ASTHMA management in women requires tailored approaches across puberty, pregnancy, and menopause, as each life stage introduces unique challenges that influence symptoms, adherence, and outcomes.
Asthma disproportionately affects women, with evidence suggesting that sex hormones play a role in disease variation during reproductive transitions. However, the exact biological mechanisms remain unclear, underscoring the need for greater clinical awareness and research.
During adolescence, non-adherence to treatment is a frequent concern. Young women may skip prescribed therapies, particularly inhaled corticosteroids, leading to heightened risk of exacerbations. This non-adherence trend is also observed in pregnancy, where many patients reduce their use of inhaled corticosteroids, short-acting beta agonists, and oral corticosteroids, especially in the first trimester compared to pre-pregnancy. Women often perceive asthma medications as risky for fetal health, despite the need for consistent disease control. Clinicians are encouraged to emphasize the importance of adherence and provide clear action plans alongside corrections of inhaler technique to safeguard both maternal and infant outcomes.
Pregnancy introduces additional complexity, as asthma can directly affect maternal and neonatal health. Understanding the risks associated with uncontrolled asthma during pregnancy can empower healthcare professionals to make considered treatment decisions. Multidisciplinary support remains critical in optimizing care for this patient population.
In menopause, new onset asthma may emerge, and respiratory symptoms in women at this stage should prompt consideration of asthma in the differential diagnosis. Timely identification and initiation of therapy are essential to improve quality of life and reduce long-term complications.
The review highlights the potential of a personalized medicine approach, focusing on treatable traits and holistic care strategies to improve outcomes across all life stages. Clinicians are urged to consider the dynamic impact of hormonal and life transitions on asthma and adopt strategies that prioritize both adherence and patient education.
Reference: Murphy VE et al. Treatment strategies for asthma in women throughout the lifespan – in puberty, pregnancy and menopause. Expert Rev Respir Med. 202:1-11.
