Chronic Obstructive Pulmonary Disease is on the rise among women and, since 2000, their mortality rates have surpassed those of men. However, despite the rising prevalence, morbidity, and mortality among women, there is little medical understanding of the disease's gender differences. A recent study in the American Journal of Respiratory and Critical Care Medicine has demonstrate the disease is manifested differently in the genders, and risk factors, symptoms, disease progression, and even diagnosis, differ substantially.

COPD is comprised of two formerly distinct diseases known as emphysema, an abnormality in lung tissue, and chronic bronchitis, an obstruction of airways. One of the major gender differences is that, in women, COPD tends to take the form of chronic bronchitis and, in men, COPD tends to take the form of emphysema. Historically, womens%u2019 smoking behavior lagged behind men and lung cancer rates in women rose substantially following the large increases in lung cancer in men in the 20th century. The same phenomenon may apply to COPD.

Women tend to be more prone to developing COPD from exposure to risk factors, such as cigarette smoke and smoke from biomass fuels used for cooking. However, women are also predominant among COPD patients who have never smoked, and may have gender-linked genetic factors that make them vulnerable to developing the disease. One important measure is the alpha-one anti-trypsin genotype of the enzyme that neutralizes white blood cell products when they are recruited in response to respiratory irritants. If the white blood cells are not neutralized by active alpha-one anti-trypsin it may lead to destruction of lung tissue itself. Women are less likely to be correctly diagnosed and report more shortness of breath, anxiety, and depression.

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