More than 7 million women in the U.S. have this deadly disease. Here's how it affects their physical and mental health.
More than seven million women in the United States have chronic obstructive pulmonary disease (COPD), an inflammatory lung disease that makes it hard to breathe. Yet, many more are walking around undiagnosed, according to the American Lung Association.
“Women often present differently than men with symptoms such as anxiety, depression and fatigue that may make both them and their physicians think it’s something else,” says Harlan Weinberg, MD, medical director of the intensive care unit at Northern Westchester Hospital in Mount Kisco, N.Y. and director of pulmonary function testing and pulmonary rehabilitation at Northwell Health.
Women with COPD are also more likely than men to have disease flare-ups, which in turn leads to a greater chance of disability and death because of the gradual — but progressive — loss of breathing ability. The sobering truth is that the number of deaths among women from COPD has increased four-fold over the past three decades and, since 2000, more women than men in this country have died of the disease. Here’s what women need to know to protect themselves:
Don’t smoke, not even socially. Women smokers are about 50 percent more likely to develop COPD than male smokers, according to a review published in 2016 in the American Journal of Respiratory Critical Care Medicine. They are also more likely to develop it earlier (before age 60) and even with less smoking. “The airways of women are smaller than those of men, so one theory is that there’s a greater concentration of tobacco smoke and other irritants in them,” explains Marc Sala, MD, pulmonologist and critical care specialist at Northwestern Medicine in Chicago. A study presented last year at the American Thoracic Society International Conference found that women with COPD reported smoking less than men but experienced worse symptoms, reported lower quality of life and more flare-ups.
It’s critically important to avoid secondhand smoke, as well. A 2016 study published in the British Medical Journal found that both men and women with COPD who live with a smoker, or are otherwise exposed to secondhand smoke, have more respiratory symptoms and worse outcomes than those who don’t. And while there are no conclusive studies linking vaping to COPD, it’s reasonable to think it carries the same risks, Weinberg points out.
Be tuned into symptoms. Even doctors themselves associate COPD with older male smokers, which is why getting a diagnosis as a woman can be so challenging. (It’s often misdiagnosed as asthma.) If you have symptoms such as trouble breathing, wheezing or a chronic cough and you’ve ever smoked — or you work in an occupation where you’re regularly exposed to lung harming chemicals, such as hairdressing, housekeeping or construction — let your doctor know.
“Sometimes physicians aren’t as good at connecting the dots as they should, and if they don’t know that you smoked in your teens and 20s, they may just assume you have asthma rather than COPD,” says Weinberg. “In addition, some women downplay symptoms such as shortness of breath or coughing up mucus, which their doctor really does need to know about.”
Don’t be afraid to push for the gold standard diagnostic test for COPD, known as spirometry. This in-office test measures how much air you inhale and exhale by having you breathe into a tube attached to a machine called a spirometer. Research shows that women are less likely to get one than men with the exact same smoking history and disease symptoms.
Make sure you’re getting the right treatment. Quitting smoking is one of the top things you can do to help slow the progression of COPD, and women appear to reap its benefits even more than men, according to a 2017 report put out by the Global Initiative for Chronic Obstructive Lung Disease. Yet, studies also show that women often find it more challenging than men to stay quit. Talk to your doctor to make sure that you’ve explored all of your options, including nicotine replacement options such as a patch, gum or inhalers, as well as medications that can help curb cravings.
If you do have COPD, it’s also imperative that you get pulmonary rehabilitation, which teaches you ways to help improve your symptoms such as instruction on breathing techniques, adds Sala. Programs vary, but most mean seeing a therapist once or twice a week for eight to 12 weeks, after which you’re given a “prescription” for exercises you can do on your own. These programs have been shown to improve symptoms and overall quality of life, but women are less likely to enroll in them, according to a 2018 report by the British Lung Foundation.
Take care of your mental health. Women with COPD are more likely to experience anxiety and depression than men, probably because their quality of life overall is more impaired, says Weinberg. Yet, only about a third of them get treatment such as counseling to help them manage these conditions.
“It’s a vicious cycle, because the more depressed a woman feels, the harder she may find it to follow her treatment plan and stop smoking, which then in turn cause more flare-ups that leave her even more distraught,” explains Weinberg. The symptom flare-ups also make the disease worse.
The best way to treat depression among women with COPD is to combine pulmonary rehabilitation with a type of therapy known as cognitive behavior therapy, where you’re taught specific skills to help you better deal with the disease.
“The good news is most women, when they’re diagnosed and given the appropriate treatment for COPD, can manage their disease well with medications and never need to go on oxygen therapy,” says Sala. “That’s why it’s so important to see your doctor and to be persistent about a diagnosis if you notice symptoms.”
