During the last decades female life expectancy has risen
far beyond 50 years worldwide. This means that the quality of life after
menopause is highly relevant today. Menopause implies profound hormonal and
metabolic changes leading to higher risk of diabetes and cardiovascular
diseases. Although researchers are increasingly aware that hormonal status and
inflammation may also deteriorate respiratory health, our knowledge is very
scarce. So far, no prospective study had investigated whether menopause
increases the risk of asthma in the general population.
However, the empirical research, performed by Triebner and colleagues confirmed that menopause might increase the risk for developing asthma. They used data from the “Respiratory Health in Northern Europe” study, which included 2,322 women from random population samples in Norway, Iceland, Sweden, Denmark, and Estonia. These women provided information on their respiratory health and menopausal status in 2000 and 2012.
The researchers studied the association between menopausal status and newly diagnosed asthma, after the age of 44. They found that the odds of getting asthma were more than twice as high for women going through the menopausal transition or after menopause, compared to non-menopausal women. The risk was particularly high for overweight and obese women. The results were not due to general aging and were independent of smoking and geographical location.
However, the empirical research, performed by Triebner and colleagues confirmed that menopause might increase the risk for developing asthma. They used data from the “Respiratory Health in Northern Europe” study, which included 2,322 women from random population samples in Norway, Iceland, Sweden, Denmark, and Estonia. These women provided information on their respiratory health and menopausal status in 2000 and 2012.
The researchers studied the association between menopausal status and newly diagnosed asthma, after the age of 44. They found that the odds of getting asthma were more than twice as high for women going through the menopausal transition or after menopause, compared to non-menopausal women. The risk was particularly high for overweight and obese women. The results were not due to general aging and were independent of smoking and geographical location.
Adult-Onset Asthma
Asthma symptoms in older adults may seem like other
illnesses or diseases, such as a hiatal hernia, stomach issues, rheumatoid
arthritis and chronic obstructive pulmonary disease. Doctors may misdiagnose
asthma since most adults lose lung capacity starting in middle age. However,
untreated asthma may cause greater loss in your lung function.
The signs of adult onset asthma include the following:
·
A dry cough that happens during the night or due
to specific triggers.
·
Tightness in the chest
·
Difficulty breathing
·
Wheezing when exhaling
·
Experiencing shortness of breath after
exercising.
·
Colds that extend for 10 days
·
Colds that go into the chest.
Hormonal fluctuations can increase mucus production in
the upper and lower airways making it harder for the lungs to expel air and
worsen symptoms. Studies show there is an increase in near-fatal asthma cases
during the first four days of the menstrual cycle. So, the similar negative
health related disturbance might affect a woman during menopausal transition,
when all hormone levels wildly fluctuate and eventually decrease.
Estrogen supplements also may be a contributor to asthma.
In fact, the Asthma and Allergy Foundation of America stated that researchers
have found that women who take estrogen supplements for a decade following
their last menstrual period are 50 percent more likely to develop asthma than
postmenopausal women who have never used estrogen.
Diagnosing Asthma
The process of diagnosing asthma is the same for people
of all ages. Common symptoms of asthma include:
·
Coughing, especially at night
·
Wheezing
·
Shortness of breath
·
Tightness in your chest
Symptoms can be mild to severe and often stop and start.
Symptoms are usually worse at night.
If you suspect you may have asthma, discuss your symptoms
with your healthcare practitioner. At an older age, symptoms of asthma are
often confused with those of a common cold or cough. Wheezing and shortness of
breath can also be caused by many other conditions and lung diseases including
vocal cord dysfunction and pulmonary edema, a disease caused by heart failure.
Treatments are very different so a correct diagnosis is important. Be prepared
for your doctor to ask the following questions:
During the past 12 months, have you:
·
Had a sudden, severe episode or recurrent
episodes of wheezing, coughing or shortness of breath?
·
Had colds that “go to the chest” taken more than
10 days to get over?
·
Had wheezing, coughing or shortness of breath
only when you’re in certain places, such as your home workplace or outdoors?
·
Had wheezing, coughing, shortness of breath when
exposed to certain substances such as pollen, tobacco smoke, cat dander or
perfume?
·
Used any medications that help you breathe
better? If so, how often did you use them and how well did they work?
In the past four weeks, have you had wheezing, coughing
or shortness of breath.
·
At night that has awakened you?
·
In the early morning?
·
After running, moderate exercise or other
physical activities?
Be prepared to talk about your family health history as
asthma is a hereditary disease. After analyzing your symptoms and history of
symptoms, your healthcare provider will probably follow-up with a physical
examination.
Physical examinations usually include a variety of ways
to find out if allergies are triggering your symptoms. By listening to your
lungs with a stethoscope, healthcare providers can hear wheezing or other signs
of obstructed airways. Your healthcare provider will also looks up your nose
for nasal secretions, swelling or polyps which are other signs of allergies.
Your skin may be examined for other conditions that are associated with asthma
such as eczema or hives.
An important step in diagnosing asthma includes pulmonary
(lung) functioning tests. There are three tests that can directly measure your
breathing:
1. Spirometry-
This test determines how well you breathe by measuring how much air your lungs
hold. It takes 10 to 15 minutes and requires you to take deep breaths and
forcefully exhale into a hose connected to a machine called a spirometer.
2. Challenge
Test- With this assessment, you are required to deliberately inhale an
airway-constricting chemical or take a few breaths of very cold air. After
inhaling this substance, you retake the spirometry test.
3. Peak
Expiratory Flow- Like the spirometry test, this test measures how well you
breathe. You are required to forcefully blow into a peak flow meter (a small,
hand held device that measures the rate at which you can force air out of your
lungs).
4. If
you are diagnosed with asthma, you will probably need to monitor your peak flow
over a six to eight week period as you take asthma medications. The good news
is asthma is a treatable condition.
Manage Your Asthma by Controlling Symptoms
You can control your symptoms of asthma by reducing or
eliminating allergens from your environment. Avoid indoor and outdoor allergens
and irritants. There are many ways to go about this including the following:
·
Optimize your exercise routine - The Asthma
Society of Canada warns that if you have any limitations in your ability to
exercise due to asthma, your asthma is not being properly controlled. If this
is the case, you actually may experience worsening symptoms so it’s important
to focus on working with your doctor to control your asthma before you start
exercising. Furthermore, you might experience exercise-induced asthma which
strikes 5-10 minutes after exercising. This situation occurs because of
humidity and temperature changes in the body’s airways. Triggers include length
of time spent exercising, the temperature and humidity while exercising, and
triggers such as allergens and air pollution that are present in the air.
However, it’s also important to get regular exercise since physical activity
will improve your heart and lung function. Therefore, work with your doctor to
come up with an exercise regimen that’s right for your situation.
·
Give your lungs a break, STOP SMOKING. Your
lungs are working over time and are trying to send you a message.
·
Diet - The George Mateljan Foundation reports
that eating a Mediterranean diet can provide antioxidant support that promotes
respiratory health. Additionally, nutrients such as magnesium, selenium,
omega-3 fatty acids, vitamin C, vitamin E and beta-carotene are believed to
enhance lung function. Foods to consume regularly include organically grown
fruits and vegetables, especially apples, garlic, onions, chard, spinach,
broccoli, parsley, bell peppers, strawberries, cauliflower, lemons, romaine
lettuce, mustard greens, Brussel sprouts, papaya, turnip greens, kale, cabbage,
kiwifruit, cantaloupe, oranges, grapefruit, tomatoes, collard greens,
raspberries, peppermint leaves, asparagus, celery, fennel bulb, pineapple,
winter squash, apricots, guava, persimmons, crimini mushrooms, and watermelon.
Other beneficial foods include tea, calf liver, cold water fish (cod, salmon,
mackerel, herring and halibut), shrimp, snapper, yellowfin tuna, sunflower
seeds, flax seeds, extra virgin olive oil, rosemary, cayenne pepper,
ginger and turmeric. Foods to avoid eating include milk and other dairy
products as well as eggs. The foundation also warns against eating a diet that
is high in vegetable oils (such as corn oil and safflower oil), farm-raised
meats, margarine, salt and artificial food additives (such as food colorings
and preservatives) since these foods are associated with increased rates of
asthma
·
Manage the healthy weight. Women with a body
mass index lower than 23 had four times the risk of respiratory symptoms.
Problems were also pronounced in women who were overweight.
Although estrogen is reduced in
all women following menopause, thinner women have the lowest amounts, the
researchers said. At the menopause, the fat cells become the main source of
estrogen, and those who have more fat cells will have higher levels of the
hormone, which seems to protect the lungs. But in very overweight women, it
appears that the protective effects of estrogen are outweighed by other factors
such as the labor of carrying extra weight affecting breathing. This happens to
a smaller extent in women who are overweight versus those who have a low body
mass.
·
Reduce other triggers
The potential triggers include
pets (due to their dander, saliva, oil secretions, urine and feces), pollution,
pollens, cold air, and indoor hazards such as dust mites, cockroaches, mold and
chemical fumes.
o Reduce
pet allergens by dusting and cleaning often
o Lower
mold allergens by making sure bathrooms, kitchens and basements have good air
circulation and are cleaned often.
o Reduce
dust mites by washing all bedding every week in hot water, removing carpeting,
cleaning fabrics and curtains often and cutting down the humidity.
o Cover
mattresses with a mattress pad
o Use
air filters and air conditioners
o Vacuum
often
Also, a variety of prescription medications are
available. Asthma sufferers can enjoy healthy, active lives by controlling
their symptoms. Medicines can help keep the air tubes in your lungs open. Two
forms of asthma medications are available including bronchodilators and
anti-inflammatories.
Asthma attacks can be controlled and prevented by taking bronchodilators. Anti-inflammatories help keep your air tubes open to prevent attacks. Many forms are available including sprays, pills, powders, liquids and shots. Discuss all treatment options with your healthcare provider so you can be in control of your asthma. Also, drink lots of water.
Asthma attacks can be controlled and prevented by taking bronchodilators. Anti-inflammatories help keep your air tubes open to prevent attacks. Many forms are available including sprays, pills, powders, liquids and shots. Discuss all treatment options with your healthcare provider so you can be in control of your asthma. Also, drink lots of water.
Estrogen
Replacement Therapy
Studies presented to the Annual Congress of European
Respiratory Society in Stockholm, are the first to show that hormone
replacement therapy may have a significant role in lung protection and repair.
Christiana Dimitropoulou-Catravas, PhD, Assistant
Professor in the Department of Pharmacology and Toxicology at the Medical
College of Georgia, US, who was the lead author on a study investigating the
role of estrogen in asthma, explains that by stabilizing estrogen levels,
inflammation and asthma may be better controlled.
Dimitropoulou-Catravas says that “fluctuating estrogen
levels can activate proteins that produce an inflammatory response, which can
bring on asthma symptoms. With any medication, it’s a balance of risk vs.
benefit. Estrogen replacement therapy, which can bring estrogen levels into
balance, has been associated with an increased cardiovascular risk, such as a
higher risk of stroke. But if someone has severe asthma and it can be linked to
low levels of estrogen, replacement therapy might be an answer.”
The Mayo Clinic states that “hormone replacement therapy
may improve asthma symptoms in women who have gone through the menopause but
point out that studies remain conflicting as hormone replacement appears to
worsen asthma in some women.”
Sources and
Additional Information:
