• Kai Triebner, Bobette Matulonga, Ane Johannessen, Sandra Suske, Bryndís Benediktsdóttir, Pascal Demoly, Shyamali C Dharmage, Karl A Franklin, Judith Garcia-Aymerich, José Antonio Gullón Blanco, Joachim Heinrich, Mathias Holm, Debbie Jarvis, Rain Jõgi, Eva Lindberg, Jesús Martínez Moratalla Rovira, Nerea Muniozguren Agirre, Isabelle Pin, Nicole Probst-Hensch, Luca Puggini, Chantal Raherison, José Luis Sánchez-Ramos, Vivi Schlünssen, Jordi Sunyer, Cecilie Svanes, Steinar Hustad, Bénédicte Leynaert, and Gómez RealFranciscoF1 Department of Clinical Science.32 Department of Gynecology and Obstetrics, University of Bergen, Bergen, Norway..
• 1 Department of Clinical Science.
• Am. J. Respir. Crit. Care Med. 2017 Apr 15; 195 (8): 1058-1065.

RationaleMenopause is associated with changes in sex hormones, which affect immunity, inflammation, and osteoporosis and may impair lung function. Lung function decline has not previously been investigated in relation to menopause.ObjectivesTo study whether lung function decline, assessed by FVC and FEV1, is accelerated in women who undergo menopause.MethodsThe population-based longitudinal European Community Respiratory Health Survey provided serum samples, spirometry, and questionnaire data about respiratory and reproductive health from three study waves (n = 1,438). We measured follicle-stimulating hormone and luteinizing hormone and added information on menstrual patterns to determine menopausal status using latent class analysis. Associations with lung function decline were investigated using linear mixed effects models, adjusting for age, height, weight, pack-years, current smoking, age at completed full-time education, spirometer, and including study center as random effect.Measurements And Main ResultsMenopausal status was associated with accelerated lung function decline. The adjusted mean FVC decline was increased by -10.2 ml/yr (95% confidence interval [CI], -13.1 to -7.2) in transitional women and -12.5 ml/yr (95% CI, -16.2 to -8.9) in post-menopausal women, compared with women menstruating regularly. The adjusted mean FEV1 decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) in post-menopausal women.ConclusionsLung function declined more rapidly among transitional and post-menopausal women, in particular for FVC, beyond the expected age change. Clinicians should be aware that respiratory health often deteriorates during reproductive aging.

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