COPD Symptoms & Causes Gender Differences in COPD By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Deborah Leader, RN Medically reviewed by Medically reviewed by Sanja Jelic, MD on September 20, 2020 Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Review Board Sanja Jelic, MD on September 20, 2020 Print When many think of chronic obstructive pulmonary disease (COPD), they think of it as a man's disease. However, as the prevalence of COPD in women increases, it's important to explore the gender differences in COPD. Here's what you need to know about how COPD affects women differently than men. BSIP / UIG/Universal Images Group / Getty Images Today, More Women Than Men Die From COPD The idea that COPD is a disease mainly men have to worry about was initially supported by statistics in 1959, when the number of men compared with women who died from the disease was five to one. However, the number of women dying from COPD between 1968 and 1999 increased by 382 percent, while in men, there was only a 27 percent increase. The year 2000 marked the first year that more women than men died from COPD, and that trend has continued. Symptoms That Are Specific to Women The hallmark symptoms of COPD include dyspnea, chronic cough, and sputum production. Experts have recently found that the effects of COPD in women are far more detrimental than they are in men. Women are more likely to experience the following symptoms: More severe shortness of breathMore anxiety and depressionLower quality of lifeIncreased airway hyperresponsivenessWorse exercise performance Furthermore, women have more frequent exacerbations than men do and are at greater risk of malnutrition. Gender Bias in COPD Diagnosis Research shows that physicians are more likely to give a COPD diagnosis to a male patient rather than a female, even if the patients have similar symptoms. This implies that there may be a gender bias when it comes to making a COPD diagnosis. Moreover, women are also less likely to be offered a spirometry test or referred to a specialist. Once doctors receive abnormal spirometry results, however, this gender bias seems to disappear. This is why spirometry testing is so important for both men and women who are found to be at risk for COPD. Women Are More Susceptible to Tobacco's Side Effects There is growing evidence that women are more likely to have a greater reduction in lung function at comparable levels of smoking than men. This may be because women's lungs are generally smaller, so the lungs are possibly exposed to a greater amount of tobacco smoke when women smoke the same number of cigarettes as men. Other possible explanations for women being more susceptible to the harmful effects of tobacco smoke include: Possible under-reporting of tobacco consumption among womenA genetic predisposition for lung damage from smoking that is gender-specificLevels of secondhand smoke exposureDifferences in cigarette brandsHormonal effects on lung development and size of the airwaysDifferences in the way that women metabolize cigarette smoke "But I Never Smoked!" Roughly 15 percent of all people who are diagnosed with COPD have never smoked. Notably, out of this group, nearly 80 percent are women, suggesting that women may be more vulnerable to risk factors associated with COPD that are not related to smoking. Smoking Cessation: A Primary Treatment Goal Smoking cessation remains the most important and the most cost-effective intervention for anyone with COPD, regardless of gender. It is especially beneficial for women. A spirometry test measures something called FEV1, or forced expiratory volume in one second. This test measures the amount of air that you can exhale from the lungs forcibly in one second. Women with COPD who quit smoking tend to show a greater average increase in FEV1 after one year than men. This means that lung function may improve more in women than in men in the first year after quitting smoking. Should Treatment Options for Women Be Different? Current COPD guidelines have yet to recommend different treatment options for men and women, though it's possible this practice will change as research advances. If you are a woman with COPD, however, there are certain treatment considerations that you should be aware of. Inhaled corticosteroids (ICS): These are often used in COPD treatment to prevent COPD exacerbation in those with severe COPD, and women are more likely to have severe COPD. Women using ICS should be aware that they may decrease bone density and increase the risk of osteoporosis and hip fracture. Since women are already at a greater risk for osteoporosis than men, women using ICS should also talk to their doctor about taking calcium and vitamin D supplements, taking bisphosphonates, and having their bone density monitored. In addition, keep this in mind: when discontinuing ICS, women may have a higher probability of respiratory deterioration than men. If you are planning to stop using your ICS, talk to your doctor first to discuss your options.Metered dose inhalers (MDIs): Some older studies have shown that women are more likely to incorrectly use an MDI than men; however, this needs to be investigated further. If you are a woman who uses an MDI, take the time to be sure you know how to use it effectively.Oxygen therapy: This type of therapy is recommended for some patients who have low blood oxygen levels. One study suggests that women who are treated with long-term oxygen therapy have better survival rates than men. Talk to your doctor for more information.Lifestyle changes: In a 2005 study, women with COPD were more likely to have a lower body mass index (BMI) than men with the condition. For your overall health, it's generally recommended to keep your weight in the "normal" range of 18.5 to 24.9. But when you have COPD and your BMI is lower than 21, mortality increases, so it's important to monitor this number and possibly add calories to your diet if you find your BMI is slipping under 21. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Punturieri A, Croxton TL, Weinmann G, Kiley JP. The changing face of COPD. Am Fam Physician. 2007;75(3):315-6. Thun MJ, Carter BD, Feskanich D, et al. 50-year trends in smoking-related mortality in the United States. N Engl J Med. 2013;368(4):351-64. doi:10.1056/NEJMsa1211127 DeMeo DL, Ramagopalan S, Kavati A, et al; COPDGene Investigators. Women manifest more severe COPD symptoms across the life course. Int J Chron Obstruct Pulmon Dis. 2018;13:3021-3029. doi:10.2147/COPD.S160270 Gut-Gobert C, Cavaillès A, Dixmier A, et al. Women and COPD: do we need more evidence? Eur Respir Rev. 2019;28(151). pii: 180055. doi:10.1183/16000617.0055-2018 Terzikhan N, Verhamme KM, Hofman A, Stricker BH, Brusselle GG, Lahousse L. Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study. Eur J Epidemiol. 2016;31(8):785-92. doi:10.1007/s10654-016-0132-z Jenkins CR, Chapman KR, Donohue JF, Roche N, Tsiligianni I, Han MK. Improving the management of COPD in women. Chest. 2017;151(3):686-696. doi:10.1016/j.chest.2016.10.031 U.S. Department of Health and Human Services: Office on Women's Health. Chronic obstructive pulmonary disease (COPD). Updated June 11, 2019 Wu J, Sin DD. Improved patient outcome with smoking cessation: when is it too late? Int J Chron Obstruct Pulmon Dis. 2011;6:259-67. doi:10.2147/COPD.S10771 Calzetta L, Puxeddu E, Rogliani P. Gender-related responsiveness to the pharmacological treatment of COPD: a first step towards the personalized medicine. EBioMedicine. 2017;19:14-15. doi: 10.1016/j.ebiom.2017.04.035