Birth Control Pill May Cut Women’s Risk for Asthma

By Serena McNiff
HealthDay reporter

WEDNESDAY August 19, 2020 (HealthDay News) – Could birth control pills be a bulwark against asthma?

New research suggests that hormonal contraceptives, which alter the natural ebb and flow of female hormones, can do just that.

A study of more than half a million women in the UK found that those who used hormonal contraceptives – whether pills, patches or injections – had a significantly lower risk of developing asthma than women who did not use it.

Female hormones have a mysterious relationship with asthma. Asthma is more common in boys than in girls during childhood, but after puberty, women are at greater risk of developing asthma and more likely to have severe symptoms.

Every hormonal event in a woman’s reproductive cycle – puberty, menstruation, pregnancy and menopause – has been shown to cause asthma-related ripple effects in some women who already have asthma.

“We know that over 40% of women with asthma suffer from increased exacerbations during their menstrual cycle, which highlights the role of sex hormones,” said study author Bright Nwaru, of the University of Gothenburg in Sweden.

Yet, how hormones are linked to asthma in women and how hormonal contraceptives can alter this relationship remains unclear.

According to Dr. Bruce Levy, chief of pulmonary and critical care at Brigham and Women’s Hospital in Boston, “There has been a good bit of research, but I would say that no definitive mechanism has been identified. I think most general practitioners, as well as specialists, are aware of this phenomenon, but why it happens remains to be determined. “

Previous research on the impact of hormonal contraception on asthma development has been inconsistent, and this study was one of the first large-scale surveys to examine this relationship.

Dr. Paul Greenberger is an allergist at Northwestern Medicine in Chicago. He said, “We’ve focused on this area over the years, but it’s not fully understood. That’s why it’s an interesting study.”

One theory is that hormones play a role in the inflammation that constricts the airways in patients with asthma, Greenberger said.

Continued

Although Levy noted that this study cannot prove that taking hormonal contraceptives prevents asthma, it does reveal a strong connection.

“It’s an association – it’s not proven, and it needs to be presented with some recognition that it’s not evidence,” Levy said.

Nwaru and an international team of researchers derived the data for this study from a large UK-based health database. They followed more than 500,000 women, aged 16 to 45, from 2000 to 2016. Throughout the study, approximately 25,000 of the women developed asthma.

After adjusting the data for factors such as obesity and smoking, which could cloud the results, the investigators found that women who used any type of hormonal contraceptive had a 30% lower risk of developing asthma. than women who did not use it.

And the benefit was greater for women who used it longer – women who took hormonal contraceptives for seven years were less at risk than those who used them for three to four years, or one to two years.

“It adds another layer of importance to the observation,” Levy said. “This is another line of evidence to suggest that it is not just a random association that turned out to be found by chance, but that it is something that appears to be related to duration during which contraceptive pills are used. “

In the study, published online recently in the Journal of Allergy and Clinical Immunology, the authors noted that more research is needed to better understand the relationship between female hormones and asthma.

Nwaru’s team also added that this topic should be studied in a clinical trial to see if the results of this study can be confirmed in a controlled setting.

“Our results do not suggest any change in current asthma management guidelines, but indicate the need for further confirmatory studies [e.g. clinical trials] to confirm our findings, ”Nwaru said.

While doctors are unlikely to prescribe birth control pills to prevent asthma anytime soon, more research could potentially lead to hormone therapy for asthma prevention, the study team suggested.

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Sources

SOURCES: Bright Nwaru, PhD, Krefting Research Center, Institute of Medicine, University of Gothenburg, Sweden; Bruce David Levy, MD, MS, chief, pulmonary and critical care medicine, Brigham and Women’s Hospital, and professor, medicine, Harvard Medical School, Boston; Paul Greenberger, MD, allergist and immunologist, Northwestern Medicine, and professor of medicine, Northwestern University Feinberg School of Medicine, Chicago;Journal of Allergy and Clinical Immunology, June 8, 2020, online



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