Women generally report poor quality of life compared to males of similar lung function and women are three times more likely to get admitted for acute exacerbation of asthma than men.
Asthma is a chronic disease that affects millions worldwide and an estimated 250,000 deaths occur annually due to asthma. Research studies show that asthma is more prevalent in females compared to males. Though several reasons have been postulated for this increased prevalence among women, none has been scientifically proven. The reasons attributed for increased prevalence of asthma in females include
- Influence by the female hormones
- Increased bronchial hypersensitivity in the females
- Anxiety
- Different perception of airflow obstruction
- Hypersensitivity to tobacco smoke
The likelihood of developing asthma in lifetime is 10% greater in females than males. In population less than 18 years, the incidence of asthma is 54% higher in the boys compared to the girls. As the girls reach puberty, the incidence of asthma increases and overtakes the males suggesting that hormonal influences may predispose women to asthma. The increased incidence of asthma in post menopausal women taking hormone replacement therapy further strengthens the role of hormones. In addition; in a small sub group of women asthma symptoms are worsened premenstrually, indicating a possible hormone mediated role.
Female asthmatics are more nervous and anxious compared to male counterparts during acute asthma exacerbations with similar degree of airflow obstruction. Some researchers suggest that the perception of airflow obstruction is different in females due to some unknown reasons. Studies show the female asthmatics are more likely to adhere to asthma medications, do routine peak flow estimations, visit their doctor regularly and have a written asthma plan. These rules out possible non-compliance with the physician recommended medications by the female patients.
Some unknown non-respiratory factors plays a role in women's perception of asthma and its symptoms. The exact mechanisms by which these sex related differences manifests is largely unknown. Women with asthma should be educated regarding the sex specific differences in asthma, about possible premenstrual worsening, about increased risk of asthma with hormone replacement therapy. They should be counselled to reduce their anxiety related to asthmatic symptoms and instill greater confidence in self management of asthma.
Reference
Current Opinion in Pulmonary Medicine:
January 2011 - Volume 17 - Issue 1 - p 6–11
doi: 10.1097/MCP.0b013e3283410038
http://journals.lww.com/co-pulmonarymedicine/Abstract/2011/01000/Asthma,_the_sex_difference.3.aspx
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