8 Surprising Ways that COPD Affects Women Worse Than Men: Tips for Managing the Risks and Challenges that Face Women with COPD
When it comes to sex and gender-related differences in COPD, women certainly seem to get the short end of the stick. Studies show that women not only tend to be more prone to getting COPD, but also suffer from worse symptoms, later diagnoses, and other COPD-related health problems more often than men.
This is a relatively new revelation; back in the day, COPD used to be known as a “man's disease,” and very little was known about COPD in women. Before the early to mid 1900's, the vast majority of tobacco smokers were men, and it was rare for women to smoke or develop smoking-related diseases like COPD.
This isn't true anymore, however, and the trend seems to flipping in the opposite direction as more women than ever have been diagnosed with COPD in recent years. This shift has made it possible for researchers to study COPD in women more extensively, and this research has revealed some significant—and surprising—differences in how women are affected by this disease.
Some of these differences between men and women have biological origins, including differences in lung anatomy and how men's and women's bodies are affected by COPD. On the other hand, some differences originate from within the healthcare system, which (often unwittingly) tends to treat men and women differently during diagnosis, evaluation, and treatment for COPD.
Unfortunately, many of these disparities result in extra risks and disadvantages for women, including later COPD diagnoses, quicker lung function decline, and even a higher risk of death. However, many of these risks can be mitigated with simple preventative measures and increased awareness of these risks among doctors, caretakers, and people with COPD.
In this post, we're going to take a closer look at the scope and the nature of the problems that women with COPD face in regard to their symptoms, their healthcare, and the impact of the disease. Most importantly, we also present dozens of practical strategies—and links to other helpful resources—that women with COPD can use to minimize these extra risks.
All women with COPD deserve to know how the disease might affect them differently and what they can do in response. Knowledge is power, and the more you learn, the more empowered you will be to take control of your health and live your best life possible with COPD.
The Major COPD Risks that Affect Women, and What You Can Do About Them
In the following sections, we'll explain eight major challenges that women with COPD encounter and explore some of the biological and structural reasons for why these issues tend to affect women more than men. You'll also find a plethora of helpful tips throughout this guide for how women can overcome these challenges and get better outcomes for their health.
If you are a woman with COPD, or know someone who is, we hope that this guide will serve as a helpful tool for managing the gender-specific risks that come with the disease. For more information on COPD management, including more information about sex differences among people with COPD, check out our huge collection of helpful guides in our Respiratory Resource Center.
A quick note: We understand that sex and gender are not one and the same, and that COPD differences intersect both gender and sex. For the sake of brevity and simplicity, however, we use these terms interchangeably—or use one term to refer to both concepts at once—at times in this guide.
Women's Lungs Are More Sensitive to Damage from Smoking
How heavily someone smokes throughout their lifetime—a factor that's often measured in “pack years—influences how severe their COPD-related lung damage is later in life. For example, a person with COPD who smoked one pack of cigarettes every day for 10 years (which is the equivalent of 10 pack years of smoking) will likely have more severe lung damage than someone who only smoked half a pack a day for 10 years (equivalent to 5 pack years of smoking).
Unfortunately, research suggests that women's lungs are more vulnerable than men's to the damaging effects of tobacco smoke. This not only makes women more vulnerable to developing COPD, but also causes women to develop more severe COPD than men who have an equivalent number of pack years.
One study, for example, found that women who smoke less than men have nearly the same amount of measurable emphysema (i.e. damaged air sacs in the lungs). This was true even though the men had smoked significantly more—four more cigarettes per day, on average—than the women in the study.
It's important to note that, as a whole, men actually tend to have worse emphysema than women. However, research suggests that this is largely due to the fact that men tend to smoke more heavily; on average, male smokers in the US have a whopping 33% more pack-years than women, with women averaging 15 pack years and men averaging 20.
However, women still sustain a disproportionately large amount of lung damage despite smoking less—and even starting smoking later—than men. While researchers aren't exactly sure why this happens, they believe this phenomenon could be the result of certain biological features in women that predispose their lungs to smoking-related damage.
These biological features include female hormones like estrogen and progesterone, which have been shown to play a role in how the lungs respond to cigarette smoke. Women also tend to have smaller airway spaces than men, which some researchers believe could result in the airways getting a higher dose of toxins when they're exposed to cigarette smoke.
This effect might not be limited to smoking, however; some studies suggest that women's lungs might be more sensitive to other kinds of respiratory hazards, like air pollution, chemical fumes, and second-hand smoke. This is bolstered by the fact that even women who have never smoked before in their lives get COPD at significantly higher rates than men who have never smoked; nearly 80% of nonsmokers with COPD are women.
What Women with COPD Can Do About It:
If you are a woman who smokes, quitting smoking is one of the best possible things you can do for your health. There's no way to reverse the damage that's already done, but you can prevent additional damage—and reap a ton of other benefits—if you stop smoking now.
Check out the following guides to learn everything you've ever wanted to know about quitting smoking:
- How to Quit Smoking Part 1: Overcoming Doubts & Finding Resources to Help You Quit
- How to Quit Smoking Part 2: Coping with Nicotine Withdrawal & Choosing a Quit-Smoking Medication
- How to Quit Smoking Part 3: Taking the First Steps & Strategies for Staying Smoke Free
Protect Your Lungs from Potential Hazards
Women should also be extra careful about exposing their lungs to other respiratory hazards, since they seem to be extra vulnerable to their damaging effects. For example, women—like all people—should avoid hazardous occupations (e.g. jobs that expose you to exhaust fumes or dust) and take steps to reduce indoor air pollution in their homes (e.g. avoid using wood-burning stoves, noxious chemicals, and other products that release harmful fumes indoors).
Protecting your lungs from these hazards can also help prevent irritation, inflammation, and flare-ups that make COPD symptoms harder to control. It can also reduce your risk for COPD exacerbations, which can cause additional, permanent lung damage and lung function decline.
We'll discuss more about how to avoid common respiratory hazards (and link you to several in-depth guides on the topic) in the sections below.
Women Have a Higher Risk of Getting COPD than Men
As we discussed in the previous section, women's lungs tend to be more vulnerable to respiratory irritants than men and tend to sustain more lung damage from each cigarette they smoke. Therefore, it should be no surprise that this causes women to have an overall higher risk for developing COPD than men.
Research suggests that this difference is quite significant; one large systematic review found that women who smoke are fifty percent more likely to get COPD than men who smoke. Other studies show that women tend to be more likely to get COPD from lesser amounts of smoking, and also tend to develop COPD earlier in life.
However, because COPD is such a complicated disease that usually develops years after the exposure that causes it, pinning down the exact reason for gender differences in COPD risk difficult. In addition to biological factors, there are likely a variety of social, lifestyle, and demographic factors at play, such as: gender-related differences in healthcare accessibility, healthcare quality, smoking behaviors, geographical location, and more.
What Women with COPD Can Do About It:
Take Good Care of Your Lungs
The only reliable way to reduce your risk for COPD is to protect your lungs from smoke and other respiratory irritants (like air pollution) throughout your lifetime. The more frequently your lungs are exposed to and inflamed by respiratory hazards, the more you put yourself at risk for lung diseases like COPD.
Because women are more susceptible to COPD, women should be extra careful about what they breathe into their lungs. That means not smoking, or quitting if you do, and doing your best to breathe clean, pollutant-free air as much as possible.
Of course, there's only so much you can do about certain respiratory irritants like outdoor air pollution. But even if you live in a place with low air quality, you can still take steps to reduce how much air pollution breathe (e.g. planning outdoor activities for times when your local air pollution is low).
Here is a list of some of the major respiratory irritants that can increase your risk for COPD:
- Second-hand smoke
- Any kind of smoke or combustion fumes (e.g. smoke from fireplaces, wood-burning stoves, car exhaust, cooking fumes, etc.)
- Radon gas (a common radioactive gas found in homes that can only be detected with a proper radon test)
- Common commercial cleaning and pest-control products
- Many crafting, renovation, and construction materials, including paints, treated lumber, adhesives, solvents, new carpets and flooring, etc.
- Occupational hazards like dust, chemical fumes, and diesel exhaust
It's worth mentioning that, even though any kind of respiratory irritant can be dangerous if you're exposed to it long term, smoking is by far the biggest hazard and the most important one to avoid. Smoking is responsible for more cases of COPD than anything else; a full 85 to 90 percent of all COPD cases are caused by smoking.
Check out the following guides for even more tips about what you can do to avoid respiratory irritants and reduce your risk for COPD:
- How Volatile Organic Compounds Harm Your Lungs, and How to Avoid Them
- How to Cope with Poor Outdoor Air Quality
- How to Protect a Child from Lung Diseases Like COPD
Reduce Sources of Pollution in Your Home
Even though we've already stressed the importance of avoiding respiratory irritants, it's important to discuss indoor air pollution specifically, especially since women tend to be exposed to this type of pollution the most. That's because, even in modern times, women tend to spend more time than men at home doing household tasks that could be hazardous to their lungs.
Cooking and cleaning, for example, two major sources of exposure to respiratory irritants at home. In fact, research shows that non-smoking women who cook more often—and have smokier kitchens when they cook—are more likely to develop COPD.
Fumes from cleaning products, especially chemicals like ammonia and bleach, can also damage your lungs and increase your risk for COPD. Luckily, there are many things you can do to reduce the risks from cooking and cleaning, but you need to do them consistently to keep the air in your home clean.
One of the best things you can do is establish a good ventilation system in your kitchen and any rooms you use chemicals to clean. The goal is to create an air flow that funnels the fumes outdoors, and you can do this with a fume hood (e.g. above your kitchen stove), a ventilation fan (which many bathrooms have pre-installed), or simply by opening up some windows to allow the fumes to escape.
You can also reduce your exposure to chemical irritants by being more selective about what kinds of products you use. Many household cleaning products can be hazardous, so it's a good idea to look at the labels of everything you buy and try to find alternative products that are safer for your lungs.
These are just a few of many possible steps you can take to keep your indoor air as clean as possible. For more tips about how to cook and clean more safely and reduce other sources of air pollution in your home, check out the following guides from our Respiratory Resource Center:
- How to Improve Your Indoor Air Quality for COPD
- How Cleaning Products Can Damage Your Lungs, and What You Can Do to Prevent It
- Your Complete Guide to Choosing an Indoor Air Filter to Improve Your COPD Symptoms
- Spring Cleaning Tips for Healthy Lungs & COPD
Women are Less Likely to Receive a Correct COPD Diagnosis
Unfortunately, women with COPD tend to be disadvantaged in the US healthcare system, and the problem begins at the very first step: women with COPD are less likely to get an accurate COPD diagnosis, more likely to get misdiagnosed with asthma, and tend to get diagnosed later (as in after the disease has progressed further) than men.
One of the main reasons for these discrepancies seems to be doctor bias that affects how they evaluate men vs. women with symptoms that could be a sign of COPD. As a result, women with COPD symptoms are less likely to receive a spirometry test than men, which is likely the primary reason that women are under-diagnosed compared to men.
Spirometry tests are the most powerful tool that doctors have to diagnose COPD, and getting one is vital for an accurate COPD diagnosis. In fact, research shows that the gap between COPD diagnosis rates in men versus women is reduced when doctors have spirometry test data to help them make their diagnoses.
This suggests that, if doctors just did spirometry testing in a more consistent manner, they could significantly reduce or eliminate the diagnosis divide between women and men. However, while this might sound simple, it's not such an easy task; this issue is part of a wider problem of gender bias in healthcare that sees women disadvantaged in a wide range of different ways.
Fortunately, these long-standing issues have received a lot more attention in recent years. As doctors and researchers continue to investigate these gender biases in healthcare, they can develop new strategies for addressing them and reducing the negative effects they have on patients.
What Women with COPD Can Do About It:
Be on the Look Out for COPD Symptoms
Women, and especially women who have risk factors for lung disease, need to be on the lookout for signs of COPD as they age. Never ignore any long-term changes in your respiratory symptoms, especially persistent coughing or shortness of breath.
If you do notice any changes, makes sure to bring them up with your doctor as soon as soon as possible after they occur. The earlier you get diagnosed, the earlier you can get treatment that can improve your quality of life and the long-term outlook for your health.
To learn more about how to recognize the early symptoms of COPD, check out the following guides:
Advocate for Yourself
Ideally, every doctor would always treat men and women equally and would know how to properly diagnose COPD in women just as well as men. However, this is unfortunately not the case, and the responsibility often falls instead on women patients to advocate for themselves.
Unfortunately, this isn't always easy to do, especially if you (like many people) find medical professionals intimidating or simply have trouble speaking up at the right times. Luckily, being a good self-advocate is something you can learn, and you can even enlist others to help you if you need.
One way to become a better self-advocate is to be more pro-active about your health in general. That means educating yourself about your body and common disease symptoms, and being diligent about bringing things up with your doctor if you have any symptoms or concerns.
It could also mean standing up for yourself if a medical professional doesn't take your concerns seriously. If you think that something you're worried about needs to be looked into further, don't rely on your doctor bring up the next step; if you go to your doctor with persistent respiratory symptoms, for example, you might need to ask your doctor specifically to do a diagnostic spirometry test.
If you're unable to advocate for yourself for any reason, or simply need some backup, you can always bring someone else to advocate on your behalf. Sometimes, two voices are more effective than one at getting stubborn healthcare professionals to listen to your needs.
It's also important for women to be aware of doctors potential biases and find a doctor they can trust. Your doctor should be someone who listens, respects your concerns, and never ignores