<\/p>\n\n\n\n
\u201cIt\u2019s not the number of breaths you take, but the moments that take your breath away.\u201d A nice sentiment, but maybe not the inspirational desk plaque you want if you are one of the millions of people who struggle with asthma. And while it shouldn\u2019t make you gasp in surprise, given that our sex hormones affect our health<\/a> in a myriad of ways, progesterone<\/a> has an important role in lung function, especially when it comes to asthma.<\/p>\n\n\n\n The American Lung Association<\/a> (ALA) defines asthma as \u201ca chronic lung disease that makes it more difficult to move air in and out of [the] lungs.\u201d It may involve coughing, wheezing, or shortness of breath as the airways periodically become irritated and swollen and excess mucus is produced. Instead of breathing through a wide, flexible tube, it feels like trying to breathe through a narrow straw. <\/p>\n\n\n\n While the exact cause of asthma is not well understood, the ALA cites various contributors and risk factors such as genetics, allergies, lung damage due to infection, pollution, smoking, and obesity. Asthma is also categorized into subtypes based on a person\u2019s triggers (exercise, allergies, sleep, etc.) and based on whether or not certain inflammation-causing white blood cells are present in the airways. Because hormones play a significant and complex role in inflammation<\/a>, and vice-versa, hormonal changes can improve or worsen asthma.<\/p>\n\n\n\n A big clue that sex hormones specifically (like estrogen<\/a> and progesterone<\/a>) have some relationship to asthma is that asthma rates vary based on menstrual status and the menstrual cycle. According to the CDC<\/a>, 7.3% of boys have asthma, compared to 5.6% of girls, but only 6.2% of adult men have asthma compared to 9.7% of women. In other words, for kids, asthma is more common in boys, but after puberty, women are 50% more likely to have asthma than men. Estrogen is generally considered a pro-inflammatory hormone, and the development of asthma during puberty is generally thought to be a result of rising estrogen levels. <\/p>\n\n\n\n Asthma symptoms can also fluctuate along with a woman’s cycle. As if the normal symptoms of PMS<\/a> aren\u2019t bad enough, this 2024 study<\/a> investigating progesterone and asthma estimates that up to 40% of women with asthma experience perimenstrual<\/em> asthma, a worsening of asthma symptoms around their period [1]. Progesterone is often considered an anti-inflammatory hormone, and this 2024 study<\/a> on airway inflammation found that mice treated with progesterone had less lung inflammation, less mucus production, and countered the pro-inflammation effects of neutrophils [2]. The lack of this helpful effect during menstruation may contribute to worse symptoms directly before or during a period. Another study<\/a> also suggested that increased prostaglandins<\/a> during menstruation may play a role in this effect, highlighting that the relationship between periods and asthma is likely due to multiple factors [3]. <\/p>\n\n\n\n Progesterone is often considered an anti-inflammatory hormone, and this 2024 study on airway inflammation found that mice treated with progesterone had less lung inflammation, less mucus production, and countered the pro-inflammation effects of neutrophils. The lack of this helpful effect during menstruation may contribute to worse symptoms directly before or during a period.<\/p><\/blockquote><\/figure>\n\n\n\n Interestingly, while puberty is associated with developing asthma for the first time, so is menopause. A 2024 study<\/a> that followed postmenopausal women for a ten-year period found that this was especially true for women experiencing menopause later in life (after age 50) and for women who used hormone therapy to treat menopause symptoms<\/a>. Researchers blamed estrogen, generally considered a pro-inflammatory hormone, on this effect [4]. But again, the relationship between hormones and inflammation is a complex one, and multiple hormones play important roles and can either increase or<\/em> decrease inflammation at different times.<\/p>\n\n\n\n A 2024 study<\/a> exploring the role of sex hormones on asthma symptoms analyzed the UK\u2019s Clinical Practice Research Datalink (CPRD) to find correlations between contraceptive use and asthma attacks [5]. This dataset contains anonymous health data from over 60 million patients in the United Kingdom. Of these 60 million patients, over 826,000 were women with asthma, and over half of these women had used oral contraceptives at some point. 132,676 women met the criteria for their combination-pill (COP) cohort and 129,151 met their criteria for progestin-only pill (POP) cohort. The study specifically looked at women being prescribed contraceptives for the first time and compared them to women who were not currently using contraception. The study analyzed data from these women for a maximum of two years, but for less time if women no longer met the criteria. <\/p>\n\n\n\n There was not a significant difference between women newly prescribed a combination pill (with both synthetic estrogen and progesterone) and non-users, but there were several differences in the progestin-only<\/a> cohort. For women under 35, there was a 39% increased risk of asthma attacks with POP use<\/em> compared to non-users. In women with lower corticosteroid use (lower corticosteroid use implies that these women generally have well-controlled asthma) there was a 20% increased risk of asthma attacks with POP use. Finally, in women with eosinophilic-asthma<\/a> (with this type of asthma, there are more inflammation-causing white blood cells in the airways) there was a 24% increased risk of asthma attacks (however, this group was smaller, so the correlation is less certain) [5]. The connection between POP use and increased risks of asthma attacks is troubling, especially since the birth control in question, the mini-pill, is available without a prescription and does not list asthma<\/a> as a reason to avoid it.<\/p>\n\n\n\n The connection between progestin-only pill use and increased risks of asthma attacks is troubling, especially since the birth control in question, the mini-pill, is available without a prescription and does not list asthma as a reason to avoid it.<\/p><\/blockquote><\/figure>\n\n\n\n Recall that in studies exploring the phenomenon of perimenstrual asthma, researchers concluded that too little<\/em> progesterone was the problem exacerbating asthma. But in the study detailed above that found a correlation between using a progestin-only pill or \u201cmini-pill,\u201d researchers concluded that too much<\/em> progesterone caused more asthma attacks. What\u2019s the answer? Does progesterone stop asthma or make it worse? There are two main factors that play into this question.<\/p>\n\n\n\n First, with asthma, the lungs are not working the way they are supposed to. Like with allergies<\/a>, the statement \u201cpeanuts cause the throat to close\u201d may be true for some people, but that\u2019s not how the body is supposed<\/em> to work. This effect happens because something has gone wrong. This 2024 study<\/a> investigating the role of progesterone in asthma found that progesterone increases the allergic response in female mice with asthma, and activates cells and proteins that are supposed<\/em> to contribute to tissue repair but, when dysregulated, instead cause inflammation [6]. A much older study<\/a> from 1993 discusses how healthy women have higher levels of a protein called beta2-AR during the luteal phase, but women with asthma do not. This protein is involved in smooth muscle relaxation, which includes<\/em> opening the airways [7]. It may be that in women with asthma, the body has an abnormal response to progesterone, which contributes to the development of asthma. Indeed, this review<\/a> describes a rare condition called progesterone sensitivity, in which a person has an allergic response to rises in progesterone, and one of the symptoms of this condition is asthma [8].<\/p>\n\n\n\n It may be that in women with asthma, the body has an abnormal response to progesterone, which contributes to the development of asthma.<\/p><\/blockquote><\/figure>\n\n\n\n The second factor is that not all progesterone is created equal. In the study that found an association between the mini-pill and asthma attacks, the mini-pill is providing the body with synthetic progesterone (known as progestin) that can have different effects on the body than \u201chome-made\u201d (i.e., endogenous) progesterone. When synthetic progesterone is abundant in the body, the body\u2019s own progesterone production is impeded, and the benefits that natural progesterone provides are lost. <\/p>\n\n\n\n The different risk of asthma attacks at different times in the menstrual cycle can make managing symptoms feel complicated, but it doesn\u2019t have to be. Learning to chart your cycles and charting asthma symptoms alongside fertility signs can help women create a treatment plan that is specific to them, whether their asthma symptoms respond more to rises in estrogen or to dives in progesterone. And, if asthma symptoms are made worse by a hormone imbalance, charting can be the first step to treating the problem at its root.<\/p>\n\n\n\n Learning to chart your cycles and charting asthma symptoms alongside fertility signs can help women create a treatment plan that is specific to them, whether their asthma symptoms respond more to rises in estrogen or to dives in progesterone.<\/p><\/blockquote><\/figure>\n\n\n\n Our bodies don\u2019t act as many systems operating independently, but as a cohesive whole. While asthma is a respiratory disease, it is also an immune problem, inflammatory condition, and a byproduct of the hormones that rise and fall throughout the different stages of our lives. Continued research can help to map these intricate pathways and mechanisms and bring further clarity into what shapes conditions like asthma and the steps we can take to treat them.<\/p>\n\n\n\nWhat is asthma?<\/span><\/h1>\n\n\n\n
Women have different experiences with asthma at different life stages<\/span><\/h1>\n\n\n\n
Connection between progestin-only contraception and asthma attacks<\/span><\/h1>\n\n\n\n
The progesterone problem<\/span><\/h1>\n\n\n\n
Is the body responding abnormally to progesterone?<\/span><\/h3>\n\n\n\n
\u2026or is it just responding normally to progestin?<\/span><\/h3>\n\n\n\n
The bottom line<\/span><\/h1>\n\n\n\n
References:<\/span><\/h4>\n\n\n\n[1] Trivedi S, Deering-Rice CE, Aamodt SE, Huecksteadt TP, Myers EJ, Sanders KA, Paine R 3rd, Warren KJ. Progesterone amplifies allergic inflammation and airway pathology in association with higher lung ILC2 responses. Am J Physiol Lung Cell Mol Physiol. 2024 Jul 1;327(1):L65-L78. doi: 10.1152\/ajplung.00207.2023. Epub 2024 Apr 23. PMID: 38651968; PMCID: PMC11380947.<\/p>\n\n\n\n[2] Wang, L., Huang, FY., Dai, SZ. et al.<\/em> Progesterone modulates the immune microenvironment to suppress ovalbumin-induced airway inflammation by inhibiting NETosis. Sci Rep<\/em> 14, 17241 (2024). https:\/\/doi.org\/10.1038\/s41598-024-66439-6<\/p>\n\n\n\n[3] Rao CK, Moore CG, Bleecker E, Busse WW, Calhoun W, Castro M, Chung KF, Erzurum SC, Israel E, Curran-Everett D, Wenzel SE. Characteristics of perimenstrual asthma and its relation to asthma severity and control: data from the Severe Asthma Research Program. Chest. 2013 Apr;143(4):984-992. doi: 10.1378\/chest.12-0973. PMID: 23632943; PMCID: PMC3747720.<\/p>\n\n\n\n[4] Kesibi, Durmalouk MA; Rotondi, Michael PhD; Edgell, Heather PhD; Tamim, Hala PhD. The association between age at natural menopause and risk of asthma among postmenopausal women from the Canadian Longitudinal Study on Aging. Menopause 31(12):p 1069-1077, December 2024. | DOI: 10.1097\/GME.0000000000002443<\/p>\n\n\n\n[5] Lee, Bohee & Rafati Fard, Amir Reza & Wong, Ernie & Tan, Tricia & Bloom, Chloe. (2025). Oral contraceptives and the risk of asthma attacks: a population-based cohort study. ERJ Open Research. 01278-2024. 10.1183\/23120541.01278-2024. <\/p>\n\n\n\n
References Continued:<\/span><\/h4>\n\n\n\n[6] \u00a0Shubhanshi Trivedi, Cassandra E. Deering-Rice, Samuel E. Aamodt, Thomas P. Huecksteadt, Elizabeth J. Myers, Karl A. Sanders, Robert Paine 3rd, and Kristi J. Warren. Progesterone amplifies allergic inflammation and airway pathology in association with higher lung ILC2 responses<\/a>. American Journal of Physiology-Lung Cellular and Molecular Physiology 2024 327:1, L65-L78<\/p>\n\n\n\n[7] Tan KS, McFarlane LC, Lipworth BJ. Paradoxical down-regulation and desensitization of beta2-adrenoceptors by exogenous progesterone in female asthmatics. Chest. 1997 Apr;111(4):847-51. doi: 10.1378\/chest.111.4.847. PMID: 9106558.<\/p>\n\n\n\n[8] Chiarella SE, Buchheit KM, Foer D. Progestogen Hypersensitivity. J Allergy Clin Immunol Pract. 2023 Dec;11(12):3606-3613.e2. doi: 10.1016\/j.jaip.2023.07.050. Epub 2023 Aug 12. PMID: 37579875; PMCID: PMC10841326.<\/p>\n","protected":false},"excerpt":{"rendered":"El papel fundamental de la progesterona en la funci\u00f3n pulmonar","protected":false},"author":98,"featured_media":23704,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5177],"tags":[6523,4058,3637],"class_list":{"0":"post-23703","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-know-your-body","8":"tag-asthma","9":"tag-hormone","10":"tag-progesterone","11":"cs-entry","12":"cs-video-wrap"},"acf":[],"yoast_head":"\n