Hormone Replacement Therapy and Development of New Asthma

Abstract

Hormone replacement therapy (HRT) is prescribed to millions of women worldwide. Previous studies have suggested that HRT has both protective and harmful effects in asthma. Is HRT in menopause associated with new development of asthma? We undertook a nested case-control study based on theDanish registers from June 1, 1995, through December 31, 2018. A diagnosis ofasthma was defined as two redeemed prescriptions of inhaled corticosteroids within2years. HRT was defined as two redeemed prescriptions of female sex hormoneswithin 6months. Data were analyzed using a conditional logistic regression model. We included 34,533 women with asthma vs345,116 women without asthmabetween 40 and 65 years of age. In a multivariate analysis adjusted for age,household income, and educational level, active HRT resulted in a hazardratio(HR) of 1.63 (95%CI, 1.55-1.71; P< .001) of new asthma development.Women with asthma who terminated HRT were likely to discontinuetheir asthma treatment subsequently (HR, 2.12; 95%CI, 1.94-2.33; P<.001). HRT seems to play a role in the development of asthma in mature women. Clinicians prescribing HRT and women receiving HRT should be aware that new airway symptoms can develop, and discontinuation of HRT should be considered.