Is Hormone Replacement Therapy Linked to Risk of Asthma?
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.
Maureen Connelly, MD, PhD, tells WebMD, she has not seen such an increase in her patients, but does not want to imply there is no connection between HRT and asthma. She says the research "raises another red flag" about what effects estrogen might have on the body.
Connelly, an instructor of ambulatory care and prevention at Harvard Medical School, says she only prescribes HRT for "women who report that their quality of life is affected by symptoms that we associate with menopause -- hot flashes, sleep disturbances, vaginal dryness. For those women, the benefits may outweigh the risk because we don't have other things to offer them that work as well."
She says HRT is considered safe for women to use for a few years and that she often starts women on half of the typical dose, to help minimize any side effects.
Nelson Watts, MD, a professor of medicine at Emory University in Atlanta, GA, and director of the osteoporosis and bone health programs at The Emory Clinic, tells WebMD he does not think the new asthma study is convincing enough for patients or other doctors to worry about a possible connection between estrogen and breathing or lung problems. He adds that doctors are already much more selective today than they were in the past about which patients are offered HRT.
Another Emory doctor agrees that estrogen replacement therapy should be limited, and says that physicians and women need to be better educated on this issue.
"The bottom line is that the only [uses] for HRT are for symptom relief and for osteoporosis prevention," says Sally Mcnagny, MD, an assistant professor of medicine at Emory. "All other women should avoid the medication because of blood clots, possible breast cancer, increased urinary incontinence, an increase in [heart problems], possible uterine bleeding, increased headaches and now a possible increase in asthma symptoms -- not to mention cost of medication. Physicians are still behind in this area and are continually being sent mail from pharmaceutical companies about the virtues of HRT."