When Hormones Take Your Breath Away

Pretty woman using her inhaler

Credit: iStock

After a healthy childhood, my best friend suddenly started having breathing difficulties when she was 20 years old. The doctor diagnosed her with asthma. With the help of inhaled medications, she was able to control her symptoms. But a year later, the medications were no longer effective and she started having monthly, life-threatening asthma attacks. The severe attacks became more frequent a few days before her menstrual period, and the symptoms disappeared days after her period ended. At that time, I wondered if hormones could be to blame.

As a graduate student investigating the role of male and female hormones in lung inflammation, I know now that asthma can be a hormone-related health issue. Unfortunately, many people are unaware of this relationship. Hormones are chemicals that travel as messengers around the body through the bloodstream. They affect many bodily functions and play a large role in a woman’s life cycle from birth through puberty, adulthood, pregnancy and menopause. In proper balance, hormones help the body communicate and thrive. But sometimes hormone levels can be too high or too low, causing serious health problems, especially in people with asthma.

Although more young boys have asthma than girls, the pattern is reversed in adults: More women have asthma than men. During puberty girls begin to produce higher levels of the sex hormones estrogen and progesterone, which rise and fall throughout their menstrual cycle. About one-third of females with asthma report premenstrual-related asthma symptoms, which may lead to severe attacks. A research study of girls ages 8 to 17 found that those who started menstruating at earlier ages developed more severe asthma after puberty, perhaps because their hormone levels began to change earlier in life. Studies have shown that hormonal changes can disturb the airways and inflammatory responses in the lungs. As hormone levels go up and down, new blood vessels in the lungs form and disappear, affecting the lungs’ ability to take in oxygen. In addition, female hormones do not just cause breathing problems in women with asthma, but also in those who smoke or are overweight.

Researchers are working to discover how sex hormones affect the lungs in order to develop personalized treatments for asthma. Ideally, specialized treatments in the future will be gender-specific and take into consideration a person’s hormonal status.

Nathalie Fuentes OrtizNathalie Fuentes is a PhD candidate in the biomedical sciences program at Penn State College of Medicine. Her studies in Dr. Patricia Silveyra’s lab include the development of sex-specific therapies to treat lung diseases, sex differences in asthma-related lung inflammation triggered by ground-level ozone and the role of male and female sex hormones in lung disease. Nathalie is originally from Caguas, Puerto Rico.



13 thoughts on “When Hormones Take Your Breath Away

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  2. Thank you so much for your article. I have been suffering from menopause and this symptom. I went to emergency but because my oxygen levels were at 100 % they didn’t seem to think anything was wrong. I have even seen a lung specialist who didn’t seem to agree that my condition was hormone related. He only mentioned this can happen in pregnancy. He has told me I don’t have asthma and that I should stop my preventative meds. If my symptoms get worse I should get reassessed again. I hope that more doctors can become more aware of this problem here in Australia.

  3. Great article! Answered a lot of questions in my mind. I always wondered why menstruation triggered my asthma! I am now on a lowercarb (but notketo) high fat diet that is apparently regulating my hormones and this was the first month in years that I didnt have any asthma attacks. Like your friend I was diagnosed with asthma as a 20 year old following a very stressful period in my life. The dr told me it was stress induced. I didnt make the connection with other hormone issues at that time. Knowing what I know now about how stress deregulates the estrogen/progesterone balance, I wonder about how cortisol levels affect asthma as well.

  4. Great article thanks. I have been experiencing shortness of breath every month in the days that lead up to ovulation and also ro a lesser extent the days leading up to my period. And then I feel fine again. I’ve had a feeling its hormone related so it was great to read this and know I might be on to something. Thanks.

  5. I have notice that I get shortness of breath every month on ovulation day. It seems scary but after reading this article it answers a lot if my questions.

  6. Interesting article. For 18 months now I have suffered from shortness of breath. I have had blood work, a chest X-ray, a full lung function test, and heart tests, but no one has any answers for me apart from I have a small collapse at the bottom of my left lung which they have done nothing about. I was booked for a mannitol challenge but then Covid arrived and it was cancelled. Nothing has been done since and I’m still struggling so much. Funnily enough the first episode started the same month as my menstruation started to go haywire, and I’m convinced the two are linked and that I have a condition called catamenial pneumothorax. But no one will listen to me.

    • I was moved by your comment and have been having a similar challenge.
      I’m wondering if you found relief and any answers or diagnosis that you would be willing to share with me.
      I hope you are well now!

  7. Brilliant article I came across! I’ve been looking for answers and finally came to the same conclusion ( Hormone related) as I’m peri menopausal too! The week leading up to my period I have 4 days of shortness of breath and tight chest, it’s scary at times. I written a diary to look back on, this now all adds up, same dates each month this happens, then gone till the next month! Wish there was more help out there with this. I’m trying an inhaler for the first time.

  8. Thank you for this. I’ve suffered from monthly sore throats ever since I was a teenager and every time I went to the doctor it was another throat swab and ‘can’t find anything wrong’. The sore throat always lasts a week and nothing relieves the pain. I’m now in menopause, still get the occasional sore throat and on those days I’ve noticed I’m depressed, my oxygen saturation is lower then normal and my asthma is a lot more intense. I’ve often asked if it could be hormone related and was always told ‘no that’s not possible.’ Both male and female doctors wrote me off telling me it was my imagination. I’m now in my 60’s and have even been told that there’s no way I could still be having hormone issues, that at my age everything should be done and over with.

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  10. I’ve been saying for years that my breathing problems were hormone related, but doctors looked at me like I was crazy. My breathing problems began when I was 11, the year before my menstrual cycle began. It was awful. I would have to stop while walking to school to catch my breath. My mom didn’t get me tested for asthma because she said she had the same problem, that started around the same age. I found out my grandmother did too. After my menstrual cycle began, I would usually have difficulty breathing for several days before my cycle and it would usually last about 3 days. I have dealt with it for over 40 years. My daughter also has the same problem. I did take her to the doctor, and they did a pulmonary function test, but at the time she was not have trouble breathing. I’m glad to see that this is being looked into and maybe doctors will gain a better understanding.

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