As children, more boys than girls have asthma. But things change around puberty. After that girls are twice as likely to develop asthma as boys. This is partly because of hormones.
One theory is that the male hormone testosterone protects the airways of boys after the age of 11. And at the same time female hormones are kicking in for girls.
Even though the numbers even out again once women have passed through the menopause, the risks for women still remain higher than for men.
Studies show that compared to men, women can have worse symptoms more often:
- Women are more at risk of asthma attacks and are admitted to hospital more often with their asthma.
- Women who develop asthma for the first time later in life, after menopause, are more likely to have asthma that’s difficult to control, and likely to need specialist care and treatments to help deal with their symptoms.
- Everyone’s lung function starts to decline after about the age of 35. For women it declines more quickly after the menopause.
- Statistics show that women with asthma over 65, are more at risk of life-threatening asthma attacks.
Women can also have all the same triggers as men, but some of these triggers may be worse for women or affect them more often.
- Food allergies are more common in women than men. And female hormones can make them worse.
- Cigarette smoke can affect women more than men. Women and girls may be more sensitive to cigarette smoke, and girls with asthma who start to smoke may take longer and need more help to quit.
- Stress and depression are more common in women, particularly older women who tend to be carers more often.
- Indoor triggers such as cleaning products may affect women more because statistics show they’re more likely to be doing the cleaning at home.
“All women can benefit from making sure they see their GP or asthma nurse for annual asthma reviews, and at other times if they notice symptoms, especially as they get older,” says Dr Andy Whittamore, Asthma UK’s in-house GP.
“It can help make sure any symptoms brought about by hormonal changes, or by getting older, are sorted out.”
You can also lower your risk by:
- taking your preventer medicine every day as prescribed so you’re less likely to react to any asthma triggers, including hormones
- keeping a symptom diary to help find out if hormones are triggering asthma symptoms around your period
- having an asthma review at least once a year to check your medicines are still right for you, and update your asthma action plan, particularly if you’re going through hormonal changes. Get an appointment sooner if you’re having asthma symptoms.
- keeping an eye on your weight. Being very overweight (obese) puts you more at risk of asthma symptoms getting worse as you get older. It also increases the risk of women getting asthma for the first time around menopause.
- talking to your GP about your risk of osteoporosis. This is where your bones get thinner and you’re more at risk of fractures. Your risk may be higher if you’re on higher doses of inhaled steroids or need regular or long term courses of steroid tablets. Women are four times more at risk than men of developing osteoporosis. And for women who have asthma, the chances of developing osteoporosis are slightly higher than average. You can get lots of advice from the NHS on how to strengthen your bones with diet and exercise.
- being aware how other conditions could make your asthma worse - for example, acid reflux, which is more common in women
- telling your GP if you notice breathlessness. “If you notice you’re less able to climb stairs or run for the bus, or doing exercise feels more difficult, don’t put off talking to your GP or asthma nurse,” says Dr Andy Whittamore. “Some studies suggest that women are more likely to overlook symptoms like breathlessness.”
Taking painkillers when you have asthma
Paracetamol is usually safe, but non-steroidal anti-inflammatory tablets (NSAIDs) such as ibuprofen (e.g. Nurofen) and mefenamic acid (e.g. Ponstan), and aspirin, may make asthma symptoms worse or trigger an asthma attack in some people.
“If you need to take medicine for period pain, or any other kind of pain, talk to your GP, asthma nurse or pharmacist about which painkiller is best for you,” says Dr Andy Whittamore.
Taking contraceptives when you have asthma
Oral contraceptives (either the combined pill or the progestogen-only pill) are safe to take if you have asthma. And taking them at the same time as your usual asthma medicines won’t make either the pill or your asthma medicines work less well.
But it’s always worth telling your GP or pharmacist that you have asthma, and what asthma treatments you’re using. For example, the morning after pill ellaOne is not recommended for women with severe asthma. And the combined pill Cilest is not recommended if you’re taking theophylline.
“Some women with asthma have found that taking an oral contraceptive (‘the pill’) helps cut down on asthma symptoms they get around their periods,” says Dr Andy.
Taking HRT when you have asthma
Some women decide to take Hormone Replacement Therapy (HRT) to cut down menopausal symptoms, such as hot flushes and headaches. It’s also sometimes prescribed to help with osteoporosis.
HRT has asthma benefits and asthma risks:
- Some research shows that HRT may increase the risk of women getting asthma for the first time.
- Some studies show that HRT improves symptoms in women who already have asthma.
- Generally, symptoms improve after the menopause, but this is not the case for women taking HRT.
“If you’re thinking about taking HRT, talk to your GP or asthma nurse about how it might affect your asthma,” says Dr Andy Whittamore.
“Research is still ongoing into this area, and individual women may react differently to HRT.”
If your asthma’s well managed, and you’re taking your preventer every day as prescribed, there’ll be no difference to how long it will take you to get pregnant.
But there is research showing that women who don’t use a preventer inhaler and rely just on a reliever inhaler to deal with their symptoms, can take longer to get pregnant.
“Keeping your asthma under control with a daily preventer inhaler is important for you and your unborn child. And it won’t cause harm to your unborn baby,” says Dr Andy. “But if you’re taking any regular medicines talk to your midwife or doctor to check they’re the safest for you and your pregnancy.”
You can also talk to one of our respiratory nurse specialists on our Helpline on 0300 222 5800 (9am-5pm; Monday-Friday). Or you can WhatsApp them on 07378 606 728.
Last updated January 2020
Next review due January 2023