Hereditary angioedema in women: specific challenges.

Women with hereditary angioedema (HAE) present with more frequent and more severe attacks than men. The disease is often affected by estrogenic status. Estrogens increase kininogenase activities. Deliveries seem to be safe but it is advised to have C1 inhibitor (C1Inh) concentrate in the delivery room; in case of worsening during the pregnancy, it is recommended to use short-term prophylaxis with C1Inh concentrate. Women often badly tolerate attenuated androgen: 30% of women have weight gain, 30% irregular menstruations, and 6% virilization. Acid tranexamic and progestins are preferred for long-term prophylaxis for women with HAE.