December 2024
Is asthma risk increased in women with later age of menopause?
By Melanie Hinze
A recent study published in Menopause has found that women with later ages at natural menopause may be at increased risk for asthma. However, Clinical Professor John Blakey, Medical Advisor for Asthma Australia, said that although it was clear some kind of interaction was going on in this research, we were a long way off these findings influencing practice.
The study included 14,406 postmenopausal women aged 45 to 85 years (mean age at baseline, 61.4 years) from the Canadian Longitudinal Study on Aging. Participants had a mean BMI of 27.2kg/m2 and follow up occurred over 10 years.
Using multivariable Cox regression analysis, the researchers found a 30% decreased risk of asthma in women with age at natural menopause of 40 to 44 years compared with those with age at natural menopause of 50 to 54 years.
Professor Blakey said that in the past the treatment of asthma was fairly simple across all patient groups. ‘However in the past few years it’s become much more evident that we need to target treatment and treat the traits that people have, rather than a one-size-fits-all approach,’ he said.
‘However, we are yet to get consensus on what we should do differently with the changes in sex hormones,’ he said, noting that while this study added something to our understanding, it did not provide any definitive answers.
‘We know that asthma is more common and severe in boys and more common in adult women, and we know that oestrogen increases inflammation in lab studies,’ he said. ‘But if you do studies of actual women in the real world, the oestrogens are seemingly protective in terms of these patients having better lung function and less inflammation.’
Professor Blakey said that although men often had worse biomarker-related disease than women, women presented more frequently and tended to have more comorbidities.
Overall, Professor Blakey suggested that clinicians focus on retaining an awareness that asthma could occur at any age, and that it is diagnosed and treated properly in all patients. He added that in Australia at present we need to improve asthma treatment and management, especially of elderly patients.