Accelerated lung function decline and menopause

24.01.22 02:58 PM By Norma

Although the role that sex hormones play in respiratory health is well known, the relationship between hormonal changes due to menopause and female lung function is a topic that deserves more attention.

Menopause not only marks the end of women's reproductive cycle, it also represents the beginning of great changes in their organism. It is related to important changes in the activity of 7β and low levels of this substance favor not only systemic inflammation, but also that of the lungs.

 Markers of inflammation C-reactive protein (which belongs to the family of acute phase reactants) and interleukin 6 (IL6) inversely affect FVC and FEV1. This is what suggests a possible association between menopause and decline in lung function. 

This relationship has not yet been sufficiently studied, so the contributions of the study named "Menopause Is Associated with Accelerated Lung Function Decline", by  Kai Triebner et al., propose a starting point to dive deeper into this topic. Here are the highlights of the document.

Lung function and menopause

The goal of Kai Triebner et al. was to evaluate lung function by FVC and FEV1 to see if the decline in those measurements was accelerated in menopausal women. 

Method. To carry out the study, The European Community Respiratory Health Survey information about their respiratory and reproductive health.

 The researchers measured follicle stimulating (FSH) and luteinizing hormones (LH)

and added information from menstrual patterns to determine menopause using latent class-type analyses. 

To determine whether this was associated with the decline of lung function, linear mixed-effect models were used, in which the variables of age, height, weight, number of packages that the participants smoked in a certain period of years, if they were current smokers, age, and level of full-time education were adjusted. Likewise, the values obtained in the spirometry as well as the type of spirometer used in each wave of the study, were considered.

 Main outcomes.  Tests showed that menopause was associated with an accelerated lung function decline. In post-menopausal women, the adjusted mean FVC increased by -12.5 ml/yr (95% CI, -16.2 to -8.9) compared to those who were still menstruating. The adjusted mean FEV1 decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) for post-menopausal women.

Conclusions

This study showed that lung function declined faster in women who were in the middle of menopause and in post-menopausal women, beyond the expected decline with age. The results were consistent across subgroups and had nothing to do with smoking history. The decline of pulmonary function was more pronounced in the FVC measurements. The effect size for FEV1 measurements was comparable to smoking 20 cigarettes a day for 2 years, and FVC measurements was comparable to smoking 20 cigarettes a day for 10 years. 

The researchers in charge of this study concluded that the relationship between reproductive age and respiratory health needs to be investigated further. They also noted that there was also a need to investigate whether hormone replacement therapy could bring benefits to patients' lung health.