Prevalence of COPD in Women

More than 15 million people in the United States live with chronic obstructive pulmonary disease (COPD). Women may be at a higher risk of getting the disease than men.^1,2

What are the reasons for this disparity? How can doctors and scientists address it?

COPD in women

More often, doctors are diagnosing women with COPD. For the past 15 years, the number of women with the disease has equaled the number of men. COPD is also now the leading cause of death among women in the United States.³

Here are some other facts about COPD in women:⁴

• COPD deaths have declined in men but are rising in women
• Women have more severe COPD symptoms and flare-ups than men
• Doctors diagnose women at a later stage of the disease
• Doctors offer women a spirometry test for COPD diagnosis less often than men

Research also suggests that COPD could be underdiagnosed in women. That means doctors are not as likely to diagnose COPD in women, even if they have it. For example, a woman could have both COPD and asthma but only be diagnosed with asthma.^4,5

Why women are at greater risk for COPD?

So why are women developing COPD more often? Here are a few possible reasons:

Tobacco use

The top risk factor for COPD is the use of tobacco. In the United States, nearly as many women smoke as men.⁴

On average, women are smaller than men. So women’s lungs and airways tend to be smaller. This means cigarette smoke can take a greater toll on these organs. Research shows women who smoke are 50 percent more likely to get COPD than men.⁴

Tobacco marketing to women

The tobacco industry has marketed cigarettes to women, people of color, and members of the queer community to boost cigarette use among these groups. “Slim” cigarettes were touted as more feminine, and menthol cigarettes as healthier and smoother. Today, we know that menthol cigarettes are more harmful and addictive.⁴

The tobacco industry also tried to connect its products to the women’s rights movement, AIDS research, and music festivals where attendees mainly were people of color.⁴

Hormones

Doctors and scientists think the hormone estrogen could play a role in whether you develop COPD, but more research is needed. Some studies show hormone replacement therapy does not impact the rate of new cases of COPD in women. But other studies reveal better lung function in women on hormone replacement therapy.²

Air pollution

Exposure to air pollution is strongly linked to COPD. Air pollution can come from indoor sources like burning solid fuels for cooking or heating. There is also outdoor air pollution from particulate matter.²

More than 4 million people around the world die each year because of indoor air pollution. COPD causes 22 percent of those deaths. Women are much more likely to die of COPD linked to that pollution.²

Managing COPD in women

Research shows COPD may be underdiagnosed in women. Members of this group face bias in medicine and medical research. It takes more time to recruit women into clinical trials. Understanding study results is more complicated due to differences in hormones between women.^2,4

But, more research is needed to look at how sex and gender affect COPD. This could help doctors diagnose the condition better, find the best treatments, and predict how it might progress.²