The Role of Sexual Hormones and Potential Phytoestrogen-Based Therapies in Female Asthma: Perspectives and Challenges
The scientific literature extensively illustrates asthma as an inflammatory disease. Symptoms in asthmatic women appear linked to their sexual hormonal state (i.e., perimenopausal, pregnancy, menopause).
Studies establish worsened pulmonary conditions in women, reflected in severity, exacerbation rates, hospitalizations, and mortality. Plasma concentrations of estrogen, progesterone, or both correlate with asthma symptoms. Fluctuations in female sexual steroid hormones are pivotal in this context.
Alarming statistics reveal about 40% of asthmatic women suffer premenstrual exacerbations, while approximately 50% hospitalized for asthma experience premenstrual symptoms. They are unfortunately more prone to corticosteroid-refractory asthma.
Perimenopausal asthma exacerbates symptoms and is studied as a pathophysiological entity. On the other hand, absence of sexual hormonal cycles, namely childhood and menopause, favors respiratory health in asthmatic women, showing less frequency and severity of asthma episodes than other reproductive life stages (puberty or reproductive maturity).
This review proposes phytoestrogens as a promising therapeutic option offering relief for menopausal and asthma symptoms. Alongside their well-known anti-inflammatory and antioxidant abilities, phytoestrogens activate estrogen receptors, mimicking mild hormone responses benefiting postmenopausal women, especially asthmatics. This presents an intriguing potential therapy due to low toxicity and minimal side effects.
However, menopause entails significant physiological changes, including immunological senescence, potentially requiring hormone replacement therapy (HRT), which might affect asthma symptoms. Furthermore, Late-Onset Asthma (LOA), recently identified as a specific asthmatic phenotype in menopausal women, urges accelerated and innovative research in this domain.
Undoubtedly, the hormonal state plays a key role in the development, severity, and phenotype of this disease, warranting further and more extensive studies.
The search for therapeutic alternatives to alleviate asthma in women during these life stages (mainly exacerbations due to perimenopausal asthma or LOA) necessitates future clinical studies to confirm their therapeutic value.
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Source: Sommer, B.; González-Ávila, G.; Flores-Soto, E.; Montaño, L.M.; Solís-Chagoyán, H.; Romero-Martínez, B.S. Phytoestrogen-Based Hormonal Replacement Therapy Could Benefit Women Suffering Late-Onset Asthma. Int. J. Mol. Sci. 2023, 24, 15335. https://doi.org/10.3390/ijms242015335
