Sex-specific aspects of bronchial asthma

Sex-specific aspects of bronchial asthma have mainly been investigated with respect to biological factors and point to clear differences in the hormonal phases of life but are not consistently found in all studies. While the prevalence of asthma in childhood and teenage years appears to be higher in boys, the proportion of women is higher in adulthood. Women appear to have a more severe asthma phenotype with increased mortality. Obesity and gastroesophageal reflux are more frequent comorbidities in women than men. Numerous observational studies point to hormone-dependent, cyclical fluctuations in asthma control and the associated utilization of medical services. During pregnancy, bronchial asthma is the most frequent cause of respiratory problems and good treatment management is crucial for both mother and child. The menopausal transition is generally associated with an accelerated loss of the forced expiratory volume per second (FEV1) in women and an increased rate of exacerbations in women with asthma. The value of hormone replacement therapy in this context is still unclear. In summary, hormone-dependent and gender-dependent factors are likely to cause sex-specific differences in bronchial asthma. The latter are still rarely considered in studies and clear mechanistic evidence is still largely lacking.