Digital Inspiration Newsletter

Underdiagnosis of COPD in Women

Studies suggest that as many as 75% of people living with COPD in the U.S. are exhibiting symptoms without a formal diagnosis by a healthcare provider. Women are still more likely to be underdiagnosed with COPD despite rates among women exceeding male rates for more than a decade.

The underdiagnosis of COPD in women is likely caused by multiple factors, including patient and physician behaviors. For example, disease presentation in women can be different from traditional symptoms. This may result in their symptoms being attributed to other conditions like asthma or anxiety. Common symptoms for both men and women include shortness of breath, excess phlegm, and frequent coughing or wheezing.

Compared to men, however, women with COPD:

• Are more likely to develop symptoms at younger ages and be hospitalized;
• On average smoke less than men and have a lower body mass index (BMI);
• Are more likely to experience serious symptoms of COPD including severe shortness of breath; and
• Are often diagnosed with comorbidities such as asthma, osteoporosis, and depression.

While the reasons for these differences are not well understood, the COPD community must be aware to give and receive proper care. To improve diagnosis, women should be proactive when they experience the above symptoms and explore with their healthcare providers whether it could be COPD.

Additional physician education about how COPD presents in women is also necessary. Even when women display more severe symptoms, they are either not offered spirometry, a useful tool to help with the diagnosis of COPD, or they are misdiagnosed.

Women should feel empowered to ask affirmatively whether COPD may be the cause of their symptoms and request additional testing, like spirometry.

The Best Way to Reduce Your Risk of COPD or Slow Its Progression? Quit Smoking!

For decades, the tobacco industry has targeted women in their advertisement and sale of cigarettes. Since the early 20th century, advertisements have depicted images that prey upon women’s insecurities. An example of this includes cigarettes being marketed as an aid for weight loss. They often feature thin, fashionable, and wealthy-looking women. The narrative that cigarettes are a weight control method is still prevalent today. This has led to hundreds of thousands of tobacco-related deaths in women.

Women are still greatly impacted tobacco use. About 11% of U.S. women smoke cigarettes which increases their risk of developing COPD, lung cancer, and other conditions.

As of 2020, women are more likely to have COPD than men. Despite this, around 40% of women with COPD continue to smoke cigarettes. Many women think that quitting smoking after a diagnosis may not make a difference to their health.

Despite this misconception, quitting smoking can have immediate benefits. In just minutes after quitting smoking, blood pressure, heart rate, and blood nicotine levels drop. After a few weeks, your lung function and stamina can improve. Within a few months, coughing and shortness of breath decrease.

It is never too late to start your smoke-free life! Respiratory Health Association provides resources to start your quit journey.

Did You Know There Are Immediate Benefits to Quitting?

• After 20 minutes:
  • Blood pressure and pulse drop to normal; hands and feet start to warm up.
• After 48-72 hours:
  • Sense of smell and taste improve
  • Nerve endings start to regrow
  • Bronchial tubes relax.
• After 1-9 months:
  • Coughing and shortness of breath decrease
  • Cilia regrow in the lungs

Improving COPD Management for Women

Women face unique challenges when managing their COPD. This may be in part due to comorbidities (other illnesses) like asthma, osteoporosis, and depression. Additionally, without a timely diagnosis, women may experience worsening symptoms which can impact their quality of life.

Due to these differences, women living with COPD require care options and management plans specific to their needs. Along with medication such as corticosteroids and bronchodilators, there are additional therapies that can slow the progression of COPD and its comorbidities.

To improve their quality of life, women living with COPD should include these therapies:

• Smoking Cessation
• Pulmonary Rehabilitation
• Exercise
• Patient Education

Pulmonary rehabilitation (PR) is a great resource to improve disease progression in women. PR is an individualized medical program that incorporates patient education, exercise, breathing techniques, and supplemental oxygen for people with chronic lung disease.

Along with alleviating some physical symptoms such as shortness of breath and fatigue, pulmonary rehabilitation has been effective in improving mental health. The mental health benefits of PR are particularly important for women because women with COPD are more likely to experience anxiety and depression than men.

During a pulmonary rehabilitation visit, you may exercise with or without supplementary oxygen, learn about ways to manage symptoms at home, and receive nutrition counseling.

Ask your doctor for a referral to a pulmonary rehabilitation program to receive an initial pulmonary function test and learn how to manage your individual symptoms.

A major part of improving management of COPD for women is to increase awareness. The misconception that COPD is a disease that largely affects older males is harmful and outdated. COPD is a women’s health issue and through additional awareness, such as the WECARE campaign, and more medical research, we can better understand why women are more susceptible to severe COPD.

As more awareness is brought to this issue, the management of COPD in women will be improved. To improve the quality of life and well-being of women living with COPD, physicians must be knowledgeable about the gender-based differences in risk and presentation.