Why Women Are at Higher Risk for COPD Than Men

Health Professional

If you've read my posts here on the COPD site, then you know my mother died from COPD, after a long progressive decline. But, so did my father, a decade before. Having refused treatment of any kind, his decline was sudden and final. So, to my eyes, COPD has been an equal opportunity disease that takes no prisoners.

However, a recent study shows that women actually bear a higher risk of developing COPD than men do. In fact, a woman is 37% more likely to get COPD than her male counterparts. And more than half of all COPD deaths have been in women for the past decade and a half.

This is important information, because historically, COPD has been considered a disease of white men. This is due mostly to the fact that white men tended to smoke at much higher rates than other groups. Smoking is the most common risk factor for developing COPD.

But according to the American Lung Association (ALA for short), the profile of COPD is changing.

Facts From the Report

Here are some of the significant facts from the ALA's report:

  • More than 7 million women in the U.S. have COPD; millions more have symptoms, but are yet to be diagnosed.

  • Deaths among women from COPD has more than quadrupled since 1980.

  • Women have higher rates of COPD than men throughout most of their lifespan, although it appears that they are especially vulnerable before the age of 65.

  • Experts believe the rise in the rates of COPD in women is tied closely to the success of tobacco companies' marketing.

  • Women with COPD have a similar profile to men with COPD, i.e., they are white, live in the southeast and have an income below poverty level.

COPD Affects Women Differently Too

The ALA also reported that women's experience with COPD is quite different than men's as well. Here are a few of the differences:

  • Women tend to be under-diagnosed for COPD. Because even doctors tend to think of COPD as a man's disease, they often overlook the symptoms in women, or classify them as asthma. The only test that can nail down a COPD diagnosis is spirometry, and it is not widely used.

  • Women are more vulnerable to lung damage from tobacco smoke and other pollutants than men are. This is because women's lungs and airways are smaller than men's, and have less respiratory muscle to move air in and out. So, cigarette smoke and other lung irritants get more concentrated when they are   inhaled, and can cause more damage. The female sex hormone   estrogen also plays a role in how the nicotine in cigarettes is broken down, resulting in even more harmful compounds.

  • Women sometimes have trouble getting effective treatment too. Quitting smoking is the first step that should be taken, but women often have more trouble quitting and staying smoke-free than men do. Also, women with COPD tend to need more interpersonal connection and social support to cope with their disease, but they don't always get it.

  • Perceived quality of life is more of an issue for women with COPD. Women tend to have the symptom of shortness of breath more often and this is an factor affecting quality of life. In addition, women with COPD often experience anxiety and depression, conditions that tend to be under-treated in two-thirds of cases.

Poor quality of life, along with increased anxiety and depression, make it more difficult for women to follow a treatment plan, quit smoking, stay active and get the social and emotional support they need. As a result, they have a greater chance of disease flare-upsand many more frequent emergency visits. Frequent symptom flare-ups in turn further decrease quality of life and hasten the progress of COPD.

Hope for Change in the Future

All of these facts are distressing for us women and caregivers of women with COPD, but the American Lung Association suggests a number of actions that can make a significant difference in the future.

  • Strengthen the Federal and state public health response to COPD, in order to better track disease trends and allocate resources.

  • Increase our investment in specific research aimed at studying COPD in women. This would help improve both diagnosis & treatment.

  • Expand efforts to prevent COPD, by reducing smoking, exposure to secondhand smoke and air pollution and helping current smokers to quit, for good.

  • Help women living with COPD to speak out about their experiences and to advocate for themselves and their peers in the community.

Hopefully, over time, with concerted effort both from authorities, experts and stakeholders, the statistics in this report will be changed and we will discover how to lessen the impact COPD has on women.