Wednesday, April 12, 2017

Menopausal Transition Can Trigger Adult-Onset Asthma

During the last decades female life expectancy has risen far beyond 50 years worldwide. This means that the quality of life after menopause is highly relevant today. Menopause implies profound hormonal and metabolic changes leading to higher risk of diabetes and cardiovascular diseases. Although researchers are increasingly aware that hormonal status and inflammation may also deteriorate respiratory health, our knowledge is very scarce. So far, no prospective study had investigated whether menopause increases the risk of asthma in the general population.

However, the empirical research, performed by Triebner and colleagues confirmed that menopause might increase the risk for developing asthma. They used data from the “Respiratory Health in Northern Europe” study, which included 2,322 women from random population samples in Norway, Iceland, Sweden, Denmark, and Estonia. These women provided information on their respiratory health and menopausal status in 2000 and 2012.

The researchers studied the association between menopausal status and newly diagnosed asthma, after the age of 44. They found that the odds of getting asthma were more than twice as high for women going through the menopausal transition or after menopause, compared to non-menopausal women. The risk was particularly high for overweight and obese women. The results were not due to general aging and were independent of smoking and geographical location.

Adult-Onset Asthma

Asthma symptoms in older adults may seem like other illnesses or diseases, such as a hiatal hernia, stomach issues, rheumatoid arthritis and chronic obstructive pulmonary disease. Doctors may misdiagnose asthma since most adults lose lung capacity starting in middle age. However, untreated asthma may cause greater loss in your lung function.

The signs of adult onset asthma include the following:
·         A dry cough that happens during the night or due to specific triggers.
·         Tightness in the chest
·         Difficulty breathing
·         Wheezing when exhaling
·         Experiencing shortness of breath after exercising.
·         Colds that extend for 10 days
·         Colds that go into the chest.

Hormonal fluctuations can increase mucus production in the upper and lower airways making it harder for the lungs to expel air and worsen symptoms. Studies show there is an increase in near-fatal asthma cases during the first four days of the menstrual cycle. So, the similar negative health related disturbance might affect a woman during menopausal transition, when all hormone levels wildly fluctuate and eventually decrease.

Estrogen supplements also may be a contributor to asthma. In fact, the Asthma and Allergy Foundation of America stated that researchers have found that women who take estrogen supplements for a decade following their last menstrual period are 50 percent more likely to develop asthma than postmenopausal women who have never used estrogen.

Diagnosing Asthma

The process of diagnosing asthma is the same for people of all ages. Common symptoms of asthma include:
·         Coughing, especially at night
·         Wheezing
·         Shortness of breath
·         Tightness in your chest

Symptoms can be mild to severe and often stop and start. Symptoms are usually worse at night.
If you suspect you may have asthma, discuss your symptoms with your healthcare practitioner. At an older age, symptoms of asthma are often confused with those of a common cold or cough. Wheezing and shortness of breath can also be caused by many other conditions and lung diseases including vocal cord dysfunction and pulmonary edema, a disease caused by heart failure. Treatments are very different so a correct diagnosis is important. Be prepared for your doctor to ask the following questions:
During the past 12 months, have you:
·         Had a sudden, severe episode or recurrent episodes of wheezing, coughing or shortness of breath?
·         Had colds that “go to the chest” taken more than 10 days to get over?
·         Had wheezing, coughing or shortness of breath only when you’re in certain places, such as your home workplace or outdoors?
·         Had wheezing, coughing, shortness of breath when exposed to certain substances such as pollen, tobacco smoke, cat dander or perfume?
·         Used any medications that help you breathe better? If so, how often did you use them and how well did they work?

In the past four weeks, have you had wheezing, coughing or shortness of breath.
·         At night that has awakened you?
·         In the early morning?
·         After running, moderate exercise or other physical activities?

Be prepared to talk about your family health history as asthma is a hereditary disease. After analyzing your symptoms and history of symptoms, your healthcare provider will probably follow-up with a physical examination.

Physical examinations usually include a variety of ways to find out if allergies are triggering your symptoms. By listening to your lungs with a stethoscope, healthcare providers can hear wheezing or other signs of obstructed airways. Your healthcare provider will also looks up your nose for nasal secretions, swelling or polyps which are other signs of allergies. Your skin may be examined for other conditions that are associated with asthma such as eczema or hives.

An important step in diagnosing asthma includes pulmonary (lung) functioning tests. There are three tests that can directly measure your breathing:
1.       Spirometry- This test determines how well you breathe by measuring how much air your lungs hold. It takes 10 to 15 minutes and requires you to take deep breaths and forcefully exhale into a hose connected to a machine called a spirometer.
2.       Challenge Test- With this assessment, you are required to deliberately inhale an airway-constricting chemical or take a few breaths of very cold air. After inhaling this substance, you retake the spirometry test.
3.       Peak Expiratory Flow- Like the spirometry test, this test measures how well you breathe. You are required to forcefully blow into a peak flow meter (a small, hand held device that measures the rate at which you can force air out of your lungs).
4.       If you are diagnosed with asthma, you will probably need to monitor your peak flow over a six to eight week period as you take asthma medications. The good news is asthma is a treatable condition.

Manage Your Asthma by Controlling Symptoms

You can control your symptoms of asthma by reducing or eliminating allergens from your environment. Avoid indoor and outdoor allergens and irritants. There are many ways to go about this including the following:

·         Optimize your exercise routine - The Asthma Society of Canada warns that if you have any limitations in your ability to exercise due to asthma, your asthma is not being properly controlled. If this is the case, you actually may experience worsening symptoms so it’s important to focus on working with your doctor to control your asthma before you start exercising. Furthermore, you might experience exercise-induced asthma which strikes 5-10 minutes after exercising. This situation occurs because of humidity and temperature changes in the body’s airways. Triggers include length of time spent exercising, the temperature and humidity while exercising, and triggers such as allergens and air pollution that are present in the air. However, it’s also important to get regular exercise since physical activity will improve your heart and lung function. Therefore, work with your doctor to come up with an exercise regimen that’s right for your situation.

·         Give your lungs a break, STOP SMOKING. Your lungs are working over time and are trying to send you a message.

·         Diet - The George Mateljan Foundation reports that eating a Mediterranean diet can provide antioxidant support that promotes respiratory health. Additionally, nutrients such as magnesium, selenium, omega-3 fatty acids, vitamin C, vitamin E and beta-carotene are believed to enhance lung function. Foods to consume regularly include organically grown fruits and vegetables, especially apples, garlic, onions, chard, spinach, broccoli, parsley, bell peppers, strawberries, cauliflower, lemons, romaine lettuce, mustard greens, Brussel sprouts, papaya, turnip greens, kale, cabbage, kiwifruit, cantaloupe, oranges, grapefruit, tomatoes, collard greens, raspberries, peppermint leaves, asparagus, celery, fennel bulb, pineapple, winter squash, apricots, guava, persimmons, crimini mushrooms, and watermelon. Other beneficial foods include tea, calf liver, cold water fish (cod, salmon, mackerel, herring and halibut), shrimp, snapper, yellowfin tuna, sunflower seeds, flax seeds, extra virgin olive oil, rosemary, cayenne pepper,   ginger and turmeric. Foods to avoid eating include milk and other dairy products as well as eggs. The foundation also warns against eating a diet that is high in vegetable oils (such as corn oil and safflower oil), farm-raised meats, margarine, salt and artificial food additives (such as food colorings and preservatives) since these foods are associated with increased rates of asthma

·         Manage the healthy weight. Women with a body mass index lower than 23 had four times the risk of respiratory symptoms. Problems were also pronounced in women who were overweight.
Although estrogen is reduced in all women following menopause, thinner women have the lowest amounts, the researchers said. At the menopause, the fat cells become the main source of estrogen, and those who have more fat cells will have higher levels of the hormone, which seems to protect the lungs. But in very overweight women, it appears that the protective effects of estrogen are outweighed by other factors such as the labor of carrying extra weight affecting breathing. This happens to a smaller extent in women who are overweight versus those who have a low body mass.

·         Reduce other triggers

The potential triggers include pets (due to their dander, saliva, oil secretions, urine and feces), pollution, pollens, cold air, and indoor hazards such as dust mites, cockroaches, mold and chemical fumes.

o    Reduce pet allergens by dusting and cleaning often
o    Lower mold allergens by making sure bathrooms, kitchens and basements have good air circulation and are cleaned often.
o    Reduce dust mites by washing all bedding every week in hot water, removing carpeting, cleaning fabrics and curtains often and cutting down the humidity.
o    Cover mattresses with a mattress pad
o    Use air filters and air conditioners
o    Vacuum often

Also, a variety of prescription medications are available. Asthma sufferers can enjoy healthy, active lives by controlling their symptoms. Medicines can help keep the air tubes in your lungs open. Two forms of asthma medications are available including bronchodilators and anti-inflammatories.
Asthma attacks can be controlled and prevented by taking bronchodilators. Anti-inflammatories help keep your air tubes open to prevent attacks. Many forms are available including sprays, pills, powders, liquids and shots. Discuss all treatment options with your healthcare provider so you can be in control of your asthma. Also, drink lots of water.

Estrogen Replacement Therapy

Studies presented to the Annual Congress of European Respiratory Society in Stockholm, are the first to show that hormone replacement therapy may have a significant role in lung protection and repair.
Christiana Dimitropoulou-Catravas, PhD, Assistant Professor in the Department of Pharmacology and Toxicology at the Medical College of Georgia, US, who was the lead author on a study investigating the role of estrogen in asthma, explains that by stabilizing estrogen levels, inflammation and asthma may be better controlled.

Dimitropoulou-Catravas says that “fluctuating estrogen levels can activate proteins that produce an inflammatory response, which can bring on asthma symptoms. With any medication, it’s a balance of risk vs. benefit. Estrogen replacement therapy, which can bring estrogen levels into balance, has been associated with an increased cardiovascular risk, such as a higher risk of stroke. But if someone has severe asthma and it can be linked to low levels of estrogen, replacement therapy might be an answer.”
The Mayo Clinic states that “hormone replacement therapy may improve asthma symptoms in women who have gone through the menopause but point out that studies remain conflicting as hormone replacement appears to worsen asthma in some women.”

Sources and Additional Information:

Related Posts Plugin for WordPress, Blogger...