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Menopause and asthma severity

The progression and development of asthma across the menopausal transition has not been thoroughly addressed, or clearly separated from the effects of age. The present study evaluates the effects of menopause on asthma severity, quality of life and healthcare utilization using a propensity score model.

The analyses were conducted using data from participants enrolled in the Severe Asthma Research program (SARP). Ten sites enrolled asthmatics between 2002 to 2011, and contributed a standardized set of data to a central coordinating center [AJRCCM 2012;185:356-62]. Data on 166 menopausal and 538 non-menopausal asthmatic women, older than 18 years of age was available for analyses. The effect of menopause on asthma control, asthma quality of life, and all secondary endpoints was analyzed after conducting a Propensity Score matching with subsequent multivariate analysis using conditional logistic regression to adjust for the effect of the covariates that remained unbalanced after matching. Those unbalanced covariates were: the age at enrollment, gastroesophageal reflux disease, and hypertension.

Compared to non-menopaused women, menopaused women were older, reported more gastroesophageal reflux disease, sinusitis history and used more inhaled corticosteroids. They were less likely to have atopy or test positively on skin testing. Unadjusted analysis showed that menopaused women had an odds ratio of 5.62(95 CI: 3.83; 8.26) of severe asthma compared to non-menopaused women. They were more likely to require healthcare utilization. After Propensity Score matching with subsequent multivariate adjustment menopause was neither associated with greater incidence of severe asthma [OR:1.75 (95 CI: 0.52; 5.9)], or with a worse asthma quality of life [mean difference: 0.31 (95 CI: -0.30; 0.93)].

The increased unadjusted asthma severity, increased need for treatment and health care utilization in menopaused women are more likely due to other age associated co-morbidities and/or aging dependent conditions.

In elderly women, menopause is unlikely to be the reason for increased risk of severe asthma or worse quality of life.  

Reference

Zein J, Comhair S, Bleecker E, Busse W, Calhoun W, Castro M, Chung KF, Dweik R, Fitzpatrick A, Gaston B, Israel E, Jarjour N, Moore W, Teague G, Wenzel S, Erzurum S. The effect of aging and menopause on asthma severity in women. Chest. 2014 Mar 1;145(3 Suppl):22A. doi: 10.1378/chest.1783148.

Content updated March 2014

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