Estrogen: How it Affects Women’s Breathing

In a previous post, I explored how the hormone progesterone—along with carbon dioxide (CO2) tolerance and brainstem regulation—drives women’s breathing. This post examines the impact, sometimes overlooked, that estrogen has on women’s breathing.

The primary function of estrogen is the development and maintenance of the female reproductive system (e.g. ovaries, uterus). It also plays a role in:

Development of secondary sex characteristics (e.g. breasts, wider hips) during puberty

Regulating the menstrual cycle,

Influencing mood

Supporting bone density

Promoting skin elasticity

Enhancing lung and airway function

Estrogen’s effect on breathing is more subtle and complex than progesterone's. While progesterone increases respiratory drive, estrogen impacts the airways and lung function.

On its own, estrogen is thought to slightly increase sensitivity to CO2. This can increase a woman’s respiratory rate. However, it is less potent than progesterone. Its real impact is the synergistic effect it has when combined with progesterone. Specifically, estrogen upregulates progesterone receptors, making tissues in the respiratory centres more responsive to the effects of progesterone. This amplifies sensitivity to CO2, which in turn increases respiration rates.

During pregnancy, when both estrogen and progesterone levels are high, minute ventilation (the amount of air you breathe in a minute) can increase by up to 50%. A similar, smaller effect occurs during the luteal phase of the menstrual cycle.

It is also thought that estrogen helps improve the muscle tone of the airways and reduce inflammation in the airways and lungs. Some studies suggest that conditions like asthma are worse in women when the levels of both hormones are low, while lung function improves when estrogen rises. In fact, women are also more likely than men to develop asthma after puberty and again during menopause, strengthening the hypothesis that estrogen and progesterone have an impact on lung function.

This can mean significant issues for women during perimenopause when hormone levels fluctuate, and during menopause when there is a permanent drop in hormone levels. The impact of a decrease in both hormones can have some key effects:

Respiratory drive drops, leading to air hunger, which manifests as shallow, rapid breathing.

Muscle tone in the airways may deteriorate, causing constriction that increases the risk of snoring and sleep apnea.

The airways become more susceptible to inflammation, potentially worsening asthma and other respiratory illnesses

An increase in abdominal fat can potentially restrict the movement of the diaphragm

Hormone replacement therapy can help to ameliorate some of these effects, though its use depends on individual health factors and access to treatment.

Breath training, however, can be an effective tool to help women adapt to these changes. While it can’t replace hormones, it can help women optimise their breathing biochemistry, biomechanics, and psychophysiology, improving respiratory health.

Disclaimer

This blog is for informational purposes only. It is not medical advice. Always consult a healthcare professional for personalized guidance and treatment.