January 10, 2022

Is Menopause Taking Your Breath Away?

Research finds menopause may accelerate our age-related decline in lung function.
By Selene Yeager
Last week, someone in our Hit Play Not Pause group posted an article from LungDiseaseNews.com titled Study Links Menopause to Lung Function Decline in Women, saying, “Just another wonderful symptom of this phase of life … it just keeps on giving.”
The post was met with a flurry of responses, including a number of women who were wondering if this explained their current respiratory fitness issues:
Is this why I went from finishing a marathon 2 yrs ago to suddenly can’t run 3 miles without stopping or walking ? I’ve run every day for the last 6 years: 10 Halfs, 2 full marathons. All of a sudden after peri to menopause I can’t even run a mile without stopping or doing walk intervals. Literally can’t breathe. I have asthma but it doesn’t feel like that. Just have no energy or strength and can’t breathe. It’s ridiculous. I’ve done weight programs on and off too.
I believe this 100%. I already had breathing issues before which seem to be enhanced along with worsening asthma.
That explains some things. I noticed my VO2 max estimated by my Apple Watch has been slowly tanking despite the same exercise routine compared to a year ago. I hit full menopause a year ago in September. Not a coincidence, I think.
Interesting. I started having asthma symptoms at the same time as early perimenopause. I had been active and athletic for years, but I started having breathing problems during harder bike rides. Now, I take Singulair and often take 2 puffs of a rescue inhaler before I run. It helps a lot.
It’s like someone turned on the switch at 49 for me.
I am in the same boat doing what you have to do and I still cannot regain my original pace! Ugh.
The study was from the May 2016 edition of the American Journal of Respiratory and Critical Care Medicine and the findings as they were reported were downright dreadful. The first paragraph in that lungdiseasenews.com story proclaimed: “Menopausal women experience a decline in lung function similar to smoking 20 cigarettes a day for a decade, according to new research from Norway.”
“The decline in lung function may cause an increase in shortness of breath, reduced work capacity and fatigue,” said researcher Kai Triebner at the Department of Clinical Science, University of Bergen (UiB), Norway in a press release. 
Oof. That’s enough to knock the wind out of your sails, so to speak.
To draw these conclusions, the researchers analyzed data from 1,438 women enrolled in the European Respiratory Health Survey. The women in the study ranged in age from 25 to 48 at enrollment, and none was menopausal when the study began. They were followed for 20 years and during that time most went through the menopausal transition or became postmenopausal
To test lung function as it relates to menopause, the researchers examined two factors: forced vital capacity (FVC), which is a measure of lung size, and forced expiratory volume (FEV), which is a measure of lung function based on how much air you can push out of your lungs in one second.
Lung function naturally declines with age, but it appears to pick up steam during the transition to menopause. Both lung size and FEV declined in women going through the menopausal transition and after menopause beyond what would be expected through normal aging.
For example, women in perimenopause lost about 10.2 more milliliters of forced vital lung capacity each year than their pre-menopausal peers. Postmenopausal women lost about 12.5 milliliters more per year.
The decline in lung function as measured by forced exhalation was comparable with smoking 20 cigarettes (i.e. a pack) per day for two years, and the decline in lung size was similar to smoking 20 cigarettes per day for 10 years
Speaking of smoking, there are some issues in this study that are worth mentioning. First among them, there were a lot of current and former smokers in the study group. Less than half of the group—just 45 percent—were “never smokers.” The rest were all former or current smokers. Not surprisingly, current and former smokers had higher age-related declines and higher menopause-related declines than those who had never smoked.
The study also didn’t take exercise into account. It’s possible none of the women in the study did any purposeful exercise, let alone had athletic pursuits, past or present. Women taking any hormone therapy were excluded from the study. (The authors note that this is an area that should be studied further, as some hormone therapy regimens seem to be associated with higher lung function in postmenopausal women.)
This study is observational, so it doesn’t prove that menopause causes lung function decline and/or breathing problems. That said, the researchers did have some theories as to why this lung function decline seemed to be linked to the menopausal transition.
“There may be several possible explanations for these findings. Menopause brings hormonal changes that have been linked to systemic inflammation, which itself is associated with lung function decline,” Triebner said in the release.
“Hormonal changes are also implicated in osteoporosis, which shortens the height of the chest vertebrae and may, in turn, limit the amount of air a person can inhale,” he notes.
It’s also important to note that this isn’t the first study to reach these conclusions. A 2008 study of 4,259 women ages 45 to 56 (again, not taking any hormone therapy) found that women who had not had a period in six months had lower FEV scores and more respiratory problems than those menstruating regularly. These results remained even when the researchers looked at never smokers.
A 2018 research analysis on the topic concluded that the “findings generally support an association between menopause and clinically significant reductions in lung function.”
For what it’s worth, women may fare better than men in age-related decline in lung function. A 2019 systematic review of 16 studies examining normal lung function decline in aging adults found higher rates in absolute lung function decline in men compared with women.
What does this all mean? There are likely not many smokers in the room here, but if you still light up, even casually, finding a way to stay smoke free is key to better lung function in the short and long term. If you have a chronic lung disease, take your meds to help maintain your lung function.
Keep those muscles (and bones) strong. Lung function is another reason to strength train. By keeping your skeleton strong through strength training, you can prevent the bone loss and shortening of the chest vertebrae that can come with osteoporosis. Strength training also helps keep your muscles strong, including those in your core that help improve your respiratory strength. This is especially important during the menopausal transition, when we’re prone to losing muscle mass and strength as sex hormones dwindle.
Consider including breath work and/or yoga in your health and fitness routine. A 2019 study on 28 adults, average age 53 and mostly females, found that participating in a 70 minute yoga session once a week improved overall respiratory function after eight weeks.
Finally, if you’re experiencing a recent and/or marked decline in lung function and/or are having breathing problems, talk to a doctor (preferably one who understands both active women and menopause). The North American Menopause Society’s practitioner finder is a good place to start.

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