When Breathing Isn't Easy: The Facts About COPD
Medically Reviewed by E. James Britt, MD
Professor of Medicine
University of Maryland Medical Center
Pulmonary & Critical Care Medicine
COPD, Women and You
The news that you have chronic obstructive pulmonary disease (COPD) may have hit you like a ton of bricks. But the reality is that you're at least one step ahead—you've received your diagnosis, something millions of women with COPD have yet to do. One reason? COPD, a lung disease that includes chronic bronchitis, emphysema or both, has traditionally been considered a man's disease. Not anymore.
Today, more women have COPD than men, with an estimated 6.7 million women diagnosed with the disease, compared to about 3.8 million men in 2000. Not only that, but the prevalence of COPD is increasing among women while decreasing among men. Plus, more women die every year from the disease than men.
The news isn't new; these changing demographics were first published in 2002. Yet, 10 years later, many television ads and educational materials continue to portray COPD as a man's disease. Many health care practitioners are still more likely to diagnose COPD in men than women, even when a woman has all the signs and symptoms of the disease.
Why is this a problem?
Earlier diagnosis and starting long-term treatment can improve control of symptoms. COPD is a partially reversible disease, and may be easier to reverse when diagnosed early.
COPD and Women
One proposed reason women have begun overtaking men with COPD is because we started smoking later than they did, and smoking is the major cause of COPD. It can take 20 years or more from the time one starts smoking before the disease appears.
Of course, smoking isn't the only risk factor for COPD. Long-term exposure to lung irritants such as secondhand smoke, chemicals, dust or workplace fumes (think smoky bar or stinky factory) are also linked to COPD.
Other possible causes include low birth weight, early childhood infections and genetic factors. Close to 100,000 Americans have a genetic condition known as alpha-1 antitrypsin, or AAT deficiency that has been linked to COPD.
So now that you know why you got COPD, let's talk more about what happens with COPD.
When you have COPD, your airways—the tubes that carry air in and out of your lungs—become narrowed due to irritation and inflammation. The airways sustain damage, collapse easily and trap air. The result is shortness of breath that can lead you to stop doing the activities you love, like gardening and walking. Even going up the stairs can leave you out of breath. Some people become so breathless they can't even walk to the mailbox and back. Unfortunately, they often have to reach this point before finally seeking help and getting diagnosed.
That brings us to the problem mentioned earlier: getting the right diagnosis. Studies conducted in the United States, Canada and Spain show that primary care physicians are more likely to suspect COPD in men than women—even when both have exactly the same symptoms. That means women with COPD may not be screened and may remain untreated.
Earlier diagnosis can lead to better outcomes. While there is not yet a cure for COPD, beginning treatment early can improve symptoms, increase your ability to exercise and make daily activities easier.
COPD Symptoms and Diagnosis
You can have COPD without any symptoms, particularly in the early stages of the disease. That's why it's so important to tell your doctor if you smoke or have ever smoked or been exposed to lung irritants so you can be monitored for any signs of the disease. Also watch for these symptoms and talk to your health care professional if you notice any symptoms:
- constant coughing ("smoker's cough")
- shortness of breath while participating in your normal activities
- excess mucus production, particularly in the morning
- feeling like you can't breathe
- not being able to take a deep breath
Also report any new or suddenly worse symptoms to your doctor. They could signify the start of an exacerbation, a sudden worsening of your disease. Treating exacerbations as early as possible can reduce their severity and return you to normal sooner.
COPD is diagnosed with breathing tests, medical examination, a complete medical history and, sometimes, X-rays or CT scans to rule out other problems.
The first step in treatment is to quit smoking, if you haven't already. This is not a time for the blame game. Enlist the help of your doctor and find a support system, either in person, by phone or online. You may also need medication or a nicotine replacement product, like gum or a patch.
You also need to avoid secondhand smoke and anything else that can irritate your lungs, like dust, strong perfumes, open fires and being outside during days of high air pollution.
See your health care professional regularly, even if you feel fine. To make the most of your visit, write down a list of your breathing symptoms. How severe are they? How often do they occur? What are you doing when they occur? Note any activities you've given up because of shortness of breath. If you're not sure, just ask your partner or a friend. They'll let you know if you've been skipping your weekly lunches, shopping trips and other regular gatherings. Bring your list to your first visit with your doctor. Be honest about your symptoms and how they affect your life. An open, honest partnership with your health care professionals is an important component of any COPD management plan.
In addition to reemphasizing the importance of smoking cessation, your doctor will likely prescribe a combination of medications, including a long-acting bronchodilator designed to open up the airways in your lungs; lifestyle changes, like regular exercise; and getting flu and pneumonia vaccines. You can read more about treatment options for COPD here.
Questions to ask your health care professional after your diagnosis include:
- What can I do to relieve this breathlessness?
- What exercises can help?
- Can you help me quit smoking?
- Should I see other health care professionals, such as respiratory therapists and pulmonary rehabilitation specialists?
- What are the signs of an exacerbation?
With the help of your health care team, some lifestyle changes on your part and careful adherence to your treatment plan, you can control your COPD instead of letting it control you.
This resource was created with the support of Boehringer Ingelheim Pharmaceuticals, Inc.