How Lung Conditions Look Different In Women


Did you know that lung disease appears more severely in women than men? In fact, some lung conditions are almost exclusive to women. Factors that contribute to differing symptoms between men and women include environmental, sociocultural, and occupational factors, as well as biochemistry.

According to the study “Women and Lung Disease. Sex Differences and Global Health Disparities,” women are more prone to “pulmonary hypertension, catamenial diseases, and pregnancy-associated asthma exacerbation.” This also includes autoimmune lung disease like lupus.


Biology & Respiratory System

 

Women respond to respiratory conditions differently than men, and so when it comes to smoking and tobacco consumption, the risk becomes much higher for women.

“A metaanalysis of 11 longitudinal studies suggests that women experienced a greater rate of lung function decline than men when adjusted for the amount of tobacco smoked,” The study explained. “In the Lung Health Study, lung function decline in women who continued to smoke was more rapid than in men.”

A possible reason for this could be that lung size in women is smaller, counting as a “higher dose.” The study also said that, “Women may also metabolize several components of tobacco smoke differently than men, which could translate into relatively higher and more prolonged exposure to toxic substances.”

Other factors that impact respiratory capacity are the time of exposure and age.There is higher risk in those that were exposed to environmental toxins in childhood or in the womb. Exposure can look like “indoor and outdoor air pollution, stress (both anxiety and that associated with socioeconomic status), access to health care, genetics and epigenetics, and diet.”


Women and COPD


According to “COPD Can Look Different In Women,” this chronic lung condition is of growing concern to doctors, particularly because diagnosis is often delayed. As COPD is a progressive disease, the earlier the detection, the better the response to treatment.

“Doctors may also be slower to suspect COPD in people who have never smoked. But we know now that, while smoking is a major cause of COPD, it’s not the only cause,” Pulmonologist Jamie Garfield, MD shared. “In fact, about 1 in 4 people with the condition have never smoked. And most of those nonsmokers are women.”

Garfield asserts that testing in women can sometimes miss the mark, as most doctors offer diagnostic spirometry tests to women less often than to men.Why? Because COPD has, until recently, considered a disease more prominent in men! This is because statistically, most smokers were men. 

Another factor in delayed diagnosis is that symptoms may appear differently in women, resulting in misdiagnosis such as asthma.

To help with earlier detection, Garfield shares these symptoms could point to COPD in women:

  • Depression
  • Insomnia
  • Osteoporosis

Women may experience more severe symptoms. The common symptoms of COPD for people of all genders include:

  • Persistent cough
  • Increased mucus production
  • Shortness of breath during everyday activities
  • Wheezing
  • Frequent respiratory infections
  • Fatigue

 

Due to the difficulty in identifying COPD in women early on, Garfield reminds us that diagnosis is usually made after age 60, but can start sooner, and early on set is more likely to be in women.


“Women with COPD may have smoked less - or not at all. Women are more likely to develop lung damage at lower levels of smoking than men. And about 27% of women with COPD never smoked, compared to about 14% of men,” Jamie Garfield, MD added.”

Pre-existing combinations of conditions can also muddy the waters, however, some conditions have a pattern of appearing together, so that can offer insight into diagnosis as well.


Treatment


While treatment is often the same in both genders, more gender-specific treatment is becoming more common. 

Brigham and Women’s Hospital has a new gender-specific care for women with pulmonary diseases. Their program covers asthma, COPD, lung cancer, Lymphangioleiomyomatosis, pulmonary hypertension, and voice and vocal cord dysfunction.

For gender-specific treatment options local to New Hampshire, try the following:

Parkland Medical Center (Derry, NH)
Wentworth-Douglass Hospital/Mass General Brigham (Dover, NH)
Elliot Health System (Manchester, NH)
Southern NH Health (Nashua, NH)


If  you’re a woman experiencing misdiagnosis, or relate to the symptoms and obstacles described above, look for a specialized program or provider in your area. While prevention is paramount, treatment in earlier stages of a lung condition can also be life changing. You can learn more about COPD and additional resources here.
 

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