Gender Matters in Asthma and Allergies
by Karen S. Schell, DHSc, RRT-NPS, RRT-SDS, RPFT, RPSGT, AE-C, CTTS
It is becoming clear to medical practitioners that asthma is handled differently by women and men. When you compare men and women with similar asthma conditions, women are apt to seek medical care more often than men. Women take their symptoms more seriously and are often three times more likely to be admitted to the hospital.1 More women die from asthma than men, which reinforces the theory that asthma may impact them more seriously.1
Interestingly, these gender differences in asthma do not exist from birth but develop later in life. Boys are actually at higher risk of being affected by asthma in childhood, but the risk turns to women after puberty.2
Why women are more affected
Researchers believe women may be more aware of their symptoms and have a higher level of anxiety than men. In addition, it is thought that women may have more sensitive airways that overreact to common triggers.
Fluctuating hormones associated with menstrual cycles and pregnancy may also put women at greater risk.1 Asthma symptoms show cyclic changes depending on hormone levels in women of child-bearing age. The use of contraceptives may help treat premenstrual syndrome and severe asthma.
Testosterone in men seems to suppress asthma.3 In general, female sex hormones aggravate asthma and other allergic diseases, while male sex hormones suppress such diseases.3 In addition, because the airway caliber and lung functions of males are greater than those of females, the smaller airway caliber in females may contribute to the reversal of the sex ratio in asthma after puberty.3
How to maintain control
The key to management for women and men is to stay on top of your asthma. However, women and men may need to address their asthma conditions differently in order to manage their symptoms.
If you are a woman, ask your doctor about your concerns. Any gender specific triggers, such as your menstrual cycle, can be addressed by increasing your control medications and monitoring your peak flow during pregnancy.
For males, asthma treatment may include cutting down or eliminating medication if symptoms seem to lessen or disappear over time. However, even if your asthma symptoms seem to lessen over time, it is important not to become complacent, but to monitor closely even when symptoms seem well controlled.
Tailor made treatment
Although it is clear there are gender differences in asthma, exactly why and how they occur is still not clear. Tailored treatments for the individual regardless of sex is key to proper management.
Karen Schell is an AARC member from Kansas who currently serves as director of cardiopulmonary services at Newman Regional Health in Emporia.