Women with asthma may notice that their asthma symptoms get worse at certain times of the month. Now, a new study confirms that fluctuating female hormone levels appear to affect airway inflammation, but oral contraceptives might help ease those changes.

In women who were not using birth control pills, the study found that increased levels of estrogen were associated with decreased levels of exhaled nitric oxide — indicating decreased airway inflammation. In these same women, increased levels of progesterone were associated with increased levels of exhaled nitric oxide, indicating increased airway inflammation.

However, birth control pills lessen dramatic hormone fluctuations, and researchers didn’t find differences in asthma symptoms throughout the month for women who took them.

“This study is a first step in looking at the relationship between hormones and asthma,” said the study’s lead author, Dr. Piush Mandhane, an assistant professor of pediatric pulmonology at the University of Alberta in Canada. The findings might be of use in managing asthma among premenopausal women, the researchers said.

“Among women not on oral contraceptives, we did have changes in exhaled nitric oxide that were related to estrogen and progesterone levels. We didn’t have an association with estrogen and progesterone in women on oral contraceptives,” said Mandhane.

Results of the study are published in the November issue of the journal Chest.

Mandhane said that because many women report a change in asthma symptoms related to menstrual cycles, it’s often assumed that there is an association. But, he said, the relationship between hormonal fluctuations and asthma symptoms hasn’t been well-studied.

The current study included 17 women. Eight were on birth control pills that contained estrogen and progesterone. The average age of the women using oral contraceptives was 25.5, while the average age of the women not taking birth control pills was 37.5.

Three of the women in the group not on birth control reported experiencing menstrual-cycle related asthma prior to the study, while just one woman in the birth control group did.

The researchers gathered daily information about symptoms and conducted blood tests to measure estrogen and progesterone levels, performed spirometry (a lung function test) and took measurements of exhaled nitric oxide. They also conducted allergy tests, via skin pricks every other day.

They found that women who didn’t take birth control pills had an average exhaled nitric oxide level of 48.2 parts per billion (ppb), while those on oral contraceptives had an average level of 27 ppb. In women who weren’t taking oral contraceptives, each increase in estrogen levels was associated with a decrease in exhaled nitric oxide, while each increase in progesterone was associated with an increase in exhaled nitric oxide. That means when progesterone levels are elevated (before menstruation), asthma symptoms are likely to be worse.

Progesterone increases also aggravated allergy symptoms, with more severe allergic reactions evident on skin prick tests when progesterone levels were elevated.

The researchers didn’t find any statistically significant differences in allergic reactions during the month for women on birth control pills.

Mandhane said that “birth control works by flattening out the fluctuations in hormone levels,” and that’s likely why there weren’t many differences in asthma symptoms for women taking birth control pills.

“Hormones do play a role,” said Mandhane, “and women need to be aware that there’s a potential relationship between their asthma symptoms and their menstrual cycles.”

Dr. Jennifer Appleyard, chief of allergy and immunology at St. John Hospital and Medical Center in Detroit, said that this study “lends credence to the fact that asthma is affected by hormones. This is definitely not something women should just write off. It’s not just all in their minds.”

But she also pointed out that this was a small study, and that the women in each group were very different from each other. “There were a lot of older women in one group who took more asthma medication. It’s not really comparing apples to apples,” she said.

Because birth control pills can have some serious side effects, Appleyard said she would not advise someone to go on oral contraceptives just to help their asthma. However, if a woman notices a difference in her symptoms throughout her menstrual cycle, she may want to talk to her doctor about increasing her asthma medications during that particular time in her cycle, she said.

Technorati Tags: airway inflammation, asthma symptoms, birth control pills, menstrual cycles, oral contraceptives

If you suspect that you may be pregnant and you are taking a contraceptive pill like Mircette, it is wise to stop taking your pills until you have at least carried out a home pregnancy test - this will ensure that there are no risks to the fetus. You may be wondering though, if a home pregnancy kit works by measuring hormone levels- and you have been taking synthetic hormones in your Mircette contraceptive pill - “Will I get an accurate result from my DIY test?.

Pregnancy tests do not measure estrogen and progestin, the two hormones in combined oral contraceptive pills so even if you get pregnant while taking an oral contraceptive, you can rely on the result of the test being accurate. Taking Mircette will NOT interfere with your pregnancy test result.This is true whether you are still taking Mircette or have recently stopped taking it because of your suspicion that you may be pregnant.

Mircette is an extremely effective oral contraceptive pill so it is highly unlikely that you will become pregnant while taking it, unless you have missed several days of taking your pill. If you have stopped taking Mircette or any other brand of oral contraceptive pill, now is the time to decide if you wish to become pregnant now or sometime in the near future. If you do not wish to get pregnant at this point in your life, you should resume taking the pills and use back up contraception for a week.

But don’t estrogen levels rise when I’m pregnant and oral contraceptives, like Mircette, contain estrogen?

Yes, when you are pregnant estrogen levels are higher but this is NOT the hormone that is measured by a pregnancy test kit. All pregnancy test kits measure beta HCG (a placental hormone called human chorionic gonadotropin). A urine or a blood sample can be used to measure beta HCG. Most home urine pregnancy tests will turn positive 10 - 16 days after conception occurs. If you were not taking oral contraceptives, this would be around the time of your first missed period. When you are on oral contraceptives, ovulation could have occurred at a more irregular time so that if the pregnancy test is negative, you are either not pregnant OR you are less than 14 days pregnant from the date you ovulated. If you were to become pregnant while taking oral contraceptives, a normal ‘withdrawal bleed’ would not occur. - Dr. Rick Jelovsek MD.

Technorati Tags: birth control pills, contraceptive pills, mircette, mircette pill, pregnancy test