Early menopause and hormone therapy may reduce all-cause, non-cancer and CV mortality , reveals PLCO trial

Early natural menopause (early-M; <45 years of age) increases the risk of lung morbidities and mortalities in smokers. However, it is largely unknown whether early-M due to surgery demonstrates similar effects and whether menopausal hormone therapy (MHT) is protective against lung diseases.

The researchers conducted the study to assess the associations of early-M and MHT with lung morbidities and mortalities using the prospective Prostate, Lung, Colorectal and Ovarian (PLCO) trial.

The researchers aimed to  estimate the risk among 69 706 postmenopausal women in the PLCO trial, stratified by menopausal types and smoking status.

It was found that Early-M was associated with an increased risk of most lung disease and mortality outcomes in ever smokers with the highest risk seen for respiratory mortality (HR 1.98, 95% CI 1.34 to 2.92) in those with bilateral oophorectomy (BO). Early-M was positively associated with chronic bronchitis, and all-cause, non-cancer and respiratory mortality in never smokers with natural menopause or BO, with the highest risk seen for BO-respiratory mortality (HR 1.91, 95% CI 1.16 to 3.12). Ever MHT was associated with reduced all-cause, non-cancer and cardiovascular mortality across menopause types regardless of smoking status and was additionally associated with reduced risk of non-ovarian cancer, lung cancer (LC) and respiratory mortality in ever smokers. Among smokers, ever Menopausal hormone therapy use was associated with a reduction in HR for all-cause, non-cancer and cardiovascular mortality in a duration-dependent manner.

The study concluded that Smokers with early-Menopause should be targeted for smoking cessation and lung cancer screening regardless of menopause types. Menopausal hormone therapy users had a lower likelihood of dying from lung cancer and respiratory diseases in ever smokers.

Reference:

Gai X, Feng Y, Flores TM, et alEarly menopause and hormone therapy as determinants for lung health outcomes: a secondary analysis using the PLCO trialThorax Published Online First: 13 June 2024. doi: 10.1136/thorax-2023-220956