BRONCHOSPASM SECONDARY TO REPLACEMENT ESTROGEN THERAPY

A postmenopausal woman with severe obstructive airways disease and bro nchospasm developed increased airflow limitation with the reintroducti on of estrogen therapy for osteoporosis. Discontinuation of the estrog en caused symptomatic improvement and decreased her corticosteroid req uirement. Readministration of estrogen caused recrudescence of her sym ptoms and a decline in her peak expiratory flow rate and spirometric d ata, which reversed with withdrawal of the estrogen therapy. Bronchosp asm during the luteal phase of the menstrual cycle is well known,1-3 b ut exacerbation of reactive airways disease with the administration of exogenous estrogen has not previously been reported; however, with th e increasing practice of reintroducing estrogen in postmenopausal wome n to reduce the risk of symptomatic osteoporosis, other susceptible wo men may suffer clinically significant deterioration of their underlyin g pulmonary disease.