Asthma diagnosis and treatment
Endogenous and exogenous sex steroid hormones and asthma and wheeze in young women

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Background

Emerging evidence suggests that both endogenous and exogenous sex steroid hormones may influence the occurrence of asthma and wheeze among women.

Objective

We investigated the associations between exogenous sex hormone (oral contraceptive [OC]) use and wheezing in young women with and without asthma history. To investigate the role of endogenous sex hormones, we examined the association between age at menarche and the development of asthma after puberty.

Methods

We conducted a study among 905 women who had undergone menarche. Subjects were between 13 and 28 years of age and had participated in the Children's Health Study.

Results

In women without asthma, OC use was associated with higher risk of current wheeze (odds ratio [OR], 1.75; 95% CI, 1.15-2.65). In contrast, OC use was associated with a markedly reduced prevalence of current wheeze in women with a history of asthma (OR, 0.18; 95% CI, 0.06-0.56; P value for interaction = .003). These associations showed significant trends with duration of OC use. Age at menarche was associated with new-onset asthma after puberty. Compared with women who had menarche after age 12 years, women with menarche before age 12 years had a 2.08-fold (95% CI, 1.05-4.12) higher risk of asthma after puberty.

Conclusion

Both endogenous and exogenous sex steroid hormones affect asthma and wheeze occurrences in young women.

Clinical implications

Because women have higher asthma risk after puberty, and OC use is common among young women, clinicians may inform women with asthma about the potential effects of OC on asthma-related respiratory symptoms.

Section snippets

Study design and subject enrollment

Details of the CHS have been described previously.12, 13 In brief, the CHS was a population-based study that examined the determinants of respiratory health in 6259 school age children (3245 girls and 3014 boys) who were recruited from public school classrooms located in 12 Southern California communities. We recruited 4th grade (n = 2192), 7th grade (n = 1048), and 10th grade (n = 938) students during 1993 and 1994 and another cohort of 4th grade students (n = 2081) during 1995 and 1996. The

Results

Subjects were between 13 and 28 years of age at the time of follow-up, and their mean age was 19.9 years (SD, 3.2 years). The majority of the study participants were non-Hispanic white, more than 50% were exposed to secondhand smoke, and 18.9% were current smokers (Table I). Hispanic-white women were at reduced risk of current wheeze (OR, 0.69; 95% CI, 0.50-0.96). Most of the participants (81%) had some form of health insurance. Exposure to secondhand smoke and personal smoking were

Discussion

Our study supports a role for endogenous and exogenous sex hormones in asthma occurrence. We observed that early menarche was associated with increased asthma risk after puberty independent of BMI. We also observed that OC use was associated with increased occurrence of current wheeze among young women with no history of asthma. In marked contrast, women with a history of asthma who used OC had a reduced risk of wheezing. The associations showed significant trends with duration of OC use. These

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  • Cited by (0)

    Supported by the National Institute of Environmental Health Sciences (grants 5P01ES09581, 5P01ES011627, and 5P30 ES07048), the US Environmental Protection Agency (grants R826708-01 and RD83186101), the National Heart, Lung, and Blood Institute (grant 5R01HL61768), the California Air Resources Board (contract 94-331), and the Hastings Foundation.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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