Hormone Replacement therapy to treat menopausal symptoms has always faced a lot of controversies. Despite its clinically beneficial role in controlling the hot flushes and other associated symptoms of menopause, and its protective action against osteoporosis, HRT has been associated with increased risk of breast and endometrial cancer, gall bladder stones and thrombo-embolic events. Now, another new study has found that HRT in post- menopausal women is associated with increased severity of asthma attacks which may require hospitalization. The study, which was presented at the European Respiratory Society’s Annual Congress in Amsterdam, is the first of its kind to find a link between HRT and severity of asthma attack.
The study was led by Klaus Bonnelykke from the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) at the Danish Pediatric Asthma Center and Zorana Jovanovic from the Danish Cancer Society. The researchers selected 23,138 women from the Danish Diet, Cancer and Health Cohort, who were on HRT for treatment of menopausal symptoms. They noted the incidence of asthma attacks in these women which were severe enough to warrant hospitalization. They also obtained information about the smoking status of the participants, occupational exposure to things which could precipitate an asthma attack, their body mass index and whether they had undergone hysterectomy. This information was gathered to rule out any co- founding factors which may be the cause of asthma attack.
The study showed that women on HRT had 1.3 times more likelihood of being hospitalized because of a severe asthma attack compared to women who were not on HRT. The risk of having a severe exacerbation of asthma increased in proportion to the duration for which the patient was on HRT and increased to 1.5 times in patients who were on HRT for more than 10 years. According to the researchers, although further randomized trials are required to confirm the association, the results of the study can serve as a warning to physicians dealing with patients with severe exacerbation of asthma, which may require hospitalization. If the patient is on HRT, they may consider stopping HRT altogether.