Women over 35 years / climacteric period

Question

Hello,
I am looking for information about the climacteric period in case of CF, is there any information about intake of hormones, Orkambi, transplantation and gain of weight? How does the metabolism change? What does this mean for women with CF? In general I am looking for information around this topic.
Many thanks

Answer

Dear questioner,
you are asking a lot of questions, however at the actual timepoint, there are no scientifically proven answers concerning CF women.
Concerning the question on the intake of hormones, it can be drawn on a literature passage from 2012 (Chotimall SH et al. Effect of estrogen on pseudomonas mucoidy and exacerbations in cystic fibrosis. N Engl J Med, 2012), where the intake of the pill in CF women had been investigated. In this sutdy, a connection had been found between estradiol and estriol and the formation of a mucoid Pseudomonas aerugionsa in vitro and increased exacerbations during the follicular phase. Intake of hormones for anti-conception shows therefore possibly an additional, prophylactic option against a mukoid Pseudomonas. In this study, it does not deal however with women in the climacteric period, however in spite of this it is about the effect of female hormones on a CF specific problem.
Women on therapy with Orkambi or also transplanted CF patients are recommended to do anti-conception preferably with hormones. A interaction with Orkambi respectively with the immuno-suppressive drugs after (lung-) transplantation, is not described. Gain of weight, if it should occur during this medication, is more connected to the therapy with Orkambi resp. connected to the systemic therapy with corticosteroids after transplantation.
It has to be taken into account, that female CF patients have a 20% reduced fertility compared to healthy women. Possible reasons for that are i.a. an underweight or impairment of the central regulation system with the consequence of a reduced stability of the hormone cycle and therefore more rare ovulations. In these women, the start of the clilmacteric period is even harder to define.
I hope to have helped you further with my remarks and stay with my best regards,
Dr. med. Christina Smaczny

28.04.2017