Charles Nicole Pulmonology Department, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia
Background: Hormonal changes in women, especially at menopausal transition, may have significant consequences on respiratory function. This issue in asthmatic patients is more frequent, more severe, and less controlled after menopause. Tunisian data regarding this issue are limited; therefore, we assessed the clinical and functional particularities of asthma at menopausal transition. Materials and Methods: This descriptive-analytical study was performed for two years (2016-2017) on 82 asthmatic women followed up in the pulmonology department of Charles Nicolle hospital of Tunis. According to hormonal status, two groups were defined: G1 (menopausal patients) and G2 (non-menopausal patients). Asthma control and severity of asthma as well as other variables including gender, age, body mass index (BMI), comorbidities, allergenic status, spirometry results, health care use in the past 12 months, and prescribed medications were evaluated. Results: The mean age of patients was 50 years and half of them (60%) were menopausal women. Allergy was the most common cause of asthma (82%). A mean of 2.3 exacerbations per patient was recorded. Asthma was well controlled in 58% of patients and was moderate to severe in 80% of them. Menopausal asthmatic women had more comorbidities (p=0.006), particularly arterial hypertension (p <0.0001). Atopy was more common in non-menopausal women and they were all allergic (p=0.01). Menopausal asthmatic patients had more airflow obstruction with lower forced expiratory volume 1 and forced vital capacity (p <0.0001). They also had more exacerbations (p <0.0001) with lower PaO2 (p=0.006). Univariate analysis showed that menopause was a predictive factor of severity (p=0.01) and bad control of asthma (p=0.03). Multivariate analysis confirmed that menopause was a predictor of severity (p=0.01; OR=5.02, IC [1.36-18.46]) but not control of asthma despite the tendency to significance (p=0.07). Conclusion: Our results confirm that menopause is a factor influencing the control and severity of asthma.