Hormonal contraceptives and asthma in women of reproductive age: analysis of data from serial national Scottish Health Surveys

Abstract

Objectives: Sex steroid hormones may explain known gender-related variations in asthma prevalence and clinical manifestation. We investigated the relationship between use of hormonal contraceptives and asthma in women, and assessed evidence of biological interaction between use of hormonal contraceptives and body mass index in this relationship. Design: Population-based analysis using data from serial Exposure: Current use of hormonal contraceptives. Main outcome measures: Self-reported current physiciandiagnosed asthma, current wheezing symptoms, wheezing attacks and treatment for asthma or wheeze. Results: Women comprising 30.9% (95% confidence interval 29.3-32.5) were currently using any hormonal contraceptive and current physician-diagnosed asthma was present in 6.5% (95% confidence interval 5.7-7.4). Use of any hormonal contraceptive was associated with reduced risk of current physician-diagnosed asthma (odds ratio 0.68; 95% confidence interval 0.47-0.98) and receiving !3 asthma care episodes (odds ratio 0.45; 95% confidence interval 0.25-0.82), but the evidence was equivocal for wheezing attacks. Use of hormonal contraceptives among overweight or obese women was non-statistically significantly associated with asthma, but there was 42-135% increased risk in overweight and obese non-contraceptive using women. Conclusions: Use of hormonal contraceptives may reduce asthma exacerbations and number of care episodes. Overweight and obese non-contraceptive-using women may be at increased risk of asthma. Prospective studies are now needed to confirm these findings. Both oestrogen and progesterone may stimulate smooth airway muscle function and inhibit the activities of TH2 responses. Future studies should investigate these underlying mechanisms.

Endogenous and exogenous sex steroid hormones in asthma and allergy in females: A systematic review and meta-analysis

“…A total of 22,488 records were retrieved, of which 64 articles (reporting 57 studies) met the criteria to be included in the review. E5 , E10 , E11 , E12 , E13 , E14 , E15 , E16 , E17 , E18 , E19 , E20 , E21 , E22 , E23 , E24 , E25 , E26 , E27 , E28 , E29 , E30 , E31 , E32 , E33 , E34 , E35 , E36 , E37 , E38 , E39 , E40 , E41 , E42 , E43 , E44 , E45 , E46 , E47 , E48 , E49 , E50 , E51 , E52 , E53 , E54 , E55 , E56 , E57 , E58 , E59 , E60 , E61 , E62 , E63 , E64 , E65 , E66 , E67 , E68 , E69 , E70 , E71 , E72 In total, 554,293 participants were analyzed across the included studies. Of the 57 studies, 22 were included in at least ...…”

“… E4 Data extraction and risk-of-bias assessment were undertaken by N.M. and U.N. for the study authored by B.I.N. and A.S. E5 …”

Interacting effects of obesity, race, ethnicity and sex on the incidence and control of adult-onset asthma

“…The obesity-related risk for asthma was more pronounced in women who did not use oral contraceptives (OR 2.97, 95 % CI 2.80, 3.15) than in those taking oral contraceptives (OR 2.06, 95 % CI 1.89, 2.24). Results from other studies indicated that oral contraceptive use lowered the risk for asthma in girls during puberty [ 33 ] and decreased the risk for asthma and asthma exacerbations in Scottish women [ 34 ].…”

Gender aspects of natural course of asthma

“…Так, 30,9 % женщин применяли контрацептивы (95%-ный ДИ -29,3-32,5), при этом использование любой формы контрацепции ассоциировалось со снижением риска диагностирования БА (ОШ -0,68; 95%-ный ДИ -0,47-0,98), а также со снижением риска обострения БА за последние 12 мес. (ОШ -0,45; 95%-ный ДИ -0,47-0,98) [37]. В некоторых исследованиях для выявления ассоциации БА с гормональными механизмами регуляции изучалось влияние эндокринных факторов и оценивалось влияние препаратов эстрогена.…”