Abstract
Background: Physiological research on dyspnea has provided some information on how sex differences in lung and airway size can influence the experience of dyspnea during exercise; however, there is still a knowledge gap with regard to sex-related differences in other respiratory symptoms, including cough and sputum production.
Objective: The objective of this analysis was to assess sex related differences in reported objective symptoms using data from the population-based Burden of Obstructive Lung Disease (BOLD) study in Albania.
Method: Males and females with impaired lung function may experience the same symptoms but per-ceive and/or report them differently. In this analysis were included 997 responders who had completed the core questionnaire, which included data on respiratory symptoms using the following questions: “Do you usually cough when you don’t have a cold?” and “Do you usually bring up phlegm from your chest, or do you usually have phlegm in your chest that is difficult to bring up when you don’t have a cold. Chronic was defined as three months or more per year. Data used were drawn from the final report for Albania provided by BOLD team.
Results: Overall, male gender was associated with increased odds for reported chronic cough at any group age [Total: 14.7 (2.3) vs. 6.6 (0.9)]. This difference is very much reduced in the group age 70+ years old [25.8 (8.2) vs. 21.3 (6.8)]. In the contrary when we used the estimated population preva-lence of chronic cough by pack-years and gender, female gender was associated with increased odds for reported chronic cough especially in the 10+ pack-years groups [50.4 (11.0) vs. 12.2 (8.3) in 10-20 pack-years and 29.0 (5.5) vs. 26.0 (3.3) 20+ pack-years] indicating a increased smoking susceptibility of female gender. In contrast, female gender was associated with decreased odds for reported phlegm. Even for the same pack-years of smoking, female gender is associated with decreased odds for report-ed chronic phlegm [0 vs. 7.1 (8.6) in 10-20 pack-years group; 0 vs. 15.4 (3.0) in 20+ pack-years group].
Conclusions: Physicians need to recognize that although a female may not report chronic sputum or phlegm production and a male may not report chronic cough, a diagnosis of Chronic Obstructive Pulmonary Disease should still be considered as symptoms often are the first step to a diagnosis of under-lying airway disease.
References
Watson L, Vestbo J, Postma DS, et al. Gender differences in the management and experi-ence of chronic obstuctive pulmonary dis-ease. Respir Med 2004; 98: 1207–1213
Ofir D, McBride I, Webb KA, et al. Gender dif-ferences in exertional dyspnea with advancing age [abstract]. Proc Am Thorac Soc 2006; 3: A224
Black LF, Hyatt RE. Maximal respiratory pres-sures: normal values and relationship to age and sex. Am Rev Respir Dis 1969; 99: 696–702
De Torres JP, Casanova C, Hernández C, et al. Gender and COPD in patients attending a pulmonary clinic. Chest 2005; 128: 2012–2016
Becklake MR, Kauffmann F. Gender differ-ences in airway behavior over the human life span. Thorax1999; 54: 1119–1138
Johnson JL, Campbell AC, Bowers M, et al. Understanding the social consequences of chronic obstructive pulmonary disease: the ef-fects of stigma and gender. Proc Am Thorac Soc 2007; 4: 680–682.
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