By Melinda Young
A noncontraceptive benefit of people using oral contraceptive pills (OCPs) could be that these may help modulate asthma severity, new research suggests.1 In a study that looked at mice with experimental asthma, researchers found that the OCP and depot-medroxyprogesterone acetate (DMPA) likely are modulators of asthma severity. They appear to modify glucose transporter-1 (GLUT-1) responses in the airways.1
These findings, combined with earlier human subjects research, suggest that some forms of contraception hold promise for patients with asthma, and this is something OB/GYNs need to be aware of when they see patients with asthma.
“Asthma disproportionately affects females — 60% of all adult asthmatics are female,” says Jay Horvat, a respiratory scientist and a professor in immunology and microbiology at the School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing at The University of Newcastle and Hunter Medical Research Institute in Australia. Horvat answered questions about the study via email.
“A large proportion of premenopausal women experience a worsening of asthma during menstruation,” he says. “Importantly, 80% of severe asthmatics are female, and females are more likely to suffer fatal asthma attacks than men.”
Although the mechanisms that lead to increased disease burden in females are mostly unknown, there is increasing evidence that this outcome could be influenced by female sex hormones. Estrogen and progesterone play a role in regulating airway inflammation and the airway’s hyperresponsiveness, as well as mucus production, in asthma.1
Females with asthma sometimes have symptoms that worsen during the late-luteal and early follicular phases of the menstrual cycle, which is called perimenstrual asthma and affects up to 40% of pre-menopausal females with asthma.1 Although the study’s authors refer to females and female sex hormones, they also recognize that female sex hormones may be relevant for transgender people and some non-binary people, Horvat notes.
“The research conducted in this study, and previous literature referenced, has only addressed female sex hormones in female presenting individuals and female animals,” he explains.
The new study highlights the potent protective effects of hormone-based contraceptives and hormone therapies for modulating the severity of asthma, Horvat adds. Researchers demonstrated that OCP and DMPA treatments decrease GLUT-1 responses, and female patients with asthma taking an OCP have lower sputum GLUT-1 expression.1,2
“The study was based on earlier findings from the team that observed that females with asthma who were using the oral contraceptive pill had better lung function, lower airway inflammation, better control of their asthma, and were using less inhaled corticosteroids than females with asthma who were not using the OCP,” Horvat explains. “In this current study, we extended on these earlier observations to show how the OCP and DMPA reduce key inflammatory responses in asthma by modifying metabolism in cells in the airways,” Horvat explains.
“The airways cells that drive inflammatory responses in asthma require the energy generated from cellular metabolism to promote disease,” he adds. “And the research team made the novel discovery that the OCP and DMPA reduce the cellular expression of a protein known as GLUT-1.” GLUT-1 allows glucose into cells to fuel metabolic activity. In severe asthma, GLUT-1 is increased. Blocking GLUT-1 protects against asthma, particularly in severe asthma that is induced by estrogen, Horvat says.
Investigators’ ongoing research is focused on fully characterizing the mechanisms that underpin the protective effects of the OCP and DMPA on asthma, Horvat says. “The overarching goal of the research is to develop and test transformative new therapies for asthma and other respiratory diseases that specifically target the protective effects of hormone responses on cellular metabolism,” he explains. “Such therapies are likely to be particularly important in females that experience a significant worsening of respiratory symptoms during menstruation and in menopause but are also likely to be effective for asthma in males.”
While the research is new and more studies, including those involving human participants, are needed, the body of research on asthma and contraception suggests this potential benefit to the use of the OCP and DMPA could be mentioned to patients with asthma.
“Given that contraceptive use and hormone-based therapies have a broad range of effects on many systems in the body and their use is not appropriate or safe for some individuals, the authors strongly encourage seeking guidance from an appropriate medical professional regarding their asthma management,” Horvat says.
Robert Hatcher, MD, MPH, founding author of Contraceptive Technology and Professor Emeritus of Gynecology and Obstetrics at Emory University School of Medicine in Atlanta, says finding improvement in a problem as serious as asthma by using combination contraceptive pills or DMPA was 100% news to him. It certainly deserves greater attention, he says.
Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.
References
1. Brown AC, Carroll OR, Mayall JR, et al. Female sex hormones and the oral contraceptive pill modulate asthma severity through GLUT-1. Mucosal Immunol. 2025; Feb 26:S1933-0219(25)00024-8. [Online ahead of print].
2. Scott HA, Gibson PG, Garg, ML, et al. Sex hormones and systematic inflammation are modulators of these obese-asthma phenotype. Allergy. 2017;71:1037-1047.
A noncontraceptive benefit of people using oral contraceptive pills (OCPs) could be that these may help modulate asthma severity, new research suggests.
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