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 Past research has shown that young women can boost their lung
function through their mid-twenties by following a healthy lifestyle
that includes getting plenty of aerobic exercise and avoiding
cigarettes. After that, lung function declines gradually, and the
process can be sped up when people smoke or carry excess fat around
their midsection.
"Our study adds, that with increasing reproductive age slope of
decline becomes steeper and the decline becomes faster, and it
accelerates beyond the age-related expectations," said lead study
author Kai Triebner, a researcher at the University of Bergen in
Norway.
The good news for women is they can take steps to manage their
respiratory health early in life to limit the potential for declines
in lung function with menopause to lead to meaningful health
problems, Triebner added by email.
"Generally speaking you cannot build up lung function again unless
the loss was due to a medical condition, but you can manage the
decline," Triebner added.
Women go through menopause when they stop menstruating, which
typically happens between ages 45 and 55. As the ovaries curb
production of the hormones estrogen and progesterone in the years
leading up to menopause and afterwards, women can experience
symptoms ranging from irregular periods and vaginal dryness to mood
swings and insomnia.
For the current study, researchers examined data on 1,438 women who
were followed for 20 years starting when they were between 25 and 48
years old.
None of the women had started going through menopause when they
joined the study. By the end, they had either started or completed
the process of going through menopause.
To assess shifts in lung function tied to menopause, researchers
examined what's known as forced vital capacity (FVC), a measure of
lung size, as well as forced expiratory volume (FEV1), or how much
air can be pushed out of the lungs in one second.
Lung function decline was faster during the transition to menopause
and sped up even further after menopause, compared to when women
were still menstruating, researchers report in the American Journal
of Respiratory and Critical Care Medicine.
For example, transitional women lost about 10 milliliters of forced
vital lung capacity more per year than pre-menopausal women, and
after menopause women lost a mean of 12 ml/year more.
For forced vital capacity, the decline after menopause was
comparable to smoking 20 cigarettes a day for 10 years, the study
found.
With forced expiratory volume, the decline after menopause was
comparable to smoking 20 cigarettes a day for two years.
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The more pronounced decline in forced vital capacity compared to
forced expiratory volume suggests that menopause may be more likely
to lead to what's known as restrictive breathing problems, such as
sarcoidosis, that make it difficult to fully expand the lungs when
inhaling, rather than breathing problems such as chronic obstructive
pulmonary disorder (COPD) that make it difficult to exhale air from
the lungs, the authors conclude.
The study is observational and doesn't prove menopause directly
causes breathing problems, the authors note.
While the findings don't explain why lung function dropped for women
after menopause, it's possible that hormonal changes during this
time that are linked to systemic inflammation may also trigger lung
function declines, the authors point out.
Hormonal changes are also implicated in osteoporosis, which shortens
the height of the chest vertebrae and may, in turn, limit the amount
of air a person can inhale.
Both before and after menopause, though, the rate of decline in lung
function is slow, and may only be significant in women with lung
disease, said Dr. David Jacoby, a researcher at Oregon Health and
Science University in Portland who wasn't involved in the study.
"Someone with lungs damaged by smoking who has no symptoms at age 30
may have symptoms of her lung disease later in life as her lung
function declines with age," Jacoby said by email. "The message, an
obvious one, is to avoid smoking to avoid damaging your lungs, and
if you have chronic lung disease, take your medications to keep your
lung function as good as possible."
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