New Asthma Around Menopause?What Studies Show About HRT

Asthma is often thought of as a childhood condition, but some women first develop it in midlife. Because hormones shift so much around menopause, researchers have looked at both menopause itself and hormone therapy. The findings don’t line up neatly.

Does menopause itself raise the risk?

Northern Europe. Researchers followed 2,322 women aged 45 to 65 without asthma and not using hormones, for about 12 years.¹

Stage at follow-up	Odds of new asthma, versus not yet in menopause
In the transition	About 2.4 times1
Early postmenopause	About 2.1 times1
Late postmenopause	About 3.4 times1

The pattern held regardless of smoking.¹

United States, an older study. In a cohort followed through the 1980s, postmenopausal women who had never used hormones had a lower risk of asthma than women before menopause.² So even the menopause question has conflicting answers; the Northern European authors themselves describe the evidence as limited and conflicting.¹

Does hormone therapy raise or lower it?

Study	Women	Finding
US cohort, 1980s	Pre- and postmenopausal women aged 34 to 682	Any HRT use: about 1.5 times the risk; 10+ years: about double2
France	57,664 women3	Raised risk mainly with estrogen alone, about 1.5 times; a small rise with combined HRT3
UK, 2000 to 2016	353,173 women aged 46 to 704	Current HRT use went with about 20% lower risk, and longer use with lower risk still4

Making sense of it

All of these are observational studies, so none can prove hormones cause or prevent asthma. They differ in era, in the hormone products used, and in how asthma was recorded. The UK authors called for more studies to confirm their result.⁴

What it means for you:

• New breathlessness, wheeze or a cough at night in midlife deserves a check; don’t assume it’s just menopause or just age.
• If you’re weighing HRT, asthma isn’t a clear reason for or against it on current evidence. Mention your breathing history so it’s part of the decision. See is menopause hormone therapy safe?
• If your asthma changed after starting or stopping HRT, note the dates and tell your doctor.

Try: “I’ve started wheezing and coughing at night for the first time in my fifties, and I began HRT last year. Could the two be linked, and should I have my breathing tested?”

My Body Changed. Now What? covers bringing changes like this to an appointment in Chapter 6, “Nights, Moods and Lost Words,” in a section called “The Visit Brief.” The Visit Brief puts your stage, top three changes, and health and family history on one page, so a new symptom gets a proper look. See the book.