Early natural menopause increases risk of lung disease and death in women who smoke

August 19, 2022

2 minute read


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According to data published in the American Journal of Obstetrics and Gynecology.

The data also showed that women who continued to smoke had worse outcomes than those who quit.




Data derived from Zhai T, et al. Am J Obstet Gynecol. 2022; doi:10.1016/j.ajog.2022.07.031.

“These findings have strong clinical and public health relevance, as preventive strategies, including smoking cessation and CT lung screening, should target this population (i.e. female smokers with natural early menopause) to improve their health and well-being after menopause” Shuguang LongMBBSPhD, an assistant professor in the department of internal medicine at the University of New Mexico in Albuquerque, told Healio.

Leng and colleagues assessed the impact of early menopause on lung health, lung cancer risk, all-cause mortality, and cause-specific mortality in 1,666 former or current moderate-to-heavy smokers who were enrolled in the Pittsburgh Lung Screening Study. Most participants were non-Hispanic Caucasian (91.2%) and current smokers (63.9%), with a mean age of 59.4 ± 6.7 years.

Early menopause was reported by 19.1% of 1038 women who experienced natural menopause and 71.3% of 628 women who underwent surgical menopause, with no significant differences in demographics between early and non-early menopause. early, regardless of the type of menopause.

Lung health

Shuguang Leng, MBBS, PhD

Shuguang Long

Among women with natural menopause, those who experienced early menopause were more likely to have self-reported wheezing (OR = 1.65; 95% CI, 1.18-2.3), to have diagnosis of chronic bronchitis (OR=1.73; 95% CI, 1.19-2.53) or CVD (OR=1.87; 95% CI, 1.13-3.11), radiographic emphysema ( OR = 1.7; 95% CI, 1.25-2.31) and incident airway obstruction (OR = 2.02; 95% CI, 1.03-3.96) .

Compared to other women who had a surgical menopause, those who had an early menopause did not have a greater risk for these outcomes, with the exception of cardiovascular disease diagnosed by a doctor (OR = 4.03; CI at 95%, 1.78-9.14).

Early natural menopause was associated with lower lung function and a more rapid decline in lung function compared to non-early natural menopause. These associations were not observed between women with early and non-early surgical menopause.

Cancer and mortality

Women who experienced early natural menopause had a higher risk of all-cause mortality (HR = 1.4; 95% CI, 1.05-1.86) than other women who experienced unnatural menopause. early, mainly due to respiratory death (HR = 2.32; 1.52-3.52). Early menopause in this group was also associated with an increased risk of cancer mortality (HR=1.74; 95% CI, 1.11-2.74) and lung cancer mortality in particular (HR=1 .94; 95% CI, 1.05-3.58).

Although the trends were similar among women with early and non-early surgical menopause, none of the differences were significant, according to the study.

Smoking status, time of menopause

Analyzes of smoking status and timing of menopause in women with natural menopause revealed that women who experienced early menopause and who were current smokers had the highest risk of lung cancer (HR = 4.65; 95% CI, 2.55-8.49) and cancer mortality (HR = 4.61; 95% CI, 2.63-8.07) compared to women who had non-early menopause and who had quit smoking.

Going forward, Leng expressed interest in exploring whether lung cancer screening recommendations for women who smoke or currently smoke could be improved by taking into account the type and timing of menopause.

“We would also like to assess whether the results can be generalized to smokers with unnatural menopause, for example, women undergoing oophorectomy and/or hysterectomy,” Leng said.

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