title: Menopause as a predictor of new-onset asthma: A longitudinal Northern European population study.
abstract: BACKGROUND
  There is limited and conflicting evidence on the effect of menopause on asthma.
  
  
  OBJECTIVE
  We sought to study whether the incidence of asthma and respiratory symptoms differ by menopausal status in a longitudinal population-based study with an average follow-up of 12 years.
  
  
  METHODS
  The Respiratory Health in Northern Europe study provided questionnaire data pertaining to respiratory and reproductive health at baseline (1999-2001) and follow-up (2010-2012). The study cohort included women aged 45 to 65 years at follow-up, without asthma at baseline, and not using exogenous hormones (n = 2322). Menopausal status was defined as nonmenopausal, transitional, early postmenopausal, and late postmenopausal. Associations with asthma (defined by the use of asthma medication, having asthma attacks, or both) and respiratory symptoms scores were analyzed by using logistic (asthma) and negative binomial (respiratory symptoms) regressions, adjusting for age, body mass index, physical activity, smoking, education, and study center.
  
  
  RESULTS
  The odds of new-onset asthma were increased in women who were transitional (odds ratio, 2.40; 95% CI, 1.09-5.30), early postmenopausal (odds ratio, 2.11; 95% CI, 1.06-4.20), and late postmenopausal (odds ratio, 3.44; 95% CI, 1.31-9.05) at follow-up compared with nonmenopausal women. The risk of respiratory symptoms increased in early postmenopausal (coefficient, 0.40; 95% CI, 0.06-0.75) and late postmenopausal (coefficient, 0.69; 95% CI, 0.15-1.23) women. These findings were consistent irrespective of smoking status and across study centers.
  
  
  CONCLUSIONS
  New-onset asthma and respiratory symptoms increased in women becoming postmenopausal in a longitudinal population-based study. Clinicians should be aware that respiratory health might deteriorate in women during reproductive aging.
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway. Electronic address: kai.triebner@uib.no.
authors.forename: Kai
authors.initials: K
authors.lastname: Triebner
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Ane
authors.initials: A
authors.lastname: Johannessen
authors.affiliation: Department of Electronic Engineering National University of Ireland, Maynooth, Ireland.
authors.forename: Luca
authors.initials: L
authors.lastname: Puggini
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
authors.forename: Bryndís
authors.initials: B
authors.lastname: Benediktsdóttir
authors.affiliation: Department of Occupational Medicine, University of Bergen, Bergen, Norway.
authors.forename: Randi J
authors.initials: RJ
authors.lastname: Bertelsen
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway.
authors.forename: Ersilia
authors.initials: E
authors.lastname: Bifulco
authors.affiliation: Allergy and Lung Health Unit, Melbourne School of Population Health, University of Melbourne, Melbourne, Australia.
authors.forename: Shyamali C
authors.initials: SC
authors.lastname: Dharmage
authors.affiliation: Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Dratva
authors.affiliation: Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
authors.forename: Karl A
authors.initials: KA
authors.lastname: Franklin
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Respiratory Medicine and Sleep, Landspitali-the National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: Thórarinn
authors.initials: T
authors.lastname: Gíslason
authors.affiliation: Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mathias
authors.initials: M
authors.lastname: Holm
authors.affiliation: Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, United Kingdom.
authors.forename: Deborah
authors.initials: D
authors.lastname: Jarvis
authors.affiliation: Inserm UMR1152 Team of Epidemiology, Paris, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Leynaert
authors.affiliation: Department of Medical Sciences, Lung Medicine and Allergology, Uppsala University, Uppsala, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lindberg
authors.affiliation: Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.
authors.forename: Andrei
authors.initials: A
authors.lastname: Malinovschi
authors.affiliation: Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ferenc
authors.initials: F
authors.lastname: Macsali
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, University of Uppsala, Uppsala, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Norbäck
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Ernst R
authors.initials: ER
authors.lastname: Omenaas
authors.affiliation: Department of Applied Mathematics, Málaga University, Málaga, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Rodríguez
authors.affiliation: Department of Occupational Medicine, University of Bergen, Bergen, Norway.
authors.forename: Eirunn
authors.initials: E
authors.lastname: Saure
authors.affiliation: Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Vivi
authors.initials: V
authors.lastname: Schlünssen
authors.affiliation: Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Sigsgaard
authors.affiliation: Department of Occupational Medicine, University of Bergen, Bergen, Norway.
authors.forename: Trude D
authors.initials: TD
authors.lastname: Skorge
authors.affiliation: Department of Medical Sciences, Occupational and Environmental Medicine, University of Uppsala, Uppsala, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Wieslander
authors.affiliation: Department of Public Health and Epidemiology, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Zemp
authors.affiliation: Department of Occupational Medicine, University of Bergen, Bergen, Norway.
authors.forename: Cecilie
authors.initials: C
authors.lastname: Svanes
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway; Core Facility for Metabolomics, University of Bergen, Bergen, Norway.
authors.forename: Steinar
authors.initials: S
authors.lastname: Hustad
authors.affiliation: Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gómez Real
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology; D001249:Asthma / Q000097:blood / Q000453:epidemiology*; D004958:Estradiol / Q000097:blood; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000097:blood; D008875:Middle Aged; D016017:Odds Ratio
chemical_list: D004958:Estradiol
keywords: Amenorrhea; Respiratory Health in Northern Europe; asthma; estrogens; longitudinal; menopausal asthma; menopause; reproductive aging; respiratory symptoms; sex hormones