Women

Asthma and periods


Some girls find that their asthma is worse around the time their periods start, although this usually settles down as their menstrual cycle becomes established.

However, women with severe asthma may find that their symptoms are worse just before or during menstruation. Keeping a peak flow and/or symptom diary will help you clarify whether this is an issue for you. If you don't already have one, talk to your doctor about an asthma Self Management Plan, and whether it could include taking extra preventer treatment during the week before your period.

Some medications used for period pain (aspirin and other non-steroidal anti-inflammatory tablets, eg Nurofen, Ibuprofen and Ponstan) can induce an asthma attack in some people. Paracetemol is usually safe. The oral contraceptive pill has no effect on asthma.

Asthma during pregnancy


Around one third of women find their asthma improves in pregnancy, one third stay the same and one third find their asthma gets worse. If your asthma gets worse you may need to increase your medication, and to revise your asthma Self Management Plan with your doctor. You will also need to discuss your plans for the delivery of your baby. If your asthma is severe the delivery may be best handled in a hospital environment in order to access appropriate support if required.

Inhaled asthma treatment will not harm your baby during pregnancy. Your baby will do best if you are breathing well and easily, so it is important that your asthma is well controlled.

A very small minority of women with severe asthma need to take steroid tablets during pregnancy. Using steroid tablets for long periods of time or repeatedly during pregnancy can increase the risk of your baby being born underweight. However, the risk to the baby of uncontrolled asthma is potentially much more harmful. You and your doctor need to weigh up the risks against the benefits.

During labour and delivery you have the same choice of pain medication as any woman. If you do happen to have an asthma attack at this time, treat it as you would normally.

As for any expectant mum, it is important not to smoke, and to exercise moderately.

How important is a family history of asthma?

Both genetic and environmental factors are important in determining whether someone will develop an allergic (atopic) condition such as asthma, rhinitis (hay fever) or eczema. A child, who is born into a family where parents or other close relatives already have other allergies or asthma, has a higher than normal chance of developing an allergic condition - boys more so than girls. The chance is increased if both parents are affected.

What can I do during pregnancy to reduce the chance of my baby having asthma?

The most important advice for a pregnant woman is not to smoke, and this is even more important if there is a family history of asthma. It seems to be that some babies who genetically have a 'low risk' of developing allergy may have their risk increased by the mother smoking while pregnant.

  • There is no proof that you can reduce the risk of your baby having asthma by altering your diet when pregnant or breastfeeding. If you have food allergies yourself, continue to avoid these foods. It is important to let your doctor or midwife know so that they can check that you are still getting the right nutrition for you and your baby.
  • Research is currently being done to look at the effect of controlling things that can cause allergies, particularly to house dust mites and cats, both during pregnancy and soon after birth. There is increasing evidence that the timing, nature and level of allergen exposure in early life may be significant in the later development of asthma. 

What steps can I take to prevent my infant developing asthma?

  • Breastfeeding was formerly thought to be protective against the development of asthma and allergies but recent studies have cast doubt on this. There are still many good reasons to breastfeed your baby, but this may not be effective in protecting against asthma and allergies. Further research is currently being undertaken in this area.
  • Your inhaled asthma medications are not found in breast milk, and even if you have to use steroid tablets the small quantities that are found in breast milk will not have any harmful effect on your baby. If your baby is being breastfed, avoid using oils containing peanut oil for cracked nipples. Some babies can develop an allergy to the nut content of the oil.
  • Smoking should be avoided after your baby is born as well as during pregnancy. Exposure to tobacco smoke is linked with wheezing in the newborn and increased frequency and severity of asthma symptoms in children with asthma as well as Sudden Infant Death Syndrome (SIDs).
  • You may need to deal with things in your home that can cause allergies, such as indoor pets, particular plants in the garden, and areas that harbour house dust mites such as bedding, soft furnishings and carpets. As far as pets go, there is currently research showing that exposure to more than one dog or cat in the first year of life may reduce a child's risk of allergic disease. More study is needed in this area, however.
  • The use of sheepskins should be avoided. These have been shown to harbour high quantities of house dust mite and are a risk factor. There is evidence to show that feather bedding is better than synthetic in terms of house dust mites. (See the fact sheet on House Dust Mites for further information).

How important is diet in the development of asthma and other allergic conditions?

Most babies with wheezing do not have allergic triggers. Colds and cigarette smoke are much more common triggers.

To avoid the risk of your baby not receiving a balanced diet, always talk with your doctor or a qualified dietitian before excluding any foods from your baby's diet.

Breastfeeding

Your inhaled asthma medications are not found in breast milk, and even if you have to use steroid tablets the small quantities that are found in breast milk will not have any harmful effect on your baby.

Asthma and Menopause


As at any time when hormone levels are fluctuating, menopause may have an effect on your asthma.
The use of steroid tablets or high doses of inhaled steroids for a number of years may increase your risk of osteoporosis. You can reduce this risk by using a spacer to take your inhaled medications, and rinsing your mouth out after taking it. The risk of osteoporosis can also be reduced by ensuring that you have a diet high in calcium (eg yoghurt, cheese, milk) and regular weight bearing exercise (walking is ideal), that you don't smoke, and that you drink only moderate amounts of alcohol.

© Asthma and Respiratory Foundation of New Zealand (Inc.) 10/2000  Photocopy permission granted