Severe Premenstrual Exacerbations of Asthma: Effect of Intramuscular Progesterone

Beynon, Huw; Garbett, N D; Barnes, Peter J.

doi:10.1016/s0140-6736(88)92837-1

Cited by 143 publications

(72 citation statements)

References 8 publications

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“…There are reports of six cases in the literature suggesting that exogenous sex hormones may have a therapeutic role in asthma [10,11]. However, there are two case reports which suggest that they may make asthma worse [13,14].…”

Section: Discussionmentioning

confidence: 99%

Do hormonal contraceptives influence asthma severity?

Forbes¹,

Jarvis²,

Burney³

1999

Eur Respir J

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There is some evidence that endogenous progesterone and oestrogen levels influence asthma severity in females, but little is known about the effects of hormonal contraceptives. This study aimed to describe how females with asthma perceived the effects of hormonal contraceptives on symptom severity, and to describe the association between asthma severity and current use of hormonal contraceptives.A questionnaire was sent to 891 females with asthma aged 20±30 yrs recruited from general practice registers in South London, UK. It asked about perceptions of the effects of hormonal contraceptives on asthma severity, about current use of hormonal contraceptives, and included an asthma quality of life questionnaire as a measure of asthma severity.About 6% of respondents who had ever used hormonal contraceptives reported that these had influenced asthma severity,~4% reporting worsening and 2% an improvement. There were no significant differences in asthma quality of life score between females currently taking hormonal contraceptives and those not, between those taking combined and progesterone-only preparations, or between users of different progestagen types.This study found no evidence of any important effect of hormonal contraceptives or their components on asthma severity in a group of females with relatively mild asthma. Eur Respir J 1999; 14: 1028±1033. Endogenous oestrogen and progesterone level may have an effect on asthma severity in females. About a third of females with asthma report worse symptoms in the perimenstrual part of their cycle [1±4]. In a study in the USA, a higher proportion of asthmatic females was admitted to hospital in the perimenstrual part of the cycle than at other times [5]. Studies of objective measures of asthma severity over the menstrual cycle are less consistent. Three studies found no difference in bronchial hyperresponsiveness (BHR) at two different times of the menstrual cycle [6±8], though the subjects may not have been representative of all asthmatic females, the sample sizes were small, and the times of the menstrual cycle chosen for measurement of BHR may not have been those most likely to show differences. In one study of 9 females, however, BHR increased in the luteal phase [9]. Because of the inconsistency between these studies, firm conclusions cannot be drawn about the effect of endogenous hormones on asthma severity in females.There is little published research on the effect of exogenous sex hormones on asthma and the results are also inconsistent. In the study by TAN et al. [9] the luteal phase increase in BHR was much smaller in 9 females taking oral contraceptive pills, suggesting a beneficial effect on asthma severity, though no differences in symptom outcomes were demonstrated. Some case reports and uncontrolled studies suggest that oestrogen or progesterone improve asthma symptoms or lung function [10±12] but others suggest that they might cause a deterioration [13± 15]. Females who had ever used hormone replacement therapy had a higher incidence of asthm...

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Section: Discussionmentioning

confidence: 99%

Do hormonal contraceptives influence asthma severity?

Forbes¹,

Jarvis²,

Burney³

1999

Eur Respir J

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“…Worsening of asthma may occur premenstrually in some women (57). The characteristic pattern is an increase in asthma symptoms and a fall in PEF 2-5 days before the menses.…”

Section: Brittle Asthmamentioning

confidence: 99%

Difficult asthma

Garcia

and

Humbert

2003

Allergy

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“…20 However, progestogens have also been found to have anti-inflammatory properties, and have been used successfully to treat rheumatoid arthritis, 28 and premenstrual asthma. 29 We postulate that the rapid withdrawal of the protective effects of either oestrogen or progesterone or both in the late luteal phase may explain the higher frequency of AAU in this phase of the menstrual cycle. We have assumed that the temporal relationship between the two is short; the onset of AAU is abrupt, and we are confident that this correlated well with the date of onset of symptoms.…”

Section: Discussionmentioning

confidence: 95%

Uveitis and the menstrual cycle

Sanghvi

Aziz

Jones

2004

Eye

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Purpose To establish whether there is a variation in the incidence of onset of acute anterior uveitis (AAU) in women during the phases of the menstrual cycle. Methods Prospective open study in women attending the Acute Referral Centre with a first or recurrent attack of AAU. Results There was a significant increase in the incidence of AAU during the late stages of the menstrual cycle. Conclusions The onset of AAU is partially dependent on the levels of either oestrogen or progesterone, or both. The withdrawal of the proven anti-inflammatory effects of these hormones may provoke the onset of uveitis.

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Severe Premenstrual Exacerbations of Asthma: Effect of Intramuscular Progesterone

Cited by 143 publications

References 8 publications

Do hormonal contraceptives influence asthma severity?

Do hormonal contraceptives influence asthma severity?

Difficult asthma

Uveitis and the menstrual cycle

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