A recent study published in Thorax highlights the increased risk of lung diseases and poor outcomes associated with early menopause among smokers. Conducted by Xiaochun Gai, M.B.B.S., and colleagues from the University of New Mexico School of Medicine, the study examines the impact of early menopause, particularly due to surgery, on lung morbidities and mortalities, and evaluates the protective role of menopausal hormone therapy (MHT) against lung diseases.

Study Overview

The analysis included data from 69,706 postmenopausal women, focusing on the relationship between early menopause and lung health outcomes. The study specifically assessed the effects of early menopause due to bilateral oophorectomy (BO) and natural menopause on lung disease risks and mortality rates among smokers and non-smokers.

Key Findings

Early Menopause and Lung Disease Risk

• Increased Risk for Smokers: Early menopause was linked to a heightened risk for most lung diseases and mortality outcomes in ever smokers. The highest risk was observed for respiratory mortality, with a hazard ratio of 1.98 in those who underwent BO.
• Non-Smokers and Natural Menopause: Among never smokers with natural menopause or BO, there was a positive association between early menopause and chronic bronchitis, as well as all-cause, noncancer, and respiratory mortality. The highest risk was noted for BO, with a hazard ratio of 1.91 for respiratory mortality.

Menopausal Hormone Therapy (MHT)

• Protective Effects Across Menopause Types: Ever MHT use was associated with reduced all-cause, noncancer, and cardiovascular mortality, regardless of smoking status.
• Specific Benefits for Smokers: Among smokers, MHT was linked to a reduced risk for nonovarian cancer, lung cancer, and respiratory mortality. The reduction in hazard ratio for all-cause, noncancer, and cardiovascular mortality was observed in a duration-dependent manner.

Implications

The study suggests that smokers experiencing early menopause should be prioritised for smoking cessation programs and lung cancer screening, irrespective of the type of menopause. The findings underscore the potential benefits of MHT in reducing mortality risks associated with lung diseases, particularly among smokers.

Source

PracticeUpdate