***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Epidemiological studies have suggested that female hormones might play a role in asthma and that menopausal hormone therapy ( MHT or hormone replacement therapy ( HRT ) ) might increase the risk of asthma in postmenopausal women . The only prospect i ve study addressing this issue reports an increase in the risk of developing asthma which was similar for oestrogen alone and oestrogen/progestagen treatment . Methods The association between the use of different types of MHT and the risk of asthma onset in postmenopausal women was investigated prospect ively from 1990 to 2002 by biennial question naires as part of the French E3N cohort study .  Asthma onset was considered to be the time of medical diagnosis of asthma cases occurring during the follow-up of women who were asthma free at baseline . Cox proportional hazards models were used , adjusting for potential confounding factors . Results Among 57 664 women free of asthma at menopause , 569 incident cases of asthma were identified during 495 448 years of follow-up . MHT was related to an increased risk of asthma onset ( HR=1.20 , 95 % CI 0.98 to 1.46 ) among recent users . The increase in risk of asthma onset was only significant among women reporting the use of oestrogen alone ( HR=1.54 , 95 % CI 1.13 to 2.09 ) particularly in never smokers ( HR=1.80 , 95 % CI 1.15 to 2.80 ) and women reporting allergic disease prior to asthma onset ( HR=1.86 , 95 % CI 1.18 to 2.93 ) . A small increase in the risk of asthma onset associated with the use of oestrogen/progestagen was also observed in these subgroups . Conclusion Postmenopausal use of oestrogen alone was associated with an increased rate of newly diagnosed asthma in menopausal women The protective effect of pregnancy on putative Th1-mediated autoimmune diseases , such as multiple sclerosis and rheumatoid arthritis , is associated with a Th1 to Th2 immune shift during pregnancy . The hormone estriol increases during pregnancy and has been shown to ameliorate experimental autoimmune encephalomyelitis and collagen-induced arthritis . In addition , estrogens induce cytokine changes consistent with a Th1 to Th2 shift when administered in vitro to human immune cells and in vivo to mice . In a pilot trial , oral estriol treatment of relapsing remitting multiple sclerosis patients caused significant decreases in enhancing lesions on brain magnetic resonance imaging . Here , the immunomodulatory effects of oral estriol therapy were assessed . P BMC s collected longitudinally during the trial were stimulated with mitogens , recall Ags , and glatiramer acetate .  Cytokine profiles of stimulated P BMC s were determined by intracellular cytokine staining ( IL-5 , IL-10 , IL-12 p40 , TNF-α , and IFN-γ ) and cytometric bead array ( IL-2 , IL-4 , IL-5 , IL-10 , TNF-α , and IFN-γ ) . Significantly increased levels of IL-5 and IL-10 and decreased TNF-α were observed in stimulated P BMC isolated during estriol treatment . These changes in cytokines correlated with reductions of enhancing lesions on magnetic resonance imaging in relapsing remitting multiple sclerosis . The increase in IL-5 was primarily due to an increase in CD4 + and CD8 + T cells , the increase in IL-10 was primarily due to an increase in CD64 + monocytes/macrophages with some effect in T cells , while the decrease in TNF-α was primarily due to a decrease in CD8 + T cells . Further study of oral estriol therapy is warranted in Th1-mediated autoimmune diseases with known improvement during pregnancy OBJECTIVE To study whether hormone replacement therapy ( HRT ) or Tibolone has an effect on pulmonary function in postmenopausal women . METHODS Seventy-five postmenopausal women without any risk factor for pulmonary disease were included in this r and omized , prospect i ve study . Fifty women had undergone natural menopause and 25 had had a hysterectomy/ooforectomy . Twenty-five natural menopause women were r and omly allocated to two groups : 25 patients ( Group I ) were treated with Tibolone 2.5 mg/day , 25 patients ( group II ) with Estradiol Hemihidrate 2 mg+Norethindron Asetate 1 mg/day . Twenty-five induced menopause women were treated with 17 beta-estradiol 2 mg/day . Lung function tests including forced vital capacity ( FVC ) , forced expiratory volume ( FEV(1 ) ) , FEV(1)/FVC , forced expiratory flow rate over the 25 - 75 % of the forced vital capacity volume ( FEF(25 - 75 % ) ) , and peak expiratory flow rate ( PEF ) were evaluated at the beginning and 3 months after the treatment to assess the effects of HRT and Tibolone on respiratory function . RESULTS Regardless of HRT types a significant difference was observed in FVC and FEV(1 ) after 3 months of the therapy ( P=0.001 , 0.0001 , respectively ) . No significant difference was found between pre and post therapy values in the other parameters ( P>0.05 ) . CONCLUSIONS We determined a significant increase in FVC and FEV(1 ) parameters of pulmonary functions after 3 months of the therapy regardless of HRT types . Therefore , we think that HRT regimens have modifying effects on pulmonary function in postmenopausal women We prospect ively evaluated the association of hormone replacement therapy and  asthma incidence in a cohort of pre- and postmenopausal women 34 to 68 yr of age . During 582 , 135 person-years of follow-up between 1980 and 1990 , 726 new cases of asthma were documented . Postmenopausal women who were never users of replacement hormones  had a significantly lower age-adjusted risk of asthma than premenopausal women ( relative risk = 0.65 ; 95 % confidence interval [ CI ] = 0.46 to 0.92 ) . Among naturally menopausal women , the age-adjusted relative risk of asthma for ever use of postmenopausal hormones was 1.49 ( 95 % CI = 1.10 to 2.00 ) ; for current use of hormones ( conjugated estrogens with or without progesterone ) , 1.50 ( 95 % CI = 0.98 to 2.30 ) ; and for past use , 1.52 ( 95 % CI = 1.08 to 2.13 ) , compared with never use of hormones . Ever users of 10 or more years ' duration had twice the age-adjusted risk of asthma compared with women who never used postmenopausal hormones ( 95 % CI = 1.39 to 2.87 ) . Among current users of conjugated estrogens , there was a positive dose-response demonstrated between daily dose and asthma risk ( p for trend = 0.007 ) . While confirmatory studies are warranted , these data suggest that estrogen plays a role in the pathophysiology of asthma and that long-term use and /or high doses of postmenopausal hormone therapy increase subsequent risk of asthma Objective : To investigate the variability and determinants of menopause age in two European cohort studies , the European Respiratory Health Survey and the Swiss Air Pollution and Lung Disease in Adults Cohort . Methods : Age at menopause was estimated in 5,288 women , aged 30 to 60 years , r and omly selected in nine European countries between 1998 and 2002 . Determinants of natural and surgically induced menopause were investigated by Cox regression and heterogeneity by meta- analysis .  Follicle-stimulating hormone and luteinizing hormone levels were assessed in a sub sample . Results : A quarter of the women were postmenopausal by age 50.8 years . Median age of natural menopause was 54 years . Hormone levels were within expected ranges for premenopausal and postmenopausal women . Surgically induced menopause was highly prevalent ( 22%-47 % ) , associated with earlier timing of menopause . Determinants of earlier menopause were current smoking ( hazard ratio [ HR ] , 1.59 ; 95 % CI , 1.27 - 1.98 ) , body mass index greater than 30 kg/m2 ( HR , 1.32 ; 95 % , CI , 1.02 - 1.70 ) , and low physical activity ( HR , 1.37 ; 95 % , CI , 1.12 - 1.67 ) . The determinant for later menopause was multiparity ( HR , 0.74 ; 95 % CI , 0.62 - 0.89 ) . Predictors were similar for naturally and surgically induced menopause . Oral contraceptive use yielded heterogeneous effects on timing of menopause . Later birth was associated with later menopause ( HR , 0.934 ; 95 % CI , 0.91 - 0.96 ) . This evidence of a secular trend is heterogeneous across countries . Conclusions : Age at menopause varies across Europe , shifting toward higher ages . This secular trend seems paradoxical because several adult determinants , that is , overweight , smoking , sedentarity , and nulliparity , associated with early menopause are on the rise in Europe . The heterogeneity of the secular trend suggests additional country-specific factors not included in the study , such as improved childhood nutrition and health , that have an influence on reproductive aging Abstract Objective : To assess the relation between  forced expiratory volume in one second ( FEV1 )  and subsequent mortality . Design : Prospect i ve general population study . Setting : Renfrew and Paisley , Scotl and . Subjects : 7058 men and 8353 women aged 45 - 64 years at baseline screening in 1972 - 6 . Main outcome measure : Mortality from all causes , ischaemic heart disease , cancer , lung and other cancers , stroke , respiratory disease , and other causes of death after 15 years of follow up . Results : 2545 men and 1894 women died during the follow up period . Significant trends of increasing risk with diminishing FEV1 are apparent for both sexes for all the causes of death examined after adjustment for age , cigarette smoking , diastolic blood pressure , cholesterol concentration , body mass index , and social class . The relative hazard ratios for all cause mortality for subjects in the lowest fifth of the FEV1 distribution were 1.92 ( 95 % confidence interval 1.68 to 2.20 ) for men and 1.89 ( 1.63 to 2.20 ) for women . Corresponding relative hazard ratios were 1.56 ( 1.26 to 1.92 ) and 1.88 ( 1.44 to 2.47 ) for ischaemic heart disease , 2.53 ( 1.69 to 3.79 ) and 4.37 ( 1.84 to 10.42 ) for lung cancer , and 1.66 ( 1.07 to 2.59 ) and 1.65 ( 1.09 to 2.49 ) for stroke . Reduced FEV1 was also associated with an increased risk for each cause of death examined except cancer for lifelong nonsmokers . Conclusions : Impaired lung function is a major clinical indicator of mortality risk in men and women for a wide range of diseases . The use of FEV1 as part of any health assessment of middle aged patients should be considered . Smokers with reduced FEV1 should form a priority group for targeted advice to stop smoking . Key messages These increased risks , with the exception of the cancers , are apparent for lifelong non-smokers FEV1 is second in importance to cigarette smoking as a predictor of subsequent all cause mortality and is as important as cholesterol in predicting mortality from ischaemic heart disease FEV1 should be included in health assessment of middle aged men and women Smokers with a reduced FEV1 should be targeted with advice to stop BACKGROUND Data from multiple clinical , epidemiologic , and in vitro studies are conflicting regarding the effect of estrogen replacement therapy ( ERT ) on airway function in postmenopausal women with asthma . OBJECTIVE To determine the impact of withdrawal of estrogen administration in postmenopausal , asthmatic women . METHODS Twenty asthmatic women who were postmenopausal for at least 2 years and undergoing ERT were recruited for this prospect i ve crossover study . Subjects continued taking baseline estrogen for 28 days , stopped taking estrogen for 28 days , and then resumed taking the medication for 14 days . Objective measurements were obtained by recording daily peak flows in the morning and evening and formal spirometry at days 14 , 28 , 42 , 56 , and 70 . Compliance was measured by evaluating serum estradiol levels at days 28 and 56 . Daily use of short-acting beta-agonist bronchodilators was also recorded . RESULTS Differences in estradiol levels indicated compliance with the medication regimen . The combined day 14 and 28 ( taking estrogen ) mean percent predicted forced expiratory volume in 1 second ( 
    Output:
    
Evidence on menopause and asthma was conflicting , while studies on COPD were scarce .
The findings generally support an association between menopause and clinical ly significant reductions in lung function in a non-obstructive pattern .
However , the effects of menopause are clouded by aging , menopausal hormone therapy use , and increased risk of metabolic syndrome during this period .