Women’s Health: Respiratory Conditions

Newly published Canadian research (Menopause ), connects later menopause to increase of asthma risk in women. The study, based on 10 years of follow-up data from over 14,000 postmenopausal women, showed 30% decreased risk of asthma in women with age at natural menopause.

Overall, there have been some studies connecting asthma and hormonal changes. For example, it’s been shown that women using hormone therapy had a 63% increased risk of asthma. Moreover, those who discontinued hormone therapy were twice as likely to stop their asthma treatment. However, the research on the topic is limited , few studies have investigated therapeutic response to COPD treatment according to sex.

While in childhood asthma is more prevalent in boys, adult-onset asthma is more common in women than in men.

Also, women often experience more severe symptoms and are less likely to see their asthma improve. 2/3 of all asthma deaths in the U.S. are among women.1 in 4 patients with COPD had persistent depressive symptoms over three years, and being female was associated with increases in the odds of persistent depressive.

What else do we know about how respiratory conditions manifest or affect women differently than men?

COPD:?

• Females with COPD experience significantly greater dyspnea and higher morbidity compared to males (Frontiers in Medicine , 2024)
• A range of reproductive factors, including age when periods first start and an early menopause, are all linked to a heightened risk of COPD (Thorax , 2024). Menopause before the age of 40 was associated with a 69% higher risk. Miscarriage (from 15% to 36%), stillbirth (42% more risk), infertility (13%), and having 3 or more children (34% more risk) are also associated with a heightened risk of COPD. The study is a collection of 27 observational studies, pooling individual level data from more than 850,000 women in 12 countries.

Lung cancer:?

• Lung cancer has been widely perceived as a disease that predominantly affects men. However, recent epidemiological data indicate that it is increasingly being diagnosed in women. Lung cancer diagnoses in women have increased by 84% in the last 43 years while decreasing by 36% in males, despite the fact that many of those women never smoked. Lung cancer in women between the ages of 35 and 54 is now more common than it is among men in the same age group. More women die from lung cancer than breast and ovarian cancers combined.
• Research has indicated that women with lung cancer have impaired DNA repair mechanisms compared to men. Furthermore, women are at an elevated risk of developing lung cancer with a driver mutation, particularly in the EGFR, ALK, and KRAS genes
• Lung adenocarcinoma is considered a different disease in women and men. It is strongly influenced by estrogen and is also different depending on the hormonal status of the patient: young women in more advanced stages at diagnosis exhibited more aggressive tumors, and showed poor survival compared to men and post-menopausal women ( Frontiers in Medicine , 2021)

Overall lung function:?

• ?menopausal women may experience an accelerated rate of decline in lung function (American Journal of Respiratory and Critical Care Medicine , 2017). The study collected over a 20-year period from 1,438 participants and showed that menopause was associated with accelerated impairment in lung function that exceeded the expected age-related decline.
• The changes associated with menopause and some hormone therapies can impact a woman’s voice. A study of 107 postmenopausal women, published in?Menopause, found 46% had voice changes and 33% associated these voice changes with discomfort and impact on quality of life.

Clearly,?the respiratory area is another example of why women's health should be approached across all therapeutic areas and not just women-specific conditions.