Smoke and mirrors: uncovering sex differences in COPD

Abstract

Recent years have seen an increase in recognition of women’s health and the importance of understanding how disease presentation, progression and management differ by sex and gender. Growing evidence has demonstrated the impact of hormone fluctuations, including puberty and menopause, on health-related outcomes.1 2 Organisations and policies including the European Medicines Agency, the National Institute for Health and Care Research, the UK government’s Women’s Health Strategy and the MESSAGE (Medical Science Sex and Gender Equity) framework encourage the integration and reporting of sex and gender-specific findings in health research to help improve the lives of females, women and girls across the life course.3–6 Chronic obstructive pulmonary disease (COPD) has historically been seen as a male-dominant disease; however, data suggest that the differences in COPD prevalence between males and females have narrowed in recent years. Between 2000 and 2019, the difference in COPD prevalence between males and females fell from 0.46% to 0.26%.7 Similarly, the literature suggests that differences in COPD development and presentation exist, whereby females are more likely to have higher lung function, experience more exacerbations and have worse dyspnoea.8 Smoking is a common cause of COPD, and previous studies have investigated possible sex differences in the relationship between smoking and COPD …