ACE and hereditary angioedema: However, attacks can be triggered by factors such as stressful life events, invasive medical or dental procedures, physical trauma, recent infection, and fatigue.2 Because estrogen plays a role in controlling bradykinin production, the clinical course of HAE varies during the hormonal stages of a woman's life, from puberty to monthly menses, pregnancy, and menopause.3,12 Medications can exacerbate the frequency and severity of HAE attacks including estrogen-containing medications and angiotensin-converting enzyme inhibitors.