Have you ever smoked? Find yourself hacking most mornings, maybe spitting a glob of sputum into the sink? Do you get breathless when you walk with your (much) older neighbor? Then it's time to ask your health care professional about a test called spirometry.

Spirometry is a simple test that measures your lung function, or how well you breathe in and out. It is the only way to definitely know if you have chronic obstructive pulmonary disease, or COPD. This is a serious medical condition in which your lungs do not completely empty themselves of air, so you can't get enough oxygen. It used to be called emphysema or chronic bronchitis, and the primary cause is cigarette smoking.

Chronic obstructive pulmonary disease also used to be diagnosed mainly in men—until women caught up to men in terms of smoking prevalence. Today, more women than men are dying from the disease, and overall deaths from COPD have doubled in Caucasian and African-American women over the past decade even while remaining stable in men.^24,25 This gender difference may be due to women's smaller airways, which may also be the reason it seems women are more susceptible to developing COPD compared to men even if they each smoke the same number of cigarettes.²⁶

Unfortunately, studies find that doctors are much less likely to diagnose COPD in women than in men, still figuring it's a man's disease.²⁶ Early diagnosis matters, however. While there is no cure, treatment (primarily with bronchodilators, other medications and exercise) can help prevent further lung damage, as can quitting smoking.

Spirometry is simple: You blow into the instrument as hard as possible to get a baseline measurement. Then you take a puff of a bronchodilator, a drug that opens up the airways, and test again. If you had a low score to begin with and you improve, you probably have asthma. If you don't, you probably have COPD.

"Personally, I'd like to screen anyone who has ever smoked with spirometry," said Katherine Sherif, MD, who directs the Drexel Center for Women's Health at Drexel University College of Medicine in Philadelphia. One reason, she said, is that reduced lung capacity increases the production of free radicals, byproducts of oxygen use, because you have to fight harder to breathe. These free radicals, in turn, bring on more damage as they "steal" electrons from healthy molecules, harming cells in the process. To prevent some of this collateral damage, Dr. Sherif usually prescribes antioxidants in addition to medications to help people breathe better.

While screening recommendations from various organizations vary, most recommend that anyone who has ever smoked get spirometry, generally around age 45. Most insurance plans cover it. If your physician doesn't have a spirometer in the office, ask for a referral to a lung function laboratory at a local hospital.X

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