Later-onset menopause linked to higher asthma risk

Later-onset menopause linked to higher asthma risk | Image Credit: © Goffkein - © Goffkein - stock.adobe.com.

Women with a delayed onset of natural menopause may have an elevated risk of developing asthma, according to a new study published in Menopause: The Journal of the Menopause Society.¹

Although research on the link between menopause and asthma is limited, several studies have suggested a connection between female sex hormones and asthma. Some research has found that higher estrogen levels, whether natural or synthetic, may increase asthma risk. Additionally, hormone therapy use has been linked to higher rates of asthma diagnosis, which decline after therapy cessation.

To further investigate this connection, a longitudinal study followed over 14,000 postmenopausal Canadian women and examined the relationship between age at natural menopause (ANM) and asthma incidence.

The study population included postmenopausal, nonsmoking women aged between 45 and 85 who were followed for a 10-year period. Participants were categorized by ANM into the following: age 40 to 44, age 45 to 49, age 50 to 54 (reference), and age 55 and above.

Survival analysis was employed to determine the time to onset of asthma. Multivariable Cox regression analysis was performed to assess the relationship between ANM and asthma risk, adjusting for potential confounders.

The primary outcome of interest was the incidence of asthma after natural menopause. Women who did not develop asthma during the follow-up period were considered censored observations and contributed person-years to the study. Endpoints were defined as the age at asthma onset and the age at last follow-up, which could be due to death, loss to follow-up, or study end.

The overall analysis demonstrated a 30% decreased risk of asthma in women with an ANM of 40 to 44 years compared to those with an ANM of 50 to 54 years (95% CI: 0.49 to 0.95). These findings suggest that women with earlier menopause may be at reduced risk of asthma, further supporting the hypothesis that estrogen may play a role in increasing the risk of the condition.

To these results, investigators issued recommendations for health care providers.

“This study highlights sex-based differences in asthma, with women at a greater risk for asthma than men in adulthood,” said Stephanie Faubion, MD, medical director for The Menopause Society, in a news release.² “It also showed that women with later onset of menopause are at greater risk than those with early onset of menopause. Clinicians should be aware of this link and should monitor women with later age at natural menopause for asthma symptoms.”

With asthma impacting 339 million individuals globally and menopause affecting 1.3 million US women annually,^3,4 understanding the connection between these conditions has significant clinical implications. By recognizing the unique challenges faced by menopausal women with asthma, pharmacists can tailor counseling to improve patient outcomes.

This article was published by our sister publication Drug Topics.

References

1. Kesibi D, Rotondi M, Edgell H, Tamim H. The association between age at natural menopause and risk of asthma among postmenopausal women from the Canadian Longitudinal Study on Aging. Menopause. Published online October 30, 2024. doi:10.1097/gme.0000000000002443

2. Women entering menopause later in life at greater risk for asthma. News release. EurekAlert. October 30, 2024. Accessed October 30, 2024. https://www.eurekalert.org/news-releases/1063058

3. Asthma. Fact sheet. World Health Organization. Accessed October 30, 2024. https://www.who.int/news-room/facts-in-pictures/detail/asthma#:~:text=Asthma%20is%20a%20chronic%20disease,affects%20about%20339%20million%20people.

4. Menopause. National Library of Medicine. Accessed October 30, 2024. https://www.ncbi.nlm.nih.gov/books/NBK507826/