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Evidence indicates that progesterone and estrogen may improve lung function and asthma, according to a report published in this month's Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

"Positive effects of estrogen and progesterone on lung function and asthma have been observed across the life span in women," said Catherine L. Haggerty, PhD, MPH, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pa. "Studies suggest that the hormones play a role in strengthening respiratory muscle and increasing relaxation of bronchial smooth muscle, reducing the contractile response. Estrogen and progesterone also have been shown to exhibit anti-inflammatory properties."

During the premenstrual and menstrual phase when hormonal levels are low, asthmatic patients have been found to experience increased asthma episodes, increased hospitalizations for asthma and decreased pulmonary function. While taking oral contraceptives and hormone replacement therapy, some women experience improved pulmonary function and a decrease in asthma exacerbation.

"Estrogen and progesterone are highly elevated during pregnancy, reaching their greatest concentrations during the final trimester. In some women, improvements in asthma symptoms from preconception to pregnancy parallel these changes in hormonal levels, with the lowest rate of symptoms occurring during the last four weeks," Dr. Haggerty said.

According to the authors, certain subgroups of women may be more susceptible to hormone cycles. Testosterone, estrogen and progesterone may each independently affect pulmonary function to varying degrees.

"A further understanding of the role of hormones in asthma may better predict exacerbations and direct therapeutic strategies. Such an understanding may help to improve the quality of life in women who suffer from this often debilitating disease," Dr. Haggerty said.

Women should tell their doctors if they notice a pattern of change in their asthma related to their periods, or as they approach menopause according to Joan C. Gluck, M.D., Miami, chair of ACAAI's Women's Health Committee.

"An increase in allergic symptoms can be the first sign of impending increase in asthma in pregnancy, as was recently shown. Likewise, an increase in allergy and asthma symptoms may also be an early sign of menopause. Doctors should be aware of these patterns and suggest variations in treatment relevant to hormonal changes, as well as consultation with an obstetrician-gynecologist," Dr. Gluck said.

Additional information on allergic diseases including asthma is available by calling the ACAAI toll free number at (800) 842-7777 or visiting its Web site at http://www.allergy.mcg.edu.

The ACAAI is a professional medical organization comprised of 4,200 qualified allergists-immunologists and related health care professionals. The College is dedicated to the clinical practice of allergy, asthma and immunology through education and research to promote the highest quality of patient care.

Citation: Haggerty CL, Ness RB, Kelsey S, Waterer GW. The impact of estrogen and progesterone on asthma. Ann Allergy Asthma Immunol 2003;90:284-291.