A new study on the effect of female hormones in pulmonary exacerbations in cystic fibrosis patients, entitled “Subcutaneous implant with etonogestrel (Implanon®) for catamenial exacerbations in a patient with cystic fibrosis: a case report” and published in the journal BMC Pulmonary Medicine by Dr. Adelaida Lamas, supports previous evidence associating female hormones in the development of recurrent infectious pulmonary exacerbations and the deterioration of lung function in a woman with cystic fibrosis. The new findings suggest that hormone-based birth control for women with CF could offer a therapeutic value for avoiding lung function issues.
Cystic fibrosis (CF) is a genetic disease that affects various organs, including the lungs and pancreas, and is characterized by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which results in regular infective pulmonary exacerbations with opportunistic pathogens. In the United States, patients with cystic fibrosis have an average overall survival age of 39 years. The disease affects both sexes, but there is a sexual dichotomy relative to disease severity, with women having a survival disadvantage and weaker lung function. The origin of this gender difference and susceptibility is not well understood, but in previous studies, female hormones have been implicated in the development of pulmonary exacerbations (PE).
In this study, Dr. Adelaida Lamas, who is part of Dr. Lucrecia Suárez’s group from Instituto Universitario de Oncología del Principado de Asturias, Asturias, Spain, along with colleagues analyzed the clinical case of a 20 year-old female patient diagnosed with CF with severe recurrent PE. These severe recurrent PEs were always associated with the menstrual cycle, and have been occurring since her first menstrual cycle, in combination with lung function deterioration despite being subjected to various treatments with intravenous antibiotics. As part of the study, the patient was implanted subcutaneously with 68 mg of etonogestrel (Implanon®), Organon Espanola S.A., a hormone-releasing birth control implant that prevents pregnancy for 3 years and contains a progestin hormone called etonogestrel. The researchers observed that after the insertion of the etonogestrel implant, the patient did not have pulmonary exacerbations, and pulmonary function was recovered.
Overall, this study shows and correlates with former studies that female hormones are crucial players in the development of PE and in the deterioration of lung function in female patients with CF. Notably, the study highlights that hormonal control through contraceptive methods may be considered as a possible treatment for this pathological condition.