The association of asthma, atopy and lung function with hormone replacement therapy and surgical cessation of menstruation in a population-based sample of English women

Gynaecological surgery that may lead to cessation of menstruation is a major indication for the use of hormone replacement therapy (HRT) which in turn has been associated with asthma. Information on asthma-like symptoms, lung function and immunoglobulin E (IgE) sensitization to house dust mite (HDM) and on menstrual status and use of HRT was collected from 3724 women aged between 35 and 64 years living in England. Association of health outcomes with use of HRT and with surgery resulting in cessation of menstruation was examined in multivariable models. Over a third of women who had ever used HRT had undergone surgery resulting in cessation of menstruation. Current use of HRT was associated with frequent wheeze, particularly in lean women [body mass index (BMI) < 25; odds ratio (OR) 1.90; 95% confidence interval (CI) 1.17-3.05; BMI 25+; OR 1.02; 95% CI 0.69-1.51]. Wheeze was associated with the reporting of menstrual cessation that was due to surgery even if women denied ever using HRT (OR 1.55; 95% CI 1.09-2.20). There was some evidence that HRT use was associated with airway obstruction in leaner women but little evidence that it was associated with IgE sensitization to HDM. In this cross-sectional study use of HRT was associated with asthma-like symptoms, particularly in those who have lower BMI. A substantial proportion of women whose periods have stopped because of surgery use HRT but this does not fully explain their increased morbidity.