Effect of Sex Hormone During the Menstrual Cycle on Capsaicin Evoked Cough Responses

Exclusion Criteria

• •1. Subjects who are in a pollen season that affects their asthma
• •2. Subjects who report allergies to capsaicin or bronchoconstrict at the end of the full dose capsaicin cough challenge and require short acting bronchodilator therapy (assess after visit 1)
• •3. Subjects who do not display evidence of airway hyper-responsiveness (methacholine PC20\>16mg/ml) (assess after visit 1)
• •4. Symptoms of upper respiratory tract infection in the last 1 month which have not resolved.
• •5. Lower respiratory tract infection or pneumonia in the last 6 weeks.
• •6. Current smoker or ex-smoker with ≥10 pack year smoking history and abstinence of ≤6 months
• •7. Asthma exacerbation in the previous month requiring a start of inhaled or oral corticosteroids.
• •8. Any asthma medication with the exception of infrequent (less than twice weekly) short-acting β2-agonist.
• •9. Subjects who have changed asthma medication within the past 4 weeks prior to screening
• •10. A previous asthma exacerbation requiring Intensive Care Unit admission.
• •11. Significant other primary pulmonary disorders in particularly; pulmonary embolism, pulmonary hypertension, interstitial lung disease, lung cancer, cystic fibrosis, emphysema or bronchiectasis.
• •12. Pregnancy or breast-feeding
• •13. Use of ACE inhibitors
• •14. Any centrally acting medication (opioids, gapapentin, pregabalin, amitriptyline) which in the view of the investigator could alter the sensitivity of the cough reflex
• •15. History of psychiatric illness, drug or alcohol abuse which may interfere in the participation of the trial.
• •16. History of current or previous anabolic steroid use in men.
• •17. For the natural cycle group, the female patients must have regular (24 to 35 day) natural cycles and no oral contraceptive use for ≥6 months
• •18. For female's taking the oral contraceptive pill they must be taking this ≥6 months
• •19. Use of B-blockers
• •20. Patients with clinically significant cardiovascular disease
• •21. Patients with known allergy to any of the study medications or excipients
• •22. Patients with a known potentially life threatening allergy (e.g. food allergy, stinging insect allergy), history of anaphylaxis, mastocytosis, angioedema