As adults, women have higher rates of asthma and allergic disease as well as increased asthma severity compared to men.1 Pre or peri-menstrual worsening of asthma symptoms (PMA) were reported in 17% of women enrolled in the severe asthma research program, with 52% of these women with PMA having severe asthma.2, 3 Further, use of birth control medications or hormone replacement therapy during peri or post-menopause was also linked to worsening of asthma in some women.2, 4 Mouse models of asthma showed estrogen signaling through estrogen receptor-alpha (ER-α), and not ER-β, increased allergic airway inflammation, mucus production, and/or airway hyperresponsiveness.
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