Women, pregnancy and the menopause
The normal fluctuations in hormonal levels at different stages in life can have an effect on the severity of HAE symptoms in women. Many young girls experience their first HAE attacks in adolescence, or attacks become more frequent.
Contraception
Birth control pills containing oestrogen should not be used as it may make your HAE symptoms worse. Progesterone based medication can be used, and some patients have reported that they have seen a decrease in HAE symptoms whilst taking this.
Pregnancy
Women with HAE can have children, because HAE does not impair fertility. Patients seeking to become pregnant should discuss their HAE management with their HAE consultant.
Attenuated androgens such as Danazol should not be taken while trying for a baby or throughout pregnancy or breastfeeding, but other prophylaxis are suitable.
In pregnancy, symptoms may lessen or they can become more frequent. Your HAE management may need to be reviewed and changed to cope with frequent attacks.
Delivery
HAE attacks are rare at the time of delivery, but it is important to have acute attack medication on hand for after delivery if needed. If you have a caesarean delivery and do not have prophylactic treatment, you should ensure C1 Inhibitor is administered as close as possible to the start of the procedure.
Menopause
Oestrogen based medications are not suitable for HAE patients as they can make symptoms worse. Some women find that HAE symptoms become less after the menopause – but it is important to always have a HAE management plan in place that will keep you safe in case of an unpredictable swelling of the airway.
