Female hormones and asthma

You may notice worse asthma symptoms around puberty, periods, pregnancy, menopause, and if you’re taking hormone therapies. Keeping a symptom diary can help your GP or nurse see if there’s a link between your hormones and asthma symptoms. Dr Andy Whittamore, Asthma + Lung UK’s GP.

The two main female sex hormones are oestrogen and progesterone. These hormones change around puberty, periods, pregnancy and menopause. Female hormones may increase inflammation in the airways.

Female hormones are thought to be one of the reasons why more women have asthma than men after puberty, and have worse asthma.

If you notice your asthma is worse around times of hormonal change, it could mean that female hormones are affecting you.

Your GP or nurse can support you if you notice that you’re wheezing, coughing, have a tight chest, or feel breathless more often. 

Your asthma may be affected by female sex hormones if you’re:

• a woman (assigned female at birth)
• a transgender man (assigned female at birth)
• a transgender woman (assigned male at birth)
• gender non-binary (assigned female at birth)
• intersex (have differences in sex development)

If you’re not sure how our advice on female hormones relates to your own situation, speak to your GP, nurse or gender specialist.

You can sometimes get worse asthma symptoms before or during a period.

You may notice that your asthma symptoms improve a bit if you take hormonal contraceptives. This includes combined or progesterone-only pills.

Hormonal contraceptives stop hormone levels changing during the menstrual cycle.

Other things can affect how contraceptives may affect your asthma, like smoking and your weight. It’s a good idea to talk to your doctor or nurse about this.

During your pregnancy, you may notice your asthma symptoms get worse, get better, or you may not notice any change at all to your asthma symptoms.

Find out more about how pregnancy affects asthma, and what you can do to lower the risk to you and your baby. 

Asthma symptoms can sometimes get worse in the time leading up to menopause (perimenopause). Levels of female sex hormones are changing a lot during this time.

If you get asthma for the first time after menopause, it’s more likely to be non-allergic asthma. Some people with this type of asthma find that medicines do not work as well for them and their asthma is harder to control. Always speak to your GP or nurse, and ask for an asthma review, if you’re worried about asthma symptoms.

Being very overweight (obese) can increase your risk of getting asthma for the first time around menopause.

As you approach menopause, have regular asthma reviews (at least once a year) with your GP or nurse so they can:

• support you in keeping to a healthy weight.
• help you understand your risk of osteoporosis.
• give advice about Hormone Replacement Therapy (HRT). 

Taking HRT (Hormone Replacement Therapy)

HRT can reduce menopausal symptoms, such as hot flushes and headaches. Sometimes HRT can improve asthma symptoms too.

If you’re thinking of taking HRT, it’s worth talking to your GP or nurse about how HRT might affect your asthma. Taking HRT can sometimes make symptoms worse if you start taking it after the menopause.

Most hormonal contraceptives, like the combined pill or the progestogen-only pill, are safe to take with your usual asthma medicines.

Emergency (morning after) contraceptive may not be suitable if you take oral steroids for your asthma. Speak to your GP, nurse or pharmacist for advice on emergency contraception.

Always tell your GP or pharmacist you have asthma, and what asthma treatments you’re using, before starting any new medicines. They can give you hormonal contraceptives that are safe to take with your other medicines.

There are studies that suggest an increased risk from asthma symptoms, allergic reactions, and worse lung function for people with asthma who are having hormone therapy as part of their gender reassignment.

If you’re taking male-to-female gender affirming hormone therapy, be aware of your asthma symptoms. Speak to your GP, nurse or gender specialist if you notice asthma symptoms getting worse. 

Always speak to your GP or nurse if you think female hormones are affecting your asthma. They may be able to change your treatment plan or tell you about add-on treatments.

You’re less likely to react to any asthma triggers if you’re managing your asthma well. Download an asthma action plan to help you manage your asthma well.

Go for an asthma review

Always go for an asthma review at least once a year to check your medicines and update your asthma action plan.

Take your asthma medicines as prescribed

If you’ve been given preventer medicine, take it every day as prescribed, so you're less likely to react to your asthma triggers.

Use an asthma action plan to remind you what medicines you need to take every day and what to do when you get symptoms.

Keep a symptom diary

Keeping a symptom diary can help you know what's triggering your asthma and when, including times like your period.

Female hormones and other triggers

Female hormones can also make you more sensitive to other triggers, such as hay fever, colds and flu or food allergies.

Stress and anxiety can also be triggered by female hormones, and these are asthma triggers too.

Speak to your GP or nurse about other triggers, and the best way to manage these.

Find out why women are more likely to have asthma and to have more severe symptoms. Download our report Asthma is worse for women