Researchers say COPD symptoms are harsher for women, even though they smoke less than men do.
Women with chronic obstructive pulmonary disease (COPD) experience worse symptoms than men with the same condition.
The big question now facing medical professionals is why.
Researchers have found women living with COPD report a lower quality of life than men with the disease, despite also reporting smoking fewer cigarettes.
The findings are scheduled to be presented at the American Thoracic Society’s international conference in Dallas this week.
“Women with COPD experienced increased symptom burden, poorer quality of life, more frequent exacerbations, and more impaired functional status than their male counterparts,” Dr. MeiLan Han, author of the study and a professor of internal medicine in the division of pulmonary and critical care medicine at the University of Michigan Health System, told Healthline.
COPD is a term used to describe a number of progressive lung diseases, including chronic bronchitis, emphysema, and nonreversible asthma.
Common symptoms include shortness of breath, wheezing, frequent coughing, and tightness in the chest.
COPD is a progressive disease with no known cure. In the United States, more than 11 million people have COPD, but experts say millions more are likely living with the disease without realizing it.
Many may dismiss shortness of breath or a cough as just part of getting older, but experts say it can be a sign of something more serious.
“COPD can significantly impact quality of life. Patients with more advanced COPD struggle to breathe and experience a sensation of air hunger. Patients may be limited in their activities of daily living, and even leaving their home can be a challenge. Sleep quality is impaired in patients with COPD, and daytime energy levels are decreased,” Dr. Gaurav Singh, a clinical assistant professor of pulmonary and critical care medicine at Stanford University, told Healthline.
COPD is the third-leading cause of death from disease in the United States. Women are more likely to die from COPD than men.
“Women are more susceptible and more vulnerable than men with regard to COPD. Faster decline in lung function with more severe airflow limitation, as well as increased symptom burden related to COPD in women compared to men, has been reported in other studies. Compared to men, women experience more shortness of breath, more depression and anxiety, and lower quality of life,” Singh said.
The research presented this week shows that women are more likely to report lower quality of life than men living with the same condition.
Dr. May-Lin Wilgus, a co-author of the study and assistant clinical professor in the division of pulmonary and critical care at the David Geffen School of Medicine at the University of California, Los Angeles, says this is in keeping with what she sees in her own practice.
“Women are attuned to their symptoms and tend to seek medical care when symptomatic. In addition, women with COPD are more likely to have comorbid anxiety and depression as compared to men with COPD, which may affect perception of COPD respiratory symptoms,” Wilgus told Healthline.
Dr. Brooks Thomas Kuhn, an assistant professor in the division of pulmonary and critical care medicine at the University of California Davis School of Medicine, says COPD can significantly affect patient mood.
“One of my colleagues refers to this as ‘death by armchair,’ as the impaired pulmonary function leads to the patients not being able to do activities of daily living and normal activities that give them pleasure. As their disease progresses, their ability to interact with the world around them decreases, and hence their mood is negatively affected,” Kuhn told Healthline.
The main cause of COPD in the United States is smoking, with about 90 percent of COPD cases attributable to cigarettes.
Despite this, women with COPD report smoking less than men with the same disease.
Experts say this may be because tobacco smoke affects women more severely than men.
“Women are thought to be more susceptible to the effects of tobacco smoke. While the reasons for this are unknown, some theories suggest that this may be due to women having smaller airways than men on average, which results in exposure to smoke at higher concentrations. Other biologic and genetic factors that determine how women’s bodies react to and metabolize cigarette smoke may also be responsible,” Singh said.
“The fact that women develop COPD with less smoking than men suggests that women are more susceptible to developing COPD. This has been confirmed in several studies, with women being about 50 percent more likely to develop COPD than men.
“Women experience greater decline in lung function, resulting in more severe airflow limitation, compared to men, even with a less extensive history of smoking cigarettes,” he added.
Historically, COPD was predominantly considered to be a disease of older men. In the late 1960s, tobacco companies began targeting women, and as a result, more women began smoking.
Despite more women presenting with symptoms that could be attributed to COPD, experts say many physicians still hold biased views that it’s a man’s disease.
“Smoking rates have increased in women over the past several decades, while they have declined in men. This is likely an important reason that COPD is now more common in women,” Singh said.
“Women typically also have more exposure to indoor air pollution from biofuel exposure during cooking in developing countries. Women tend to be diagnosed with COPD at a more advanced stage compared to men, due to biased views that COPD is more common in men. Awareness of the increased prevalence of COPD and adverse outcomes due to COPD in women, which now surpass rates in men, is essential,” he said.
Given the potential bias against women receiving diagnoses of the disease, Wilgus says patients, particularly smokers, should be proactive in speaking with their doctor.
“The symptoms of COPD can develop even decades after quitting smoking. Any current or former smokers who experience breathlessness, cough, or wheeze should be checked for COPD by their physicians, which generally includes a breathing test called spirometry.
“Previous studies have shown that women may be less likely than men to be diagnosed with COPD or tested with spirometry due to physician bias, despite presenting with similar symptoms; hopefully this will continue to change as we increase awareness about COPD in women,” Wilgus said.