Can My Period Worsen My Asthma?

Asthma and your Cycle

premenstrual asthma
Female asthma sufferer using an inhaler. Credit: i love images / Getty Images

Question: Can My Period Worsen My Asthma?


Just as premenstrual syndrome (PMS) may cause a number of annoying symptoms, you may also experience ‘premenstrual asthma’ just before and during the early part of your period. Patients with more severe asthma are thought to be at greater risk. This is characterized by a worsening of your asthma symptoms, such as:

In fact, anywhere from 20% to 40% of women report a worsening of asthma symptoms during the premenstrual time of the month. The increase in asthma symptoms is thought to result from declining hormone levels, both estrogen and progesterone, but the exact reasons are not completely understood. A small number of studies have documented increases in hyperresponsiveness and mast cell activation during the menstrual period. Additionally, studies have shown elevated levels of nitric oxide, a known marker for airway inflammation, to be elevated during the menstrual cycle. Finally, other studies have demonstrated that there are decreases in responsiveness in the cells (beta adrenergic receptors) that rescue inhalers act on and this may impact asthma symptoms in patients with pre-menstrual asthma.

Most women in whom menses trigger asthma respond to standard asthma treatment.

If you are unsure if your period is affecting your asthma, you may want to monitor your symptoms closely and keep an asthma diary.

Here are some potential treatments you and your doctor might discuss if you have premenstrual asthma:

  • Increasing controller medication the week before your period starts. In essence your pre-menstrual is treated like any other trigger and you and your doctor develop a strategy for addressing it. There is some thought that the addition of a long-acting beta-agonist during the second half of the menstrual cycle may help.
  • Hormone therapy with oral contraceptive pills to better regulate your hormone levels. A number of small case reports have demonstrated subjective improvement of asthma symptoms as well as was improvement in objective measures such as spirometry indices, decreased hospitalizations, and decrease in total daily steroid dosage with the use of oral contraceptives. Additional small studies document improvements when medications targeting cessation of menses are used.
  • Using your rescue inhaler as needed and be careful to avoid other asthma triggers.
  • Leukotriene inhibitors like Singulair or Accolate, which may prevent asthma symptoms related to changes in your hormone levels.
  • Avoiding NSAIDs for the treatment of PMS symptoms if you are sensitive to them.


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