theories worth considering.

The first theory is that asthma may become more severe in women because of the way their lungs develop.  The idea is that their lungs are smaller and air passages narrower than male lungs.

The second theory suggests hormones (such as estrogen and progesterone) associated with the reproductive cycle may narrow air passages. Studies have linked estrogen with increased airway inflammation.

A third theory suggests women spend more time at home and with children, and therefore have greater exposure to dust and viral infections, two very common asthma triggers.

A fourth theory suggested by National Jewish points the finger at the difference in genetic makeup between female and male asthmatics.  The authors of the site explain: "Several specific genes are associated with asthma in females, but not in males.  There may also be sex specific differences in the regulation and expression of genes that could increase asthma prevalence and severity among women."

A fifth theory suggests that asthma may become worse during pregnancy, then going back to normal after the baby is born.

A sixth theory suggests that beginning with puberty, women are more likely to be obese, with estrogen being the likely culprit.  Increased inflammatory markers caused by fat cells are thought to contribute to worsening asthma.

What does this mean? 

What this means is that if you are a woman with asthma your lungs are probably more sensitive than male asthmatic lungs.  Likewise, while going through menstruation, pregnancy or menopause, women are at an increased risk for worsening asthma.

Most asthma experts suggests women may require a more aggressive asthma management program compared with men.

Some physicians fear increasing asthma medicine during pregnancy.  However, most physicians now believe that the consequences of poorly controlled asthma (such as lack of oxygen to the baby) are worse than poor asthma control.

Most asthma doctors now say the benefits of good asthma control with asthma controller medicine far outweigh the potential risks of asthma medicine.

What action should be taken?

Most asthma experts now recommend that every asthmatic
work with her asthma doctor to develop an asthma action plan
personally tailored to her.  This is a plan that will help you
recognize an attack and what action to take.
The experts at National Jewish recommend female asthmatics keep an asthma journal, keeping track every day of asthma symptoms, peak flow values, and medicine usage.  This will help determine if there is a trend of worsening asthma associated with menstruation, menopause, or with pregnancy.

Another important step is to make an extra effort is to maintain a good relationship with a physician, and to establish an asthma action plan and stick with it.

If a pattern of worsening asthma continues, a physician may recommend stepping up treatment prior to menstruation or during pregnancy.

Conclusion: The neat thing about asthma is that it can be controlled, and asthma attacks prevented. It may take a little extra effort on your part, but it can be done. By working with your doctor, and being compliant with your asthma medicine regime and asthma action plan, there is no reason you can't live a normal life with asthma.

No comments: