Most women begin the transition into menopause around age 45 when they experience changes in the length, frequency and severity of their menstrual periods. While menopause can bring on many symptoms like hot flashes, irritability and sleep disturbances, there’s one condition which may be tied to menopause that most women don’t know about: asthma. With asthma, your airways swell, narrow and produce extra mucus, making it harder to breathe normally. It’s one of the most common chronic conditions in the United States, and women make up the majority of asthmatics. The relationship between menopause and asthma is complicated, so it’s a good idea to talk to your doctor about any concerns you have – especially if you’re going through this life transition. Hormonal Changes in Menopause Women enter menopause when a year has passed since their last menstrual cycle, but there isn’t any way to predict when menopause will occur for you. Several factors affect when you enter menopause, like changes in hormone levels, your surgical history, and whether you’ve undergone treatments like chemotherapy or radiation. Most menopause symptoms are related to changing levels of two hormones: estrogen and progesterone. These are the hormones responsible for regulating your menstrual cycle. During menopause, levels of both hormones—especially estrogen—fluctuate irregularly, eventually falling to very low levels. Estrogen might play a role in asthma by causing an inflammatory response in your lungs and airways, changing the way they function. Asthma Changes During Menopause There are conflicting studies examining estrogen and progesterone’s role in asthma associated with menopause. Research shows asthma might be affected by hormones differently depending on where you are in menopause, but most findings indicate two things: if you’ve never had asthma before, you could develop it during menopause. And certain menopause treatments, like hormone replacement therapy, could affect your asthma. Some research shows if you’re premenopausal, you may experience a worsening of your asthma symptoms as you start menopause. Lung function can decline and you might have more respiratory symptoms like wheezing, breathlessness or coughing. Many women are likely to experience asthma symptoms for the first time around 50 years old—also the average age when women are going through menopause. Other research suggests postmenopausal women see improvement in their asthma symptoms, once their hormone levels have stabilized. The drop in estrogen levels might act like a protective shield against your asthma, preventing inflammation in your lungs and improving their function. The Role of Hormone Replacement Therapy Doctors often recommend hormone replacement therapy (HRT) for the unpleasant symptoms of menopause. This treatment option reintroduces synthetic estrogen into the body, raising estrogen levels and helping lessen or stop menopausal symptoms. But prescribed estrogen can also have an effect on asthma. If you have asthma before starting menopause, HRT might actually improve your lung function and decrease the number of asthma attacks you have. But if you’re postmenopausal and you’ve never had asthma symptoms, HRT could increase your chance of developing asthma. Some studies suggest postmenopausal women who start hormone replacement therapy are twice as likely to develop asthma compared to women who don’t use this treatment. This might be because the therapy reintroduces estrogen back into the body, which can trigger asthma symptoms by causing new inflammation in the lungs and airways. Talk to your doctor if you’re concerned about asthma and you’re menopausal. There’s no one answer to explain asthma’s relationship with menopause. Your doctor can tell you what specific symptoms to watch out for and what treatment options are available if you’re diagnosed.