What we know about PAH impacting women’s health 

For decades now, it’s been documented that more women than men are diagnosed with Pulmonary Arterial Hypertension (PAH). PAH is most often diagnosed in women between 30 and 60 years old. Although the reason women are at greater risk of developing PAH is still unknown, there are a number of key facts we do know about how it is impacting women’s health.  

PAH is a form of high blood pressure which is developed in the lungs. It is a rare but serious disorder, often with no known cause but it can be triggered by a variety of factors. These include sleep apnoea and chronic obstructive pulmonary disease (COPD). PAH is a type of pulmonary hypertension that occurs when the walls of the arteries connecting the right side of the heart to the lungs, narrow and tighten. As a result, pressure in the lungs rises. This can lead to symptoms including breathlessness, exhaustion and fatigue.  

If you are a woman living with PAH, or know someone who is, read on to learn some useful facts about PAH impacting women’s health.  

More women are diagnosed with PAH than men

Women are up to seven times more likely to be diagnosed with PAH. Generally, it is developed 10 years earlier than men. While it is currently unknown why females are more susceptible, it is often thought it is related to the role of oestrogen and hormonal changes experienced by women. Furthermore it is linked to autoimmune diseases, which are more prevalent in women.  

PAH can affect your fertility

This is because the heart and lungs cannot easily adjust to the extra demands of pregnancy and labour. Throughout a pregnancy, body fluid and blood volume escalate. As a as result, it increases cardiac output and pulmonary artery pressure. 

A/Prof Rachael Cordina, clinical academic cardiologist says, “It’s highly variable and depends on the type of PAH you have. However, women who have the most trouble with fertility are women who have low oxygen saturations. Also, women with the congenital heart disease: Eisenmenger syndrome.” 

It is important to talk to your healthcare professional about your options if having a child is something you are considering. Every woman’s circumstance, while living with PAH, is different. So, if family planning is important to you and you are of child-bearing age, your healthcare team will be essential to making informed and guided decisions.  

Contraception is important

For looking after your health whilst living with PAH contraception is essential. “It’s important that every woman who has not gone through menopause, or who could fall pregnant has had a conversation with their doctor about reliable forms of contraception. Oestrogen-containing contraception such as the pill should generally be avoided, as oestrogen can cause blood clots,” says A/Prof Cordina.  

While hormonal contraception is advised against, due to the increase in blood clots, having these discussions with your healthcare team are vital. There are a variety of options available. Through discussions you will find the right one to suit your needs.  

Sex drive

PAH can affect your sex drive and your ability to perform exercise. Depending on the severity of which you live with PAH and the weakness in your heart muscle, doing vigorous exercise can be unsafe and can lead to poor blood pressure and fainting. Don’t be shy to talk about this with your healthcare provider. “There are some women who will need to take on a more passive role in sex, and less physically active so it is enjoyable and safe for them,” says A/Prof Cordina.  

Hormone replacement

“Menopause in the setting of PAH in general should avoid hormonal types of replacement therapy. This is particularly true for women who are on blood thinners such as warfarin,” said A/Prof Cordina.  

Lung Foundation Australia has developed variety of resources designed to help you live your best life with PAH. If you would like to book a call with our team to receive further information, free call 1800 654 301 or email us: enquiries@lungfoundation.com.au  

For more information and support, access our PAH resources at the link below.