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Is Hormone Replacement Therapy Linked to Risk of Asthma?

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WebMD Health News

Oct. 23, 2000 -- The already tough decision many women face about whether to use hormone replacement therapy (HRT) for relief of hot flashes and other menopausal problems just became a little more difficult: Researchers have found that women who used HRT developed asthma amore often than those women who weren't using the medication.

But because the number of women who had asthma was small, physicians tell WebMD there is little cause of alarm. And it is not known whether women who already had asthma were made worse by estrogen.

Still, experts say that even the hint of another possible side effect of HRT should serve to remind the millions of women who are using hormones to reexamine why they are taking the medication, whether they are on the lowest possible dose and when they might discontinue the treatment.

"It raises a concern, but it would be premature" to suggest that women stop taking HRT or do not begin to take it out of fear of developing asthma, R. Graham Barr, MD, MPH, tells WebMD. But he adds, "the number of things that seem to be problems with HRT is growing, [and] the list of benefits may be diminishing."

For example, many physicians believed that estrogen reduced heart disease based on preliminary research, but those findings did not hold up in later studies, says Barr, a fellow at the Channing Laboratory at Brigham and Women's Hospital in Boston. Barr is the lead researcher on the study of asthma and HRT, which was presented Monday at the annual meeting of the American College of Chest Physicians in San Francisco.

Women use HRT, typically in the form of estrogen and progestin, to reduce hot flashes, difficulty sleeping and other problems that can accompany the start of menopause. HRT is also approved by the FDA for the prevention of osteoporosis, which can follow the drop in estrogen that characterizes menopause.

In the past, many women went on HRT without understanding why they were on it, and they stayed on for years. Over time, more researchers have looked at the long-term effects of HRT, and it is now believed that women who stay on it more than five years have an increased risk of developing breast cancer.

In this study, Barr and his colleagues used information from a large, ongoing study on the health of nurses; the nurses in the study complete questionnaires every few years. Barr calculated that about 750 of 121,00 nurses developed asthma, and 345 developed both asthma and some other lung problem, such as emphysema or chronic bronchitis. Asthma was nearly twice as common among the HRT users than non-users, according to the study. But the more serious lung problems did not occur at a greater rate among the HRT users.

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