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/m(2) (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/m(2) (respiratory symptoms: OR, 1.10 [95% CI, 0.61-1.97], P-interaction = .04; FEV1 adjusted difference, -54 [95% CI, -151 to 43], P-interaction = .06). Conclusions: Menopause is associated with lower lung function and more respiratory symptoms, especially among lean women.