Abstract

Sex Hormones Effects on the Control of Menopausal Asthma

S. Aissani, I. Ararem, H. Haouichat, M.E. Haffaf and A. Zitouni

Introduction: Asthma can persist after menopause but can also occur in pre- or post-menopause. The aging of the bronchial tree and the fall of the hormones during the menopause can influence the control of asthma.

Methods and methods: This is a prospective descriptive study from 2011 to 2017. It involved 106 postmenopausal asthmatic patients divided into two groups according to the onset of asthma before or after menopause. These women received prick tests for the most common allergens, spirometry and a dosage of progesterone and estradiol.

Results: These asthmatics are 45 to 70 years old with an average age of 58.39 ± 7.32 years. They have an average body mass index (BMI) of 28.83 ± 5.68 kg/m2. The almost exclusively passive smoking exposure is found in more than half of the cases.

When asthma occurs after menopause (24 patients), the average BMI is 29.12 ± 4.46 kg/m2. These women were postmenopausal earlier in 12.5% of cases and had positive skin tests in only 23.8% of cases. When asthma occurred before menopause (82 patients), the average BMI was 28.87 ± 5.06 kg/m2. These women have been menopausal at normal age but have decreased respiratory function. Overall uncontrolled asthma was found in 58.5% of patients with postmenopausal asthma and 43.9% in those with pre-menopausal asthma with a statistically significant difference (p=0.04).

There was no significant difference in hormone levels studied between the two groups. But the severity and uncontrolled asthma are associated with significantly higher estradiol levels.

Conclusion: The involvement of estrogen in the control and severity of asthma is not negligible in this study. The possible interaction of these hormones with other field factors such as smoking exposure and obesity is strongly suspected.