For a long time, chronic obstructive pulmonary disease (COPD) – a progressive lung disease – was considered a “men’s disease”. But that is no longer the case.
“Women are more likely to develop COPD than men,” said Suzette A. Garafano, MD, clinical director of the COPD program at NYU Langone Health. “However, women are less likely to be diagnosed with the disease.”
Underdiagnosis is one of the reasons why it is important for women to know the signs and symptoms of COPD. Additionally, women experience COPD differently than men. “In general, women tend to develop COPD at a younger age, be more symptomatic, and have worse lung function than men for the same tobacco exposure,” Garafano said.
We asked Garafano for other important COPD facts women need to know.
Read: Women and COPD >>
What is COPD and what diseases does it include?
COPD is a chronic lung disease caused by damage and inflammation of the airways and lung tissue. Over time, this damage hinders the ability of air to flow smoothly in and out of our lungs, which then leads to the chronic respiratory symptoms of COPD. The disease is progressive and irreversible.
In the United States, the vast majority of COPD cases are caused by cigarette smoke. There are basically two types of COPD: chronic bronchitis and emphysema.
People with chronic bronchitis tend to have more inflammation and damage in the airways, leading to chronic coughing and mucus production. People with emphysema tend to have less airway damage and more lung tissue damage, particularly in the air sacs. People with emphysema tend to have less cough and phlegm, but are more likely to be short of breath and have more difficulty breathing.
In reality, most people with COPD have a little of both.
What are the most common symptoms of COPD?
The most common symptoms of COPD are shortness of breath, cough, excessive production of thick mucus, wheezing, and chest tightness. But not everyone with COPD has the same symptoms, and the severity of symptoms can vary.
How are asthma and COPD different and how are they similar?
Asthma and COPD have several things in common. Asthma tends to develop at a younger age than COPD, but can occur at any age. Asthma is often caused by allergies and results in a type of inflammation of the airways that is allergic or often called eosinophilic.
COPD is also an inflammatory disease, and while some COPD patients suffer from allergic inflammation, most do not. COPD is more often caused by inhaled irritants such as tobacco smoke or cigarette smoke than by allergies. And although the medications we use to treat asthma and COPD are very similar, people with the more allergic type of inflammation tend to respond better to anti-inflammatory treatments, including inhaled corticosteroids.
How does your environment increase your risk of COPD?
There are several environmental factors that can cause or worsen COPD. In addition to a personal smoking history, passive smoking is also a cause of COPD.
Certain occupations in which workers are exposed to dust fumes or chemicals or to known causes of COPD exposure – both indoor and outdoor pollution – are now increasingly recognized as causes of COPD.
There is a component of outdoor air pollution – a particulate matter called PM 2.5, caused by traffic and industry – that is most commonly associated with all types of lung disease.
Fine dust also exists indoors, even if we don’t think it’s indoors. This is more important in low- and middle-income countries, where women often have very high rates of COPD due to exposure to biomass fuels such as coal and wood for heating and cooking.
Read: How air quality affects COPD >>
What role do genes play in COPD?
The only clear genetic disorder that causes COPD is something called alpha-1-antitrypsin (AAT) deficiency. It is the cause of a very small percentage of COPD cases, although every COPD patient should have AAT levels checked.
Approximately one in four people who develop COPD have never smoked. Therefore, there must be other factors that influence a person’s chances of developing the disease, and there are recent research techniques that have identified numerous genetic variants that are linked to COPD. However, it is not really clear at this point what influence these variants have on the development of COPD or the likelihood of developing the disease.
What complications can occur with COPD?
COPD is associated with many comorbidities. Part of this is due to the common risk factor of smoking, but other diseases are directly related to the effects of COPD itself. As we all know, lung cancer is in most cases a result of smoking, but COPD is also an independent risk factor for lung cancer.
Heart disease is associated with COPD, especially when it is more advanced. It can lead to heart failure, especially on the right side of the heart, the side of the heart that pumps blood to the lungs. People with severe COPD and low oxygen levels may develop pulmonary hypertension, a serious condition.
COPD makes people susceptible to recurring respiratory infections. This can in turn lead to scarring of the lungs – a so-called bronchiectasis. Pulmonary fibrosis is accompanied by emphysema.
COPD has also been found to be linked to type 2 diabetes and metabolic syndrome. The connection is not entirely clear, but it is likely related to the systemic inflammatory effects of COPD.
Are there lifestyle changes that can help improve COPD symptoms?
The most important lifestyle change is to stop smoking.
When you stop smoking, symptoms such as coughing and mucus production may improve relatively quickly.
Exercise is also a very effective way to relieve symptoms of COPD. Starting a regular cardiovascular exercise program improves muscle strength, allowing our bodies to use oxygen more efficiently, which in turn reduces shortness of breath.
Pulmonary rehabilitation programs are available for people with advanced COPD. These are medically supervised exercise programs that have been proven to reduce shortness of breath, improve quality of life, and actually reduce mortality from the disease.
What treatments are there for COPD?
The main treatment for COPD is bronchodilators, generally administered via inhalers.
Broadly speaking, there are two types of bronchodilators. Each works in different ways to expand the airways.
Inhaled corticosteroids are less commonly used in the treatment of COPD but may be helpful in people with allergic inflammation.
In the last few years, two new classes of drugs have been shown to have benefit in COPD, and that was very exciting because we haven’t had a new class of drugs for COPD in many, many years.
One is a nebulized medication that has both bronchodilator and anti-inflammatory properties. Studies have shown it to be effective in relieving symptoms in people with COPD.
There are also injectable medications, called biologic therapies, that are now being used for COPD. These medications have been around for about a decade and have proven to be extremely successful in people with asthma. Now it has been found that they are also effective in people with COPD who suffer from allergic inflammation.
It’s very exciting and there’s a lot of research going on into these biological agents to find those that are effective in the larger group of people with COPD who don’t have the allergic form of inflammation.
Invasive procedures and lung transplants are available for people with advanced COPD.
This educational resource was created with support from Chiesi.
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