By Jennifer Wider, M.D.
Society for Women's Health Research
The number of women dying from chronic obstructive pulmonary disease (COPD) is on the rise. In fact, more women will be affected by COPD this year than from most forms of cancer.
COPD is a group of diseases that cause airflow blockage in and out of the lungs. COPD usually includes chronic bronchitis, a condition in which the air passages become swollen and filled with mucous, making it difficult for air to pass freely, and emphysema, a condition in which the air sacs of the lungs are destroyed. Smoking is the leading cause of both chronic bronchitis and emphysema.
COPD is a leading cause of death for both women and men in the United States. But the death rate for women is growing more quickly than it is for men, according to the Centers for Disease Control and Prevention in Atlanta, Ga. In addition, more women visited the emergency room and more women were hospitalized than men for COPD-related problems in recent years.
There are several reasons for this gender discrepancy. "Women tend to be smaller than men and therefore have smaller breathing passages," said Kenneth Chapman, M.D., director of the Asthma Centre and Pulmonary Rehabilitation Program at Toronto Western Hospital in Toronto, Ontario. "For a given amount of airway irritation, women have a proportionately greater injury or impairment," There has been an increase in the number of women smoking cigarettes in the United States relative to men over the last fifty years and women may be more susceptible to the effects of tobacco. Some researchers speculate that women's greater susceptibility may be related to hormones, Chapman said, while other researchers believe that the differences in lung growth patterns between men and women are important. Studies have shown that factors affecting smoking behavior are different between men and women. "Women may have different motivations that affect their smoking and smoking cessation behaviors," Chapman said. There is some evidence that women find it more difficult than men to quit smoking due to the fear of gaining weight.
Living with COPD is not easy for women or men. People with the disease usually experience coughing and shortness of breath. The cough often produces phlegm and is frequently accompanied by yellow or green mucus. People with COPD find it difficult to walk, climb stairs or otherwise exercise. They often need to prop themselves up at night to avoid breathlessness. The symptoms do not go away and often get worse over time.
There are steps to lower your risk of COPD. The most important one is smoking cessation.
"Women must not begin smoking, and if they have begun, they must quit," Chapman warned. Even if a woman has smoked for many years, quitting can dramatically curtail her risk of developing COPD.
There is evidence that early detection and treatment can positively change the course of COPD.
Spirometry is used to diagnose the disease: "it's a five minute breathing test that measures the amount of air that a person can expel forcefully from the lungs and how quickly the air is expelled," Chapman explained. By contrast, listening to a person's chest with a stethoscope and chest x-rays are by-in-large insensitive in the diagnosis of COPD.
Women who smoke should talk to their doctors about receiving the test on an annual basis, which can help track changes in lung health from year to year. Testing provides a better understanding of an individual's risk for disease and the rate of lung health deterioration; and knowing one's status can be a catalyst for lifestyle changes to improve health.
