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Women almost twice as likely to die from asthma than men 

Asthma + Lung UK say that millions of women with asthma are drawing the short straw with too little research exploring the effect of female sex hormones

Wednesday 27th April 2022

Women with asthma in the UK – an estimated three million people – are almost twice as likely to die from an asthma attack than men with asthma, analysis by the country’s leading lung health charity has found.1,2

Ahead of World Asthma Day [Tuesday 3 May], Asthma + Lung UK is launching a major report, Asthma is Worse for Women to tackle the stark health inequality that means women are more likely to have asthma, need hospital treatment for it and are more likely to die from an asthma attack.

Pollen, air pollution and dust are well-known asthma triggers, but what people might not be aware of is that fluctuations in female sex hormones can also cause asthma symptoms to flare-up or even trigger life-threatening asthma attacks. Asthma + Lung UK is now shining the spotlight on the link between times of hormonal change (during puberty, periods, pregnancy and peri-menopause) and asthma symptoms.

The charity is also encouraging GPs to explore this potential trigger with any of their patients. For example, considering adjustments to a patient’s medication regimen such as increasing the dose of preventer medication if symptoms are worse during hormone fluctuations.3

The charity says the current ‘one-size-fits-all approach’ to asthma treatment is currently failing. Investment in specific research could have a profound effect, unlocking new treatments for women or making use of existing treatments better suited to women’s lives.

In childhood, asthma is more prevalent and severe in boys. However, after puberty, the situation reverses, and asthma becomes more prevalent and severe among women. This explains why rates of admissions to hospital in England for asthma are similar by sex in the early teenage years but are 2.5 times higher in women than in men aged 20-49 years. 4

Over the past five years, more than two thirds of asthma deaths have been women, with more than 5,100 women dying from an asthma attack compared with under 2,300 men.5

Charity experts say that women continue to “draw the short straw” when it comes to research funding and without major investment into targeted research looking into the sex-related differences in asthma, more lives will be needlessly cut short.

For now, Asthma + Lung UK says the best way anyone can protect themselves against asthma triggers, including female hormones, is to take their preventer medicine every day as prescribed and have an asthma review at least once a year to ensure their medicines are working for them and update their asthma action plan. Keeping a symptom diary can also help identify what’s triggering someone’s asthma, including hormones.

Poppy Hadkinson, 30, a TV presenter from Stratford-upon-Avon, says her asthma worsened when she went through puberty, and she spent her teenage years in and out of hospital with life-threatening asthma attacks.  

She said: “I was diagnosed with asthma aged 11, which looking back on it was when I was right in the middle of going through puberty. Over the next decade, I had regular asthma attacks and would end up in hospital up to six times a year.

“There seemed to be a pattern to my symptoms, linked to my menstrual cycle. Nearly every month in the run up to my period, I’d be really ill with my asthma. My symptoms would leave me struggling to breathe, which was terrifying, and I’d often end up in hospital. The asthma attacks I suffered were so severe that I’d been ventilated four times by the time I was 22 and was questioning whether I’d make it to my next birthday.

“After my fourth intubation, I was offered a new treatment of a biologic drug, Omalizumab, for severe asthma, which has been a life-changer. While I still get some asthma symptoms before my period every month, I haven’t been hospitalised since starting the injections in 2013.

“I lost a large portion of my teenage years and my early 20s to my asthma. I would never want any other woman or girl to experience the same thing I did. We need to better understand how asthma affects women so we can find treatments that will give women like me their lives back.”

Sarah Woolnough, Chief Executive of Asthma + Lung UK, said:

“When it comes to research funding women with asthma have drawn the short straw. Gaps in our knowledge are failing women, leaving them struggling with debilitating asthma symptoms, stuck in a cycle of being in and out of hospital and in some cases, losing their lives.

“By understanding the role of sex hormones in asthma, we could transform the lives of the three million women with the condition in the UK and the many millions of women with asthma across the world. We urgently need to see more investment in research in this area so we can find new treatments and better use existing treatments to help millions of women and save lives.”

Ms Mome Mukherjee, Senior Research Fellow, AUKCAR, Usher Institute, University of Edinburgh who has been involved in research into the link between sex hormones and asthma, said:

“Despite the UK having some of the most comprehensive health data in the world at its fingertips, data on sex hormones and asthma remains largely untapped and unexplored. Because of this, women with asthma continue to experience worse outcomes. There is not enough research into why women are more likely to be hospitalised and die from asthma and what treatments new and existing, could help women. The UK has a great opportunity to become a global leader in research on the link between sex hormones and asthma, which would benefit millions of women in the UK and around the world.”

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  1. A+LUK analysis of deaths rates by sex from 2014/2015 to 2019/2020 found that women were 1.81 times more likely to die from an asthma attack than men. Sources; data from Office for National Statistics (ONS) – England & Wales, Northern Ireland Statistics & Research Agency (NISRA), National Records of Scotland (NR Scotland).
  2. Estimate from Health surveys over three million women have asthma (58.5%) in the UK compared with just under 2.4 million men (41.5%). Sources (Health survey for England, 2001; Scottish Health survey, 2003; Welsh Health survey, 2005/06; Northern Ireland Health and Wellbeing survey, 2005/06. Data accessed via UK Data Service
  4. A+LUK analysis of age breakdowns of emergency admissions data in England found that in 2018/2019 women aged 20-49 years were 2.53 times more likely to be admitted to hospital for asthma treatment than men (16,035 / 6,340). Sources from NHS Digital (England), NHS Wales, Department of Health Northern Ireland and Public Health Scotland.
  5. Sources: Office for National Statistics (ONS) – England & Wales, Northern Ireland Statistics & Research Agency (NISRA), National Records of Scotland (NR Scotland).