NEW findings from a large population-based study suggest that the use of progestogen-only oral contraceptives (POPs) may be associated with a higher risk of asthma attacks in certain subgroups of women with asthma.
Using UK Clinical Practice Research Datalink data linked to hospital admissions and mortality records from 2004 to 2020, researchers evaluated over 130,000 women aged 18–50 with asthma. They compared new users of combined oral contraceptives (COCs) and POPs to never-users, adjusting for demographics, asthma severity, and comorbidities through inverse-probability treatment weighting and Cox proportional hazards models.
Overall, neither COC nor POP use was linked to increased asthma attacks across the full cohorts. However, risk patterns changed when stratified by age, eosinophilic status, and corticosteroid use. In women using POPs, a significantly higher risk of asthma attacks was observed in those under 35 (HR=1.39), those with eosinophilia (HR=1.24), and those with low corticosteroid use (HR=1.20).
These findings point toward potential phenotype-specific effects of exogenous progesterone on asthma outcomes. The authors emphasize the need for further investigation into how hormonal contraceptives may interact with inflammatory pathways in respiratory disease, particularly in younger women and those with eosinophilic asthma.
Reference
Lee B et al. Oral contraceptives and the risk of asthma attacks: a population-based cohort study. ERJ Open Res. 2025; DOI: https://doi.org/10.1183/23120541.01278-2024.
