Treatment strategies for asthma in women throughout the lifespan – in puberty, pregnancy and menopause

INTRODUCTION: Asthma is a common chronic disease which disproportionately affects women. While sex hormones are hypothesized to be involved in changes to asthma during puberty, menstruation, pregnancy and menopause, more research is needed to understand the precise mechanisms involved. AREAS COVERED: This review summarizes the challenges in the treatment of asthma during puberty, pregnancy and menopause. PubMed was searched in the past 10 years for 'puberty/pregnancy/menopause' AND 'asthma.' Non-adherence to asthma treatment is a particular challenge in adolescence and pregnancy. Studies have shown a reduction in the use of inhaled corticosteroids, short acting beta agonists and oral corticosteroids in the first trimester compared to pre-pregnancy. Women perceive a risk of these medications which may contribute to non-adherence during pregnancy. Greater understanding of specific risks of asthma on pregnancy outcomes will assist healthcare professionals in making considered decisions for optimized treatment, including provision of an action plan and correction of inhaler technique. During menopause, new onset asthma can occur, and women with respiratory symptoms should be investigated for an asthma diagnosis so as to receive the required treatment. EXPERT OPINION: A personalized medicine approach which assesses treatable traits and provides holistic care may improve outcomes for women with asthma during puberty, pregnancy and menopause.