Understanding and Prioritizing Women’s Lung Health

07 June 2024

Respiratory disease among women often goes under-recognized and under-treated. The number of women being diagnosed with lung disease is on the rise, and women are usually diagnosed at a later stage and dying from lung disease at higher rates than men. You probably didn’t know that lung cancer is the leading cause of cancer deaths in women, surpassing even breast cancer. Research indicates that women are more susceptible to certain types of lung cancer, such as adenocarcinoma, even if they have never smoked. This susceptibility is thought to be linked to genetic, hormonal, and environmental factors.

The Respiratory Health Association notes that nearly 21 million American women live with lung disease. Women’s lung health is a critical yet often overlooked area that requires more attention from the medical community and public health policymakers. By understanding the unique risks women face and taking proactive steps to address these issues, we can work to improve lung health outcomes for women. 

Respiratory Illnesses Facing Women

Increased Rates of Chronic Obstructive Pulmonary Disease (COPD)

COPD, which includes emphysema and chronic bronchitis, has traditionally been associated with men yet, today, more women than men have COPD in the United States. The tobacco industry heavily targeted women in the 1960s, many of whom are now experiencing COPD symptoms after a lifetime of smoking. However, fewer women than men with COPD were smokers, and researchers speculate that the smaller size of female lungs and estrogen may also play a role in the disease.

Asthma Prevalence and Severity

Women are twice as likely as men to have asthma and often have more severe symptoms and higher rates of asthma-related hospitalizations. Some studies have demonstrated that hormonal changes throughout a woman’s life—during menstruation, pregnancy, and menopause—can exacerbate asthma symptoms. Researchers at Vanderbilt University Medical Center found that testosterone hindered an immune cell linked to the increased inflammation and mucus production that occurs in asthmatic individuals. 

Lung Cancer 

The incidence of lung cancer among women has been rising despite smoking rates among women historically being lower than men. Women may be more susceptible to the carcinogenic effects of tobacco due to inherent biological dissimilarities. Research suggests that women’s lungs may absorb more of the carcinogens in cigarette smoke compared to men’s, potentially increasing their risk of developing lung cancer even with lower levels of smoking.

Hormonal factors, such as estrogen, have also been implicated in lung cancer development. Studies have shown that estrogen receptors present in lung tissue can interact with carcinogens, influencing tumor growth. Hormonal variations throughout a woman’s life may also impact lung cancer risk.

While smoking remains the primary cause of lung cancer, women may encounter other environmental carcinogens that contribute to their risk. Indoor air pollution, exposure to secondhand smoke, workplace hazards, and radon are among the factors that can disproportionately affect women and contribute to lung cancer development.

Autoimmune Lung Diseases

Women are more likely to develop autoimmune diseases such as rheumatoid arthritis and lupus, which can lead to complications like interstitial lung disease. These diseases cause inflammation and scarring of lung tissue, leading to severe respiratory issues.

Addressing Women’s Lung Health

Despite strides towards gender equality, women often face unique barriers to healthcare access, including lower socioeconomic status, cultural norms, and gender disparities in healthcare provision. These barriers may result in delayed diagnosis and inadequate treatment. 

Women today still often earn less than their male counterparts.  Financial constraints can limit women’s ability to afford healthcare services, medications, and insurance coverage. Women also usually shoulder the bulk of caregiving responsibilities for children, elderly parents, and family members with chronic illnesses or disabilities. Balancing caregiving duties with personal health needs can be challenging, resulting in postponed appointments, missed screenings, and neglected self-care.

Healthcare systems may need more gender-responsive and culturally competent services tailored to women’s needs. The limited availability of female healthcare providers, inadequate reproductive healthcare options, and insensitive care environments can deter women from seeking care or accessing essential health services. Given these challenges, it is crucial to prioritize women’s lung health through research, awareness, and tailored healthcare approaches. Here are some steps that can be taken:

Increasing Awareness and Education

  1. Public health campaigns should focus on educating women about the risks and symptoms of lung diseases as awareness can lead to earlier detection and treatment, improving overall outcomes.

Encouraging Regular Screenings

  1. Routine screenings, such as low-dose CT scans for lung cancer, should be promoted among high-risk women. Early detection is key to effective treatment and improved survival rates

Promoting Smoking Cessation

  1. Smoking cessation programs need to be specifically designed to address the unique challenges women face. Providing support through counseling, medications, and community programs can help women quit smoking successfully.

Research and Gender-Specific Treatment

  1. Historically, women have been underrepresented in clinical trials and research studies, leading to gaps in our understanding of how lung cancer manifests and progresses in women. This lack of gender-specific research hinders the development of tailored prevention and treatment strategies.

Supporting Policies for Cleaner Air

  1. Advocacy for cleaner air policies can help reduce exposure to pollutants contributing to lung disease. Women, especially those in low-income communities, are often more exposed to environmental pollutants, and stronger regulations can help protect their health.

Women must be advocates for their health and leaders in their healthcare journeys. New respiratory symptoms like shortness of breath or coughing should always be reported to physicians and taken seriously, especially if there is a history of smoking or secondhand smoke exposure. Physicians, particularly those who work closely with women like primary care doctors and OBGYNs, must educate their patients on lung disease and advocate for further testing when appropriate. With a multi-pronged approach, we can work to diagnose lung disease in women earlier, leading to improved physical outcomes and better quality of life.

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