Jill Ohar, MD

Abstract: Smoking cessation is still the most important intervention in patients with chronic obstructive pulmonary disease (COPD), regardless of sex. There is some evidence that nicotine replacement therapy may be less effective in women than in men. However, women may derive greater benefits from a sustained quit attempt. For example, one study found that compared with men, women who were sustained quitters had a greater initial rise and a slower age-related decline in forced expiratory volume in 1 second. Men and women do not appear to differ in their response to bupropion or to the various types of bronchodilators. A number of factors contribute to the increased risk of osteoporosis in women with COPD. Both smoking and the degree of airflow obstruction have been identified as important risk factors for osteoporosis. Women may be particularly susceptible to the effects of smoking on bone metabolism. Immobility and decreased physical activity have also been shown to accelerate bone loss. (J Respir Dis. 2006;27(3):115-122)

Abstract: The increase in cigarette smoking among women is now being reflected in an increased incidence of chronic obstructive pulmonary disease (COPD). Since 1985, the rate of COPD-related deaths in women has steadily risen, and it nearly tripled from 1980 to 2000. There continues to be debate about whether women are more susceptible than men to COPD. Women on average have airways that are 17% smaller, and further narrowing of the airways by COPD may make women more vulnerable to symptomatic airways obstruction. There also is some evidence of greater bronchial hyperreactivity in women, although conflicting findings have been reported. Gender bias appears to exist in the diagnosis and workup of COPD. For example, there is some evidence that clinicians are more likely to consider the diagnosis of COPD in men than in women. One study showed that women who had symptoms consistent with COPD were significantly less likely than men to undergo spirometric assessment. (J Respir Dis. 2006;27(2):70-74)