COPD? What’s that? Oh, yeah...it’s a disease that has to do with emphysema. Old men get it, right?”

Well, yes… but unfortunately for women the face of COPD has changed. COPD (Chronic Obstructive Pulmonary Disease - a combination of emphysema and chronic bronchitis), is now not only as common in women as it is in men; but in the year 2000 women – for the first time ever – passed up men in deaths due to COPD.

Researchers are just beginning to scratch the surface in learning about COPD in women – how women differ from men in diagnosis, smoking addiction and quitting, and in the disease itself. Here’s some of what they’ve found so far.

Prevalence
The prevalence of COPD is increasing in women. In addition to this increase, rates of hospitalization in women are also rising. Since the year 2000 US deaths resulting from COPD in women have exceeded those in men.

Differences in Smoking and Quitting
COPD in women can be different than COPD in men. Some of the rise in COPD prevalence in women may be explained by increased tobacco use beginning in the 1950s. Yet, women appear to be at greater risk of smoking-induced lung disease, compared with men, for the same amount of tobacco exposure. This is especially interesting because compared with men, women have more difficulty quitting smoking and remaining abstinent from tobacco. However, sustained female quitters have two and a half times greater improvement in a major measurement of lung function, FEV1 (Forced expiratory volume in the first second of exhaling), than do men.

So, even though smoking cessation appears to benefit women more than men in terms of lung function, the benefit is felt less by women when it comes to relief of symptoms. This might explain why women are less likely than men to sustain long-term abstinence.

Nicotine replacement therapy reduces cravings less effectively for women than for men and is associated with greater weight gain. However, women may still benefit significantly from smoking cessation therapies. Treatment with Bupropion (Welbutrin) or with Varenicline (Chantix or Champix) has been shown to be equally effective in both sexes.

Differences in Symptoms
Compared with men who have COPD, women with COPD report more severe shortness of breath, more anxiety and depression, and lower disease-related quality of life. When stopping treatment of inhaled steroids (Flovent, Pulmicort, Azmacort, Qvar, etc), women appear to have a greater likelihood of respiratory deterioration than do men.

Higher risk of smoking-induced lung function impairment, greater shortness of breath (SOB), and worse health status in women than in men exposed to the same amount of tobacco may be related to biologic, physiologic, or sociologic sex differences, but more research must be done.

The response to tobacco smoke may vary between men and women, with men more likely to develop emphysema-type (air sac or alveoli) damage and women more likely to have airway-predominant (chronic bronchitis) changes.