Coughing, watery eyes, maybe wheezing a bit now and again? New food allergies, courtesy of perimenopause? Even menopause-induced hives?*
If these symptoms are new or feel worse than they have in the past, it could be your hormones to blame.
Like so many menopause mysteries, the research is lagging behind, so we don’t yet have definitive answers, but certainly many women report new or worsening symptoms of all of the above. And as women are more prone than men to asthma, and as many women report new allergies in perimenopause and menopause, a link between hormones and allergic disorders seems likely.
Wheezing, coughing, itching and burning skin? It might be time to talk with a menopause specialist. Book an appointment via Gennev telehealth, and get your questions answered.
Estrogen and Allergies / Inflammation
So what’s the link between menopause and allergies and asthma? Estrogen. That's right, hormone imbalance allergies are a real thing.
As we know, there are estrogen receptors all over the body, including on immunoregulatory cells. And estrogen, it appears, may skew the body’s response toward allergy and inflammation. This is generally held in check by progesterone, but in perimenopause and menopause, when levels of progesterone are low, asthma, allergies, even hay fever may appear or get worse.
A study in Northern Europe included over 2,300 women and tracked their respiratory health from 2000 to 2012. They found the “odds of getting asthma were more than twice as high for women going through the menopausal transition or after menopause, compared to non-menopausal women.” That risk rose further for women who were overweight or obese.
When it comes to asthma specifically, it may actually be the fluctuation of estrogen levels that produce the inflammatory response in a woman’s airways. Many women may have noticed symptoms rising and falling in severity with period cycles or pregnancy, indicating hormones are at least in part responsible.
And we can tell fluctuating hormones play a role in triggering asthma, because often women who have irregular periods for reasons other than perimenopause have worse asthma symptoms than women who are more regular in their cycles.
Menopause And Allergies: So what to do?
Asthma and allergies can be frightening, particularly if they’re new or more dramatic than in the past. But there are things you can do to manage symptoms and catch an attack early.
Know your cycles. Maeve O’Connor, allergist and immunologist from Charlotte, NC, says, “Most hospitalizations for asthma in women occur around the peri-menstrual stage of the menstrual cycle –- right before a woman’s period begins. This is when estrogen levels drop down to almost zero.” When cycles are irregular, as in perimenopause, you may be able to tell if a period is coming by tracking lung power with a peak flow meter. If your lung power has dropped, a period may be on the horizon.
If you experience worsened asthma during your cycle (for those who are still experiencing periods), the medication you're taking for menstrual pain can also make asthma more severe, so you may want to talk with a doctor about alternative pain relief that doesn't increase inflammation.
Knowing your cycles can help you understand what’s happening in your body and stay calm when breathing gets more difficult. Tracking cycles can be difficult to do when periods begin to fluctuate along with changing levels of estrogen, however, so we strongly suggest women track as best they can. Keeping detailed records may help you begin to identify physical signals of an approaching period.
Use maintenance medications as prescribed. It’s better for your lungs to manage symptoms rather than treat an attack once it has started.
Know your triggers. And avoid them, obviously. This counts for both asthma and allergies and is especially important if you’re at a stage in your cycle when you may be more vulnerable to triggers.
Reduce exposure to allergens. Clean often. Dust (or get someone to dust for you). Change bedding frequently. Vacuum. Be vigilant about mold. The more you can keep dust and mites (ugh, we know) and other allergens to a minimum, the better.
Manage your weight. Perimenopausal and menopausal women who are overweight have a greater risk of developing respiratory issues, so controlling menopausal belly fat as best you can may help minimize risk.
Quit smoking. Obviously, smoking is an irritant to your respiratory organs, so quit if you can, reduce if you can’t.
Eat to reduce allergens. Avoid sulfites (preservatives in wine, pickles, dried fruit), eat less salt, and try to get more foods rich with omega 3s (nuts, seeds, cold-water fish). If you eat foods that may be triggering, reduce the amount and don't exercise directly after when the results may be the worst.
Take vitamin D. According to James T C Li, M.D., Ph.D., "People with more-severe asthma may have low vitamin D levels," so consider boosting your intake of milk, eggs, and fish such as salmon, and spending a little time outdoors. If you're concerned you're not getting enough vitamin D, a supplement can be a great way to boost your levels. Plus, it's a great mood-booster if low-mood or low-energy are also issues for you.
Consider hormones. If asthma worsens to the point where it’s dangerous or limiting your life, you may want to consider hormone replacement. Again, this is an area where causes and effects are not well understood. In some women, HRT may worsen symptoms, particularly if the asthma is new. For women who have had asthma prior to menopause, HRT may help.
Seriously, if allergies are getting in the way of your life, a Gennev menopause-certified gynecologist can give you a trusted opinion, determine if medication is right for you, and they can provide prescription support. Book an appointment with a doctor here.
Women with asthma are hospitalized more often than men. Women’s mortality rates from asthma are significantly higher than men’s. But asthma is treatable. If you’re experiencing symptoms that could be asthma or allergies, talk with your doctor right away. Get started on a management plan that will make it easier for you to live your life your way.
And here's a benefit: for women who suffered with asthma even before menopause, according to the Mayo Clinic, many of them could experience relief from asthma symptoms or severity after menopause.
Do you have hormone-related asthma or allergies? How have you handled your condition? Please share with us by joining the conversation in our community forums.
*This website is not intended to replace a doctor's professional care. If you're experiencing symptoms such as difficulty breathing, coughing, wheezing, etc., please consult with your doctor right away.
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