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HRT may preserve lung function in middle-aged women

Elvira Manzano
21 Sep 2017

Hormone replacement therapy (HRT) may help delay lung function decline in middle-aged women, according to results of a longitudinal analysis presented at ERS Congress 2017, demonstrating a possible role for female sex hormones in the preservation of lung function.

“Lung function peaks during the mid-20s, and from then on it will go down,” said lead investigator Dr Kai Triebner, a postdoctoral fellow at the University of Bergen in Bergen, Norway. “However, it is possible to identify which factors influence the decline – either by slowing it down, or accelerating it. One accelerating factor, for example, is the menopause. Therefore, a key question is whether HRT could, at least partly, counteract it.”

Triebner and his team sought to analyse spirometry data of 3,713 European women participating in the European Community Respiratory Health Survey who were followed for an average of 20 years (1990 to 2010). Women who took oral HRT for 2 years or longer (n=236) were matched with women who never took HRT (n=236) for age, height, age at menopause, smoking history, and baseline lung function. The women were nonmenopausal at baseline and postmenopausal at study end. Mean age in 2010 was 59 years. Lung function was assessed at baseline and 20 years later. [ERS 2017, abstract OA4420]

Women who had oral HRT for 2 years or longer performed better in lung function tests as assessed by forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) compared with nonusers. Long-term use of HRT was associated with less lung function decline (-56.7 mL for FEV1 and -65.6 mL for FVC) compared with nonuse.  

The results may not be clinically significant in healthy women, said Triebner. “However, in women who are suffering from airway diseases, the decline in lung function may influence quality of life, as it could lead to an increase in shortness of breath, reduced work capacity, and fatigue.”

“To put these findings in context, if a woman smoked a pack of cigarettes a day for 3 years, the loss of FVC would correspond roughly in size to 46 mL,” he further elucidated.

Of note, physical activity and surgical menopause were not significantly associated with lung function decline. “However, in my personal opinion, physical exercise is still desirable.”

There have been safety concerns on the use of HRT. Debates are still ongoing hence, it may be too early to recommend this therapy in the lung-health setting. Trieber clarified that he is not advocating for HRT though and that their findings merely offer more information that can help women and their physicians in making the right treatment decisions. 

 

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