Demystifying Drug Categories for Pregnant Women

03/28/2003

By Erica Heilman

We all know that estrogen and progesterone are critical players in a woman's reproductive process. But could these hormones also improve her breathing? According to a recent report published in the March issue of Annals of Allergy, Asthma & Immunology, there is strong evidence that estrogen and progesterone may actually improve lung function and asthma. Conversely, during periods when hormonal levels are lower than average—menstruation and menopause—women with asthma may be at increased risk of asthma attacks.

Below, the report's author, Dr. Catherine L. Haggerty of the University of Pittsburgh, Graduate School of Public Health, offers an explanation for these findings and talks about how this information might help women identify high-risk times for asthma attacks.

Can you describe first the basic premise of your report? What are the effects of hormones on respiratory function?

The report looked at the association between estrogen and progesterone and pulmonary function, and asthma among women.

The data suggests that both estrogen and progesterone may be involved in improving pulmonary function and asthma. So in younger women, during the premenstrual and menstrual phases when these hormone levels are lower, asthmatics have been found to experience an increase in asthma attacks, increased hospitalization, decreased pulmonary function and maybe an increased need for medications such as bronchodilators to treat their asthma systems.

Oral contraceptives, which really dampen and smooth out these fluctuations in hormone levels, have been found to improve pulmonary function in some women as well.

Reports of lung function during pregnancy were a bit more mixed. About a third of pregnant women report that their asthma improves during pregnancy. Another third report no change, and the final third report that it actually worsens. But there are other factors that may be affecting pulmonary function in pregnant women such as increase in gastroesophageal reflux and increase in intra-abdominal pressure and all of these things also affect lung function. So it may be that even if estrogen and progesterone have a positive effect, pulmonary function is affected by so many things in pregnancy that that might be the reason for the differences among women.