Why COPD Is Worse for Women


Ellen Greenlaw

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Many people think of COPD as a man's disease. But in reality, COPD, or chronic obstructive pulmonary disease, is quickly becoming an equal-opportunity condition. In the past few decades, more and more women have been diagnosed with this chronic lung disease. And since 2000, more women than men in the United States have died of it.

Recent studies have found that COPD might actually affect women differently than it does men. Research also reveals that women's lungs may be more susceptible to cigarette smoke. If you're a woman, it's important to know the risks for COPD and how to take care of yourself if you already have it.

The Cigarette Connection

Smoking is the biggest risk factor for COPD in both men and women. Because men used to smoke more than women, more men had COPD. But now that women light up just as much as men, the tables have turned.

"It takes about 20 to 25 years to develop COPD, and because women generally started smoking at a later time period than men, it's taken them a few decades to catch up," says Brian Carlin, M.D., F.C.C.P., chair of the COPD Alliance.

Recent research has shown that cigarette smoke may affect women's lungs differently. "We've found that women who smoke the same amount as men have more lung damage," says David Mannino, M.D., professor of medicine at the University of Kentucky in Lexington. "One reason for that difference may be that women's lungs are smaller, so their lungs simply can't tolerate as much smoke as a man's."

Hormones to Blame? Another reason that COPD is worse for women may be hormonal. Doctors are starting to study how women's hormones may affect how their bodies deal with COPD. "We don't have any clear answers right now, but we hope to learn more with further research," says Dr. Carlin. He believes that learning more about how COPD affects women's lungs will help doctors develop more effective treatments for women.

More Severe Symptoms

Women with COPD also tend to experience more severe symptoms than men. "Women with COPD report more problems with breathing, shortness of breath, and reduced energy than men with the same level of disease," says Dr. Carlin.

This may be because women tend to have other medical problems that can affect their COPD. For example, women are much more likely than men to have osteoporosis. Having COPD and osteoporosis at the same time may make the symptoms of both conditions worse.

The Wrong Diagnosis

Another problem facing women is that when they do have COPD, it's often not diagnosed correctly. "One study showed that when women and men had the same symptoms, men were more often correctly diagnosed with COPD, while women were incorrectly diagnosed with asthma," says Dr. Mannino. "I think awareness is growing, but many people—doctors included—still think of COPD as a man's disease."

If you're concerned about COPD, talk with your doctor and ask to be tested. A spirometry test to check your lungs can help show whether you might have the condition.

Ways to Breathe Easier

Here's how to protect yourself from COPD and effectively manage the disease if you do have it:

  • Know the risk factors. If you're older than 35 and you've ever smoked, you may be at risk. You may also be at risk if you have been exposed to large amounts of certain fumes or pollution.

  • Know the symptoms. Tell your doctor if you're short of breath, cough up mucus, or feel less able to be active.

  • Stop smoking. It's not easy to quit, but smoking is the number one risk factor for COPD. And if you have COPD, smoking makes your symptoms worse. Get help quitting if you need it.

  • If you have COPD, take all your medications as prescribed and be sure to participate in a pulmonary rehabilitation program. 

  • Get the pneumococcal ("pneumonia") and yearly flu vaccinations to help keep your lungs healthy.

Although more women have been dying of COPD, the outlook for the disease is still optimistic. "We're making great progress in treating COPD, and our patients are seeing a much better quality of life," says Dr. Mannino. "They key is early diagnosis and proper treatment." 

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Jul 5, 2017

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Medical References

  1. Brian Carlin, MD, FCCP, chairman, COPD Alliance. Interview.; David Mannino, MD, professor of medicine, University of Kentucky-Lexington. Interview.;
  2. M.K. Han et al, Gender and Chronic Obstructive Pulmonary Disease, American Journal of Respiratory and Critical Care Medicine. vol. 176, pp. 1179-84 (2007) (http://ajrccm.atsjournals.org/cgi/content/full/176/12/1179);

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