Menopause and cystic fibrosis: What women need to know

Last updated Oct. 16, 2025, by Susie Strachan
Fact-checked by Joana Carvalho, PhD

 

For many women with cystic fibrosis (CF), menopause is not only a significant life transition but a complicated one, as CF may add extra worries and questions about what changes to expect.

David Ghozland, MD, a gynecological surgeon in Orange County, California, who specializes in women’s health, says, “I want to make a contribution to this subject, because I think this is a clinically underdiscussed field of interest with growing relevance.”

His words echo the growing awareness that women with CF need focused healthcare and support during this stage of life.

Why menopause in CF is often overlooked

According to a recent survey study, a tiny fraction of women with CF report discussing menopause with their CF care teams — just 1% — while nearly 20% say they want to.

This low number may reflect gaps in provider training and available resources to support women with CF through menopause, highlighting an opportunity to improve awareness and communication in care.

“As CF has been traditionally considered a disease of childhood, most providers have not been educated to expect or detect menopausal changes among this group,” says Ghozland.

“This gap is already urgent, and it is transforming how we must think about both standard gynecologic care and hormone management in women with CF,” he adds.

CF meets menopause early

The average age of menopause in the general population is about 51 years. However, women with CF tend to experience menopause earlier, averaging about 48 years, with some entering perimenopause in their late 30s.

“With cystic fibrosis patients now living well into their adult years, we are beginning to see an increasing number of women with CF who are going through the entire reproductive aging process with perimenopause and menopause,” says Ghozland.

These changes in lifespan and health result from advances in CF care, notably the introduction of CFTR modulator therapies and improvements in multidisciplinary support, which help women with CF live longer and healthier lives.

Overlapping symptoms

Women with CF can experience many symptoms common to menopause, such as waking up early, joint stiffness or soreness, night sweats, hot flashes, and vaginal dryness.

These symptoms alone can be a challenge, but for women living with CF, the situation is more complex. Many menopausal symptoms look very similar to, or can even worsen, CF-related issues.

For example, joint pain may be caused by CF-related arthropathy, a type of joint inflammation and soreness that comes and goes, and can affect large joints, such as the knees and wrists. Pelvic floor problems, such as stress urinary incontinence, can also be similar to changes caused by menopause.

When CF and menopause symptoms coincide like this, it can be confusing and frustrating for both women and their healthcare providers to pinpoint exactly what’s causing the discomfort.

“These women are in a unique clinical overlap in which hormonal changes coincide with chronic disease treatment,” according to Ghozland.

Estrogen’s role goes beyond hot flashes

In general, as women reach menopause, levels of estrogen — a key hormone that helps regulate sexual development, menstrual cycles, bone density, heart health, and brain function — drop significantly.

“The loss of estrogens may influence the lungs, their activity, bones, and general energy level, which is in itself a concern in CF,” says Ghozland.

Recognizing this, hormone replacement therapy (HRT) may be prescribed after menopause to help protect bone health and lung function, among other things. Lower estrogen levels may make lung infections worse and cause fatigue, which can make it harder to manage lung health, so HRT may also help with that.

Hope through holistic care

There is growing recognition of the value of integrated, holistic care, in which CF specialists, menopause experts, gynecologists, and primary care providers work closely with women living with CF. This team-based approach aims to address the complex and evolving health needs that arise for CF patients during menopause and throughout aging.

Because complications, such as blood clots and liver disease, are more common in CF, treatment plans can be personalized to balance potential benefits and risks, including if and when to consider starting HRT.

In addition to medical treatments, lifestyle approaches can play a supportive role in managing menopause symptoms. It can be helpful to:

• maintain regular sleep routines
• engage in physical activity that supports bone and lung health
• eat a balanced diet rich in calcium and vitamin D
• practice stress reduction techniques like mindfulness

Additionally, tracking your menstrual cycles alongside CF symptoms can offer insights into how hormonal changes may be affecting your overall health and symptom patterns. Keeping an eye on these changes and sharing what feels relevant with your healthcare providers might help guide more personal support through menopause.

---

Cystic Fibrosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.