Can Hormone Therapy Cause Cough as a Side Effect?

Yes, cough can occur with certain hormone therapies, although it is not among the most common side effects for most products. Reports of “cough increased” appear with combined estrogen–progestin therapies (e.g., conjugated estrogens plus medroxyprogesterone). ^[1] Some estrogen–progestin tablet products list respiratory complaints like nasopharyngitis and upper respiratory infections, which may present with cough. ^[2] Aromatase inhibitors used in breast cancer (e.g., anastrozole) list cough and shortness of breath among possible adverse effects. ^{[3] [4]} Selective estrogen receptor modulators (e.g., raloxifene) have trial data showing increased cough in treated groups. ^[5]

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Which Hormone Therapies Have Reported Cough

• Combined estrogen–progestin (HRT): Some labels report “cough increased” with conjugated estrogens/medroxyprogesterone tablets. ^[1] Additional respiratory events (pharyngitis, rhinitis, sinusitis, upper respiratory infections) are also described. ^[6]
• Estradiol plus progestin products: Clinical trial tables for estradiol/norethindrone acetate list nasopharyngitis in a notable proportion of users, which can involve cough. ^{[2] [7] [8]}
• Aromatase inhibitors (breast cancer): Anastrozole includes cough and shortness of breath among recognized side effects. ^[3] Professional labeling similarly lists cough. ^[4]
• SERMs (e.g., raloxifene): Trial data indicate increased cough in treatment arms compared with placebo. ^[5]
• Estradiol patches: Some transdermal estradiol products report “respiratory, thoracic and mediastinal disorders” like sinus congestion, which can be associated with cough. ^[9]

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Why Might Cough Happen

• General respiratory irritation or infection risk: Labels for multiple HRT products report upper respiratory conditions (rhinitis, sinusitis, nasopharyngitis), which commonly feature cough. ^{[6] [2]}
• Drug-specific effects: Agents like anastrozole may have pulmonary side effects including cough and shortness of breath. ^{[3] [4]}
• Immune or rare hypersensitivity reactions: There are rare case reports of hormone-associated lung inflammation (eosinophilic pneumonitis) after progesterone/estradiol injections, which presented with dry cough and breathing issues. [PM15]
• Hormone-related cough sensitivity: Female sex hormone balance can influence cough reflex sensitivity, with higher cough sensitivity observed when progesterone is relatively dominant. [PM16]

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When Cough Needs Urgent Attention

• Seek urgent care if you have cough with blood, chest pain, sudden shortness of breath, severe headache, or sudden vision changes, as some HRT safety information advises immediate evaluation for severe symptoms. ^[10] Shortness of breath with cough on therapies like anastrozole should also prompt timely medical review. ^{[3] [4]}

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Practical Ways to Cope With Cough

• Check timing and triggers

  • Track when the cough started relative to the hormone therapy initiation or dose change. Some products show respiratory complaints in early treatment periods; noting onset can help your clinician. ^[6]

• Rule out common causes

  • Guideline-based evaluation typically looks for asthma, upper airway cough syndrome (postnasal drip), GERD, nonasthmatic eosinophilic bronchitis, and drug-induced cough. ^[11] Collaborative approaches and speech therapy can help if cough is refractory. ^[12]

• Medication review and adjustments

  • Discuss with your prescriber whether your specific hormone product could be contributing. If on an agent known to list cough (e.g., combined HRT, anastrozole, raloxifene), dose adjustments or switching formulations (oral to transdermal, or different combinations) may be considered. ^{[1] [6] [3] [4] [5]} Transdermal options sometimes have different side-effect profiles, including fewer systemic peaks, which may reduce certain systemic reactions. ^[13]

• Symptom relief at home

  • Hydration, humidified air, saline nasal rinses, and throat lozenges can ease upper-airway irritation. If sinus congestion is prominent on estradiol patches, supportive care may help. ^[9]
  • Over-the-counter cough suppressants can be tried short-term; ask your clinician or pharmacist to avoid interactions.

• Address postnasal drip and reflux

  • For postnasal drip, consider non-sedating antihistamines or nasal corticosteroids if advised.
  • For reflux-related cough, meal timing changes, elevation of the head of the bed, and acid-reducing medications may help.

• Monitor for warning signs

  • If cough is persistent, worsening, or accompanied by breathing difficulty, chest pain, or blood, seek medical evaluation promptly. ^[10] On therapies that list shortness of breath, do not delay contacting your clinician. ^{[3] [4]}

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Special Situations

• Cancer-related hormone therapy (e.g., anastrozole): Report new or worsening respiratory symptoms (cough, shortness of breath) to your oncology team, as these are known adverse effects. ^{[3] [4]}
• Rare lung reactions: If cough is severe with systemic symptoms (fever, hypoxia) after injectable hormone support, clinicians may consider rare inflammatory reactions such as eosinophilic pneumonitis. [PM15]
• Cyclic cough patterns: If cough fluctuates with menstrual cycles or progesterone dominance, altered hormone balance may influence cough sensitivity your clinician can consider this in tailoring therapy. [PM16]

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Summary

Cough can occur with some hormone therapies, particularly certain combined estrogen–progestin regimens, aromatase inhibitors, and SERMs, though it is not the most frequent side effect overall. ^{[1] [6] [3] [4] [5]} Management starts with identifying other common causes, reviewing the specific hormone product, and using supportive measures, with urgent evaluation for red-flag symptoms. ^{[11] [10]} If needed, changing formulation or agent may reduce cough risk and improve comfort. ^[13]