Exogenous female sex steroid hormones and risk of asthma and asthma-like symptoms: a cross sectional study of the general population

Abstract

Background-Recent evidence suggests a role for hormonal factors in the aetiology of asthma. Methods-Data from a large study of women selected from the general population were used to relate treatment with oral hormonal contraceptives (OCP) and postmenopausal hormone replacement therapy (HRT) to the following asthma indicators: self-reported asthma, wheezing, cough at exertion, and use of medication for asthma. The study sample comprised 1536 premenopausal and 3016 postmenopausal women who participated in the third round of the Copenhagen City Heart Study in 1991-4. A total of 377 women were taking OCP (24.5% of premenopausal women) and 458 were on HRT (15.2% of postmenopausal women). Results-In premenopausal women 4.8% reported having asthma. The prevalence of self-reported asthma, wheeze, use of asthma medication, and cough at exertion was not significantly related to use of OCP. In postmenopausal women the prevalence of self-reported asthma was 6.2%. A weak but consistent association was observed between HRT and self-reported asthma (OR 1.42 (95% CI 0.95 to 2.12)), wheeze (OR 1.29 (95% CI 1.02 to 1.64)), cough at exertion (OR 1.34 (95% CI 1.01 to 1.77)), and use of asthma medication (OR 1.45 (95% CI 0.97 to 2.18)). Conclusions-In this study of the general population no relationship was found between the use of OCP and asthma. Although an association was observed between HRT and asthma and asthmalike symptoms, this was relatively weak and it is concluded that there is no necessity to change present prescription practice. (Thorax 2001;56:613-616)

Are there reasons why adult asthma is more common in females?

“…A few studies have addressed this issue and found a decreased risk of developing asthma with increased length of OC use [13•], no effect [14], and an increased risk of current wheeze with OC use [9].…”

Endocrine disrupters – potential modulators of the immune system and allergic response

“…Some studies suggest that asthma incidence is significantly higher in postmenopausal women being on hormone replacement therapy (HRT), than in those who never used it (54). Moreover, it has been shown the association of maternal use of oral contraceptives before birth with a higher risk of atopic diseases (asthma, allergic rhinitis and atopic egzema) in the offspring compared with children of mothers who had never taken hormonal pills (55).…”

Association between asthma and female sex hormones

“…41 In a study by Lange, no relationship was found between use of oral contraceptives and asthma. 42 Erkoçoğlu et al 45 found in a survey on 487 women by means of a questionnaire that 196 (40.2%) reported using oral contraceptives. This use was associated with higher risk of current wheezing among adolescents and young adults, but only among those who had taken the oral contraceptives recently during the previous year.…”