Female smokers with early natural menopause more prone to malignant lung changes

USA: A new study published in the American Journal of Obstetrics and Gynecology found that in middle-aged and older female smokers, early natural menopause has been linked to mortality from malignant and non-malignant lung illnesses.

Early menopause naturally has been identified as a biomarker for both somatic and reproductive aging. The greatest detrimental element for lung health and a known risk factor for early menopause is cigarette smoking. In this study, Ting Zhai and colleagues looked at the relationships between early menopause and a variety of aging and lung health indicators, lung cancer risk, and overall and cause-specific mortality in postmenopausal women who were medium or heavy smokers.

The Pittsburgh Lung Screening Study's postmenopausal women with natural (n = 1038) or surgical (n = 628) menopause participated in this study. A community-based study cohort called the Pittsburgh Lung Screening Study screens current and previous smokers for lung cancer using low-dose computed tomography. Before the age of 45 was considered to be the early onset of menopause. Because surgical and natural menopause has various biological and medical reasons, the analyses were segmented by menopause type. 

The key highlights of this study were:

1. With 1064 (63.9%) of the population at baseline being current smokers and 1519 (91.2%) of the population being non-Hispanic Whites, the average age of the 1666 female smokers was 59.46.7 years.

2. In total, 646 women (39%) reported experiencing early menopause, including 198 (19.1%) who had natural menopause and 448 (71.3%) who experienced surgical menopause (P.001).

3. Early natural menopause has been linked in statistically significant ways to an increased risk of wheezing, chronic bronchitis, radiographic emphysema, and decreased baseline lung spirometry in an obstructive pattern.

4. Additionally, early natural menopause was linked to incident airway obstruction and a quicker drop in forced expiratory volume in the first second-to-forced vital capacity ratio.

5. Additionally, women who had early natural menopause had a 40% higher chance of passing away (P=.023), which was mostly caused by respiratory illnesses.

6. Furthermore, mediation studies revealed that baseline forced expiratory volume in the first second was responsible for more than 33.3% of the amplitude of the relationships between early natural menopause and all-cause and respiratory mortality.

7. Additional research on menopausal women revealed that early menopause status reduced the connections between ongoing smoking and eventual lung cancer risk and cancer death, with early natural menopausal women who smoked had the poorest results.

These findings are highly relevant to public health because they show that this population—female smokers with early natural menopause—should be the focus of preventive measures such as smoking cessation and chest computed tomography screening in order to enhance their postmenopausal health and wellbeing.

Reference: 

Zhai, T., Diergaarde, B., Wilson, D. O., Kang, H., Sood, A., Bayliss, S. H., Yuan, J.-M., Picchi, M. A., Lan, Q., Belinsky, S. A., Siegfried, J. M., Cook, L. S., & Leng, S. (2022). Early natural menopause is associated with poor lung health and increased mortality among female smokers. In American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2022.07.031