Menopause is associated with accelerated lung function decline in the longitudinal European community respiratory health survey

Background: Menopause is associated with profound changes of hormone levels, possibly affecting immunity and inflammation, which may impair lung function. To date the effect of menopause on the age dependent decline of lung function has not been investigated. Objectives: To study whether the slope of lung function decline, in terms of forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1 ) is steeper for women who undergo menopause. Methods: The European Community Respiratory Health Survey (ECRHS), a population-based longitudinal study, provided serum samples, repeated spirometric data and questionnaire information about respiratory and reproductive health. We measured follicle stimulating hormone (FSH) and luteinizing hormone (LH) to determine the menopausal status using latent class analysis based on these measurements and questionnaire data. The associations with lung function were analyzed using linear mixed effects models, adjusted for age, height and weight at each wave, as well as smoking habits and age at completed full-time education (N=978). Results: Postmenopausal status was associated with significantly accelerated FVC decline (Early postmenopause: -5.3 ml/year [95%CI (-7.6 to -3.0)] and Late postmenopause: -7.6 ml/year (-9.9 to -5.2) compared to women of the same age with regular menstruations. There was no association between menopause and FEV 1 . Results were consistent across study centers and among never smokers. Conclusions: FVC decreased more strongly among postmenopausal women in this population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging.