For a natural life event, menopause brings a wide variety of symptoms. As if hot flashes, vaginal dryness and mood swings weren't enough, a study presented at the 2007 Congress of the European Respiratory Society in Stockholm, Sweden, announced that women no longer menstruating have an 84 percent greater incidence of asthma. The team found that women going through menopause have a new reason to consider hormone replacement therapy and to watch their weight.
Asthma Symptoms and BMI
In studying the effects of menopause and weight, Dr. Gomez-Real's colleagues used a specific set of eight asthma symptoms. They were wheezing; wheezing with breathlessness; wheezing when not having a cold; waking with tightness in the chest; shortness of breath in the daytime; shortness of breath after strenuous activity; waking with shortness of breath; and waking by an attack of coughing. Women with three of these symptoms in the 12 months before the study were considered to have asthma, and this is the same criteria a woman can use in evaluating her own symptoms.
In adults, asthma usually occurs because of inflamed airways from increased insulin resistance. When very thin women, those with a body mass index (BMI) of less than 23, go through menopause, their lack of body fat leaves them without the ability to produce any supplemental estrogen. This causes an increase in insulin resistance. On the other end of the spectrum, women with a BMI over 27 have an increase in insulin resistance directly because of their obesity. This is especially true if they have a waist circumference greater than 35 inches. This means a 5-foot, 5-inch woman weighing less than 138 pounds or more than 162 pounds has an elevated risk of postmenopausal asthma.
Gomez-Real's study found that hormone replacement therapy was an effective way to decrease asthma symptoms, making asthma symptoms another factor that women and their physicians need to consider when weighing the risks and benefits of short-term hormone replacement therapy, or HRT.
Even though HRT was shown to decrease asthmatic inflammation, it carries significant health risks and should not be used more than a few years after menopause. When HRT is discontinued, asthma symptoms will reoccur unless the woman has decreased her insulin resistance by weight management and exercise.
Urinary Symptoms of Asthma
One way that asthma presents in older women is urinary incontinence. Between 16.1 percent and 38 percent of American woman between 40 and 60 have episodes of urinary incontinence, yet only 54 percent of these women ever mentioned the problem to their doctors, according to research presented by Murray M. Finkelstein, Ph.D., M.D., in the January 2002 edition of "Canadian Family Physician." Besides finding that asthma increased the risk of urinary incontinence by 30 percent, Finkelstein also discovered a strong relationship in post-menopausal women between diabetes and incontinence. Because both type 2 diabetes and adult onset asthma are caused by insulin resistance, the same strategies used to reduce asthma symptoms---weight loss and decreasing sugar in the diet---also might improve urinary incontinence.
Stress incontinence---urination while coughing or wheezing---was also noted to be more common in older women with asthma because of coughing.
Learning to tighten the muscles that prevent urination, an exercise known as Kegels, might bring women some degree of relief from urinary incontinence. Medications aimed at decreasing bladder irritability are also available.
Emotional Symptoms of Asthma
Asthma causes hypoxia, or a decreased amount of oxygen in the blood. Without associating the two experiences, an older woman might dismiss signs such as becoming easily frustrated, having increased irritability or experiencing extreme fatigue as simply being signs of the menopausal transition. But perhaps the most common way asthmatic hypoxia presents is anxiety, either in a generalized form or in panic attacks.
Researchers from Malta, writing in the February 2010 issue of "Therapeutic Advances in Respiratory Disease," found that 51.5 percent of clients with asthma had the cardinal signs of an anxiety disorder.
References
- "Journal of Allergy and Clinical Immunology"; Lung Function, Respiratory Symptoms and the Menopausal Transition; Fransisco Gomez-Real, M.D. et al; January 2008
- "Canadian Family Physician"; Medical Conditions, Medications and Urinary Incontinence; Murray M. Finkelstein; anuary 2002
- "Therapeutic Advances in Respiratory Disease"; Anxiety and the Management of Asthma in an Adult Outpatient Population; Anthony G. Fenech, M.D. et al; February 2010
