Lung function, respiratory symptoms, and the menopausal transition

Background

There is limited information on potential changes in respiratory health when women enter the menopausal transition.

Objective

We sought to investigate whether the menopausal transition is related to lung function and asthma and whether body mass index (BMI) modifies associations.

Methods

Four thousand two hundred fifty-nine women from 21 centers (ECRHS II, 2002) responded to a questionnaire concerning women's health. Women aged 45 to 56 years not using exogenous sex hormones (n = 1274) were included in the present analysis. Lung function measurements (n = 1120) and serum markers of hormonal status (follicle-stimulating hormone, luteinizing hormone, and estradiol; n = 710) were available. Logistic and linear regression analyses were adjusted for BMI, age, years of education, smoking status, center, and height.

Results

Women not menstruating for the last 6 months (n = 432, 34%) had significantly lower FEV1 values (−120 mL [95% CI, −177 to −63]), lower forced vital capacity values (−115 mL [95% CI, −181 to −50]), and more respiratory symptoms (odds ratio [OR], 1.82 [95% CI, 1.27-2.61]) than those menstruating regularly. Results were similar when restricting analyses to those who never smoked. Associations were significantly stronger in women with BMIs of less than 23 kg/m² (respiratory symptoms: OR, 4.07 [95% CI, 1.88-8.80]; FEV1 adjusted difference: −166 [95% CI, −263 to −70]) than in women with BMIs of 23 to 28 kg/m² (respiratory symptoms: OR, 1.10 [95% CI, 0.61-1.97], Pinteraction: .04; FEV1 adjusted difference, −54 [95% CI, −151 to 43], Pinteraction = .06).

Conclusions

Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women.

Key words: Menopause, lung function, asthma, allergy, body mass index, sex hormones, estrogens, follicle-stimulating hormone, hormone replacement therapy, European Community Respiratory Health Survey

Abbreviations used: BMI, Body mass index, COPD, Chronic obstructive pulmonary disease, ECRHS, European Community Respiratory Health Survey, FSH, Follicle-stimulating hormone, FVC, Forced vital capacity, GAM, Generalized additive model, HRT, Hormone replacement therapy, LH, Luteinizing hormone, OR, Odds ratio, RHINE, Respiratory Health in Northern Europe