The effects of hormone replacement therapy type on pulmonary functions in postmenopausal women
Introduction
Hypoestrogenism in menopause leads to a number of problems. Estradiol levels do not gradually decrease in the years before menopause, but remain in the normal range, and even slightly elevate [1]. Although new evidence about its benefits and harms requires reconsideration [2], [3], hormone replacement therapy (HRT) in the postmenopausal period is still in use because of its positive effects on treatment of menopausal symptoms, prevention of osteoporosis and colorectal cancer [3]. In studies on the effect of sex steroids on the respiratory system, there is evidence, which suggests that estrogen and progesterone may play a role in modifying pulmonary functions in young women [4], [5]. But, there is limited knowledge about the relationship between HRT and pulmonary functions in postmenopausal women. Menopause is generally associated with exacerbation of pre-existing asthma and, in addition, it may coincide with the clinical beginning of asthma [6]. One such study showed that estrogen therapy is associated with an inhibitory effect on the airway reactivity of bronchial smooth muscle [7]. In another study, which is a cross-sectional study, it was reported that postmenopausal women who used HRT had higher levels of forced expiratory volume (FEV1) and less airway obstruction, and that combined estrogen+progesterone users had higher pulmonary function levels than both nonusers and unopposed estrogen users [8]. However, we have encountered no study examining baseline spirometry values both before and after the initiation of HRT. Therefore, the purpose of this study was to determine the effects of HRT on pulmonary function in postmenopausal women and compare these effects for different HRT protocols.
Section snippets
Methods
Patients, who were admitted to the menopause clinic of our department for routine examinations and had never previously received HRT, were included in the study. All patients’ hormonal patterns were consistent with the menopausal period, i.e. increased plasma level of FSH and LH and decreased plasma levels of E2 [<20 pg/ml]. The patients’ current age, age at menopause, weight, height, and body mass index (BMI) were recorded. Patients with a cardiovascular system disease, metabolic disease,
Results
The patients’ current age, age at menopause, and BMI are shown in Table 1. There was no statistically significant difference between the groups regarding age, BMI and the duration of menopause (P>0.05). The groups’ pre- and post-therapy respiratory function parameters are shown in Table 2. While evaluating the pulmonary functions FVC, FEV1, FEV1/FVC, FEF25–75% and PEF, group x treatment period (pre- and post- treatment) interaction was not statistically significant, P values being 0.137, 0.164,
Discussion
In the present study, the effects of three different treatment protocols, namely estrogen, estrogen+progesterone, and tibolone, on respiratory function were compared. To the best of our knowledge, this is the first prospective, randomized study to examine the relationship between HRT use and pulmonary function in postmenopausal women.
The mean values of PFT parameters were in the normal range in this study. Regardless of HRT types, a significant increase was observed in FVC and FEV1 after 3
Conclusions
We determined a significant increase in FVC and FEV1 parameters of pulmonary functions after 3 months of treatment regardless of HRT type. These functional changes may imply that HRT regimens have modifying effects on pulmonary function in postmenopausal women.
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