Hormone Induced Asthma
I was diagnosed with asthma as a child when I had severe allergies to
everything from dust to perfumes. I was constantly sick with a “cold” or broken
out in a rash from whatever unusual substance I had come into contact with that
day. My colds would always make me run fever and I remember having to go to the
emergency room a few times because my breathing was so bad. As I got older, I
grew out of all of the severe allergies and was never prescribed a maintenance
medicine for asthma as it would only show up when I was sick with a chest
infection. I continued to have frequent sinus infections and chronic bronchitis
(3-6 times a year) but still was not prescribed any asthma inhalers or medicines
as I did not have “attacks.”
In the fall of 2015, at 37 years old, I began getting sick every month with a sinus infection and bronchitis. By spring 2016, I was irritated enough at being sick for the last 6 months straight to ask for a referral to a pulmonologist to try to get to bottom of the issue. I had already had a septoplasty, bilateral sinus surgery, and a turbinectomy in January of 2015 to correct the damage an air bag did to my face innards in a car wreck that happened May 9, 2014 so I figured my sinuses were not the problem. At the pulmo’s office, they did a lung function test and verified that childhood diagnosis of asthma was still very much present and he told me that “as long as my allergies were not under control, neither will be your asthma.” He put me on an inhaler and a pill and gave me a rescue inhaler along with medicine to clear up the chest infection I had yet again. Since I had already tried every spray and pill known to man to stop my allergies and that didn’t seem to be working, I set about getting my allergies under control with a doctor’s help. I went to an ENT who did a blood test and said that I did not have any severe allergies. I went to an allergist/asthma/immunologist who tested me with the 50 “skin pricks” allergy test on my back and then again with 10 needles under the skin of my arm allergy test and I reacted to none of them. I had grown out of all of my allergies. What then was causing the asthma flare/bronchitis EVERY month?
The fourth of July 2016 found me searching for an open clinic that could give me a breathing treatment without me having to pay $5,000.00 for it at an Emergency Room since the antibiotics, decongestants, and prednisone I was on for the bronchitis I had was not helping my breathing. I found one clinic open and they gave me a nebulizer machine to take home with me along with the albuterol vials to go with it. The breathing treatment helped immensely and I had to use it often in the following months. My asthma did not improve. My pulmo said my lung function was steady and my lungs were clear, pronounced me fine as far as he was concerned, and told me to come back in a year. This was not good enough for me as I had no life. I was sick and breathless ALL THE TIME. I wanted the old me back. Just as soon as I would get over one round of bronchitis from an asthma flare, three weeks later, another flare would happen and I’d be sick again. I was almost always on prednisone for about 8 months straight and had all of the horrible symptoms from the medicines to deal with on top of being sick and breathless.
I mentioned to my allergist/asthma/immunologist during a visit about the correlation of an asthma flare/me getting sick every month and the timing of my period. I told her that if it was going to flare up and I was going to get bronchitis, it was ALWAYS right before or during my period. She just responded, “Hormones play a role in asthma flares,” then changed the subject to something else. Again, this was not enough of an answer for me. I also have PMDD (What is PMDD?) and knew that because of my genetic mutation, my body had a history of overreacting to normal levels of fluctuating monthly hormones. I had been on a birth control called Yaz for a decade in an effort to control the PMDD symptoms and mood swings but it still made my life a living hell every month.
I went home, printed out a 2016 calendar, highlighted in pink when my PMDD days began each cycle (11 days before my period) and my period days (5 days usually) and then accessed my medical records. I marked with a black marker an X on the days each month where I got sick with bronchitis after at least 3 days of asthma symptoms and had to go to the doctor for medicine and steroids. (See photo of calendar.) I took that calendar to my allergist/asthma/immunologist and she said, “Wow. You have figured it out. You have hormone induced asthma. You would be a perfect research subject if we were set up for research.” I was the only patient she had with hormone induced asthma. She asked me minute questions about exactly what symptoms I had with my PMDD symptoms every month and what I was on for that. She sent a message to my gynecologist requesting that I be placed on a continuous birth control so that my hormones would not fluctuate all month and so that I would not have a period.
I took the calendar to my gynecologist and explained to her what was happening. She said, “Well, you have it mapped out here and figured out the pattern. I have pregnant patients whose asthma flares because of their hormones but I have never heard of it happening to someone who is not pregnant.” She changed my birth control to Lo Estrin FE and told me not to take the 2 brown pills at the end of the month as those were the placebo pills and skipping them would keep me from having a period. My gyno said it would take 3 – 6 months to see if the new pills would work in controlling the asthma flares every month. I have been on the new birth control for 3 months now and while it is not perfect, things are improving.
I am not getting sick with sinus infections/bronchitis every 3 weeks anymore
and when I do get sick, I do not always have to use steroids to get well. I am
better able to control my asthma with just my maintenance medicines and my
nebulizer instead of constantly being on prednisone every month. Previously, my
lungs were so inflamed all the time, I had a window of about 4 days of having
asthma symptoms before I was guaranteed it would morph into an infection that
would make steroids mandatory. Now I can go weeks with an asthma flare and using
my nebulizer every day without it turning into an infection. I have also not had
ANY PMDD symptoms in the last 2 months and that alone is worth the change in
pills. We are hoping for continued improvement in the asthma symptoms as my body
gets more used to the birth control in the following months. I will come back
and update this at a later date (update at the bottom of this blog!) but I am hopeful for being able to breathe
easier in the future and to be able to do something besides work and come home
to rest.
I wrote this blog because so many people are noticing the connection between their asthma symptoms getting worse around their periods every month and wondering about it to other people they know with asthma. I believe this phenomenon is a lot more common than we currently know especially in us with gene mutations for PMDD. I believe this is an under diagnosed issue and doctors are not listening to their patients until we have diagnosed ourselves and put visual “proof” in front of their faces in order to make our case. I do not know for certain if I am in perimenopause as I would have to go off of birth control for 2 months to be tested and I cannot do that with PMDD but I am pretty positive even without that test that I have started it which would explain the sudden change in my life-long asthma symptoms. Both my mother and my grandmother began menopause in their late 30s so this is right on time in my family. There is PLENTY of research that has proven the link between hormones/pregnancy/menopause and asthma but it seems our doctors are not very aware of all of the links yet. This is where listening to your body and being your own advocate comes into play. I urge you to find a doctor who will listen to you when you put that piece of paper charting your symptoms in front of them. If they do not listen to you, find a different doctor. You are their employer and if they are not helping you, fire them. You are the only person who knows your body as well as you do. Don’t let them ignore you when you know something is not right. Keep fighting for yourself because you are worth it.
Links I Read While Researching Hormone Induced Asthma
Why do my asthma symptoms seem to get worse during my period?
Norwegian Research Linking Hormones and Asthma
Asthma and Hormones in the UK
Menopause and Asthma Connection
Update:
Today is 10/17/17 and I HAVE A LIFE AGAIN!!
I have been on Lo Estrin FE for 5 months now. During a visit with my asthma specialist last month, she was expressing her frustration that the new meds had not worked faster than they had. I told her all of the ways I was seeing improvement and told her we had to have patience. She started laughing and said, "My patient is telling me, the doctor, to have patience." Role reversal! The patience payed off.
I have not had to use the nebulizer for 20 days straight. This is a five star miracle in my world because previously, I was having to use it every 3 days at least. I have not been sick with bronchitis since the middle of August. I actually had a sinus infection in September that did not go immediately to my lungs as they ALWAYS have done in the past. I also did not have to take prednisone to get well from the sinus infection. I can clean without being afraid of getting sick from the irritants in my lungs. I can be outside for more than 20 minutes without paying the price the next day.
Things are improving and I have been enjoying October with outdoor concerts, Halloween parties, sitting on patios with friends, and having enough oxygen and energy to do anything I want to do. I am so grateful for this improvement in my symptoms and for doctors who listen to me.
If you think that you may have hormone-induced asthma as well, please chart your symptoms and cycle, talk to your doctors, and have faith that life will get better. Keep fighting.
In the fall of 2015, at 37 years old, I began getting sick every month with a sinus infection and bronchitis. By spring 2016, I was irritated enough at being sick for the last 6 months straight to ask for a referral to a pulmonologist to try to get to bottom of the issue. I had already had a septoplasty, bilateral sinus surgery, and a turbinectomy in January of 2015 to correct the damage an air bag did to my face innards in a car wreck that happened May 9, 2014 so I figured my sinuses were not the problem. At the pulmo’s office, they did a lung function test and verified that childhood diagnosis of asthma was still very much present and he told me that “as long as my allergies were not under control, neither will be your asthma.” He put me on an inhaler and a pill and gave me a rescue inhaler along with medicine to clear up the chest infection I had yet again. Since I had already tried every spray and pill known to man to stop my allergies and that didn’t seem to be working, I set about getting my allergies under control with a doctor’s help. I went to an ENT who did a blood test and said that I did not have any severe allergies. I went to an allergist/asthma/immunologist who tested me with the 50 “skin pricks” allergy test on my back and then again with 10 needles under the skin of my arm allergy test and I reacted to none of them. I had grown out of all of my allergies. What then was causing the asthma flare/bronchitis EVERY month?
The fourth of July 2016 found me searching for an open clinic that could give me a breathing treatment without me having to pay $5,000.00 for it at an Emergency Room since the antibiotics, decongestants, and prednisone I was on for the bronchitis I had was not helping my breathing. I found one clinic open and they gave me a nebulizer machine to take home with me along with the albuterol vials to go with it. The breathing treatment helped immensely and I had to use it often in the following months. My asthma did not improve. My pulmo said my lung function was steady and my lungs were clear, pronounced me fine as far as he was concerned, and told me to come back in a year. This was not good enough for me as I had no life. I was sick and breathless ALL THE TIME. I wanted the old me back. Just as soon as I would get over one round of bronchitis from an asthma flare, three weeks later, another flare would happen and I’d be sick again. I was almost always on prednisone for about 8 months straight and had all of the horrible symptoms from the medicines to deal with on top of being sick and breathless.
I mentioned to my allergist/asthma/immunologist during a visit about the correlation of an asthma flare/me getting sick every month and the timing of my period. I told her that if it was going to flare up and I was going to get bronchitis, it was ALWAYS right before or during my period. She just responded, “Hormones play a role in asthma flares,” then changed the subject to something else. Again, this was not enough of an answer for me. I also have PMDD (What is PMDD?) and knew that because of my genetic mutation, my body had a history of overreacting to normal levels of fluctuating monthly hormones. I had been on a birth control called Yaz for a decade in an effort to control the PMDD symptoms and mood swings but it still made my life a living hell every month.
I went home, printed out a 2016 calendar, highlighted in pink when my PMDD days began each cycle (11 days before my period) and my period days (5 days usually) and then accessed my medical records. I marked with a black marker an X on the days each month where I got sick with bronchitis after at least 3 days of asthma symptoms and had to go to the doctor for medicine and steroids. (See photo of calendar.) I took that calendar to my allergist/asthma/immunologist and she said, “Wow. You have figured it out. You have hormone induced asthma. You would be a perfect research subject if we were set up for research.” I was the only patient she had with hormone induced asthma. She asked me minute questions about exactly what symptoms I had with my PMDD symptoms every month and what I was on for that. She sent a message to my gynecologist requesting that I be placed on a continuous birth control so that my hormones would not fluctuate all month and so that I would not have a period.
I took the calendar to my gynecologist and explained to her what was happening. She said, “Well, you have it mapped out here and figured out the pattern. I have pregnant patients whose asthma flares because of their hormones but I have never heard of it happening to someone who is not pregnant.” She changed my birth control to Lo Estrin FE and told me not to take the 2 brown pills at the end of the month as those were the placebo pills and skipping them would keep me from having a period. My gyno said it would take 3 – 6 months to see if the new pills would work in controlling the asthma flares every month. I have been on the new birth control for 3 months now and while it is not perfect, things are improving.
I wrote this blog because so many people are noticing the connection between their asthma symptoms getting worse around their periods every month and wondering about it to other people they know with asthma. I believe this phenomenon is a lot more common than we currently know especially in us with gene mutations for PMDD. I believe this is an under diagnosed issue and doctors are not listening to their patients until we have diagnosed ourselves and put visual “proof” in front of their faces in order to make our case. I do not know for certain if I am in perimenopause as I would have to go off of birth control for 2 months to be tested and I cannot do that with PMDD but I am pretty positive even without that test that I have started it which would explain the sudden change in my life-long asthma symptoms. Both my mother and my grandmother began menopause in their late 30s so this is right on time in my family. There is PLENTY of research that has proven the link between hormones/pregnancy/menopause and asthma but it seems our doctors are not very aware of all of the links yet. This is where listening to your body and being your own advocate comes into play. I urge you to find a doctor who will listen to you when you put that piece of paper charting your symptoms in front of them. If they do not listen to you, find a different doctor. You are their employer and if they are not helping you, fire them. You are the only person who knows your body as well as you do. Don’t let them ignore you when you know something is not right. Keep fighting for yourself because you are worth it.
Links I Read While Researching Hormone Induced Asthma
Why do my asthma symptoms seem to get worse during my period?
Norwegian Research Linking Hormones and Asthma
Asthma and Hormones in the UK
Update:
Today is 10/17/17 and I HAVE A LIFE AGAIN!!
I have been on Lo Estrin FE for 5 months now. During a visit with my asthma specialist last month, she was expressing her frustration that the new meds had not worked faster than they had. I told her all of the ways I was seeing improvement and told her we had to have patience. She started laughing and said, "My patient is telling me, the doctor, to have patience." Role reversal! The patience payed off.
I have not had to use the nebulizer for 20 days straight. This is a five star miracle in my world because previously, I was having to use it every 3 days at least. I have not been sick with bronchitis since the middle of August. I actually had a sinus infection in September that did not go immediately to my lungs as they ALWAYS have done in the past. I also did not have to take prednisone to get well from the sinus infection. I can clean without being afraid of getting sick from the irritants in my lungs. I can be outside for more than 20 minutes without paying the price the next day.
Things are improving and I have been enjoying October with outdoor concerts, Halloween parties, sitting on patios with friends, and having enough oxygen and energy to do anything I want to do. I am so grateful for this improvement in my symptoms and for doctors who listen to me.
If you think that you may have hormone-induced asthma as well, please chart your symptoms and cycle, talk to your doctors, and have faith that life will get better. Keep fighting.
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