This chronic respiratory disease most commonly affects women aged 65 and older. But there are ways to manage the symptoms and slow down its progression.
In the past, chronic obstructive pulmonary disease (COPD)—a lung condition that limits airflow into your lungs and causes difficulty breathing—was thought to be a men’s disease. This was in part because they were more likely to smoke than women, and tobacco products are the leading cause of COPD in the U.S.
But in the past 25 years, women have overtaken men as the primary victims of COPD. This is not only because the rate of smoking among women has increased, but because women seem to be more susceptible to the effects of tobacco and indoor air pollution, as well as simply more genetically prone to the condition, according to research published in the International Journal of Chronic Obstructive Pulmonary Disease.
“Women are more likely to have COPD even if they’ve never smoked or only smoked a small amount,” says Amy Attaway, M.D., a pulmonologist at the Cleveland Clinic, in Ohio. Moreover, women who have gone through menopause may be especially at risk for complications from COPD. “Estrogen is thought to have a protective effect on the lungs when you have it,” she says. “So when you go through menopause, your COPD can get worse.”
Having COPD can also increase your risk for conditions such as heart disease, diabetes, and osteoporosis—just another reason why it’s important to take steps to manage the condition with medication and lifestyle habits. Use this guide to get started.
How COPD Changes as You Age
With the condition, the airways can become narrower and more inflamed, which allows less air to move into and out of your lungs. This leads to trouble breathing, according to the American Lung Association (ALA).
At first, the symptoms of COPD—including fatigue and chest tightness—may be so mild that you may simply chalk them up to the effects of getting older. But COPD is a progressive disease, which means it tends to worsen over time, and complications often crop up in response.
That doesn’t mean you’re inexorably destined to feel worse, however. There are things you can do to manage your symptoms, reduce the risk of flare-ups, and slow down the progression of the disease.
What to Know About Treating Your COPD Over the Long Term
Your doctor will likely prescribe medication as a first-line treatment, but over time you may need to take more steps to manage your symptoms. Here are some of the treatments your doctor may recommend.
- Bronchodilators, medications that can help relax your airways. They can be short-acting (meaning they work quickly to help you breathe easier) or long-acting (meaning they can help open up your airways over the long term).
- Corticosteroids, medications that can decrease inflammation and mucus production. They can be taken orally or, when combined with a bronchodilator, inhaled.
- Pulmonary rehabilitation, in which a doctor, nurse, or respiratory therapist teaches you breathing exercises to improve lung function.
- Supplemental oxygen, which is delivered via a nasal prong or face mask.
- Surgery, including a lung transplant, which can help people with severe COPD breathe easier.
- Regular vaccinations, including those against influenza, respiratory syncytial virus (RSV), shingles, and pneumococcal pneumonia. (Having COPD can make it harder to clear your lungs of bacteria and other irritants, which can raise the risk of infections.)
The Comorbidities of COPD
The chronic inflammation from COPD can also increase your risk for other health conditions, says Dr. Attaway:
Lung cancer
Among people who smoke, those who have COPD are about six times more likely to have lung cancer than those who don’t have COPD, according to a review published in 2022. While smoking is a risk factor for both lung diseases, it’s also thought that the chronic inflammation from COPD can cause further damage to the lungs that increases the risk for lung cancer.
What to do: Talk to your doctor about being screened for lung cancer once a year with a low-dose computed tomography (CT) scan (which uses a small dose of radiation). The test can detect lung cancer in people who are at high risk for the disease before the symptoms appear, says Craig Hersh, M.D., a pulmonary-medicine specialist at Brigham and Women’s Hospital, in Boston. And if you currently smoke, you may benefit from a smoking-cessation program.
Depression and anxiety
Up to 33% of people with COPD have mental-health conditions such as anxiety and depression, according to another review published in 2022. And not only can the condition take a toll on your mood, but mental-health disorders can also worsen your COPD. “If you’re too short of breath to get out of the house and interact with people, that can worsen your depression,” says Dr. Hersh.
What to do: Practicing relaxation techniques and breathing exercises can help quell anxiety. You may also benefit from a COPD support group, or counseling or medication from a therapist, psychologist, or psychiatrist.
Osteoporosis
Osteoporosis is common among both post-menopausal women and people with COPD, who are especially prone to the bone condition. According to a study published in 2022, about 58% of people with COPD have low bone density. “Cigarette-smoking makes osteoporosis worse,” says Dr. Hersh, “as do some of the treatments for COPD, like steroid medication.”
What to do: Talk to your doctor about receiving regular bone scans for osteoporosis, says Dr. Hersh. You may also be a candidate for medications that can help slow down bone loss or prevent bone fractures, such as hormone therapy or bisphosphonates.
Malnutrition
About one in six people with COPD may be malnourished, in part because they usually need to work much harder to breathe than someone without the disease. People with COPD can also experience appetite loss. “The lungs can be very hyper-inflated, so there’s less room for your stomach,” says Dr. Attaway.
What to do: Try adding more protein, such as chicken, eggs, or fish, into your diet. Protein can help strengthen your respiratory muscles, which can help you breathe easier, according to the American Lung Association.
High blood pressure
COPD is thought to increase stiffness in the arteries, which can lead to high blood pressure, according to research. It can also specifically cause high blood pressure in the arteries that shuttle blood to the lungs—a condition called pulmonary hypertension.
What to do: You may be able to lower your BP levels with dietary changes or lifestyle changes, including smoking cessation.
Diabetes
People with COPD are more likely to have diabetes than those without COPD, possibly because smoking may alter the genes that are linked to both conditions, according to a study published in the journal Medicina. “Diabetes can also worsen lung function,” says Dr. Hersh.
What to do: If you haven’t been tested for diabetes, talk to your doctor about whether you’re a candidate for an A1C test (a blood test that measures your average blood-sugar level over a three-month period). If you test positive, you may be able to lower your blood-sugar levels with dietary changes, or your doctor may recommend insulin therapy.
Coronary artery disease
COPD is a risk factor for coronary artery disease (CAD)—a type of heart disease caused by buildup of plaque in the arteries, says Dr. Attaway. Research suggests that CAD is a leading cause of hospitalization among people with COPD.
What to do: Talk to your doctor about ways you can lower your risk of CAD, which may include treating other conditions that can increase your risk of heart problems (such as diabetes and high blood pressure).
Assembling Your COPD Care Team
COPD can usually be managed by a primary care doctor, especially cases that are mild or moderate, says Dr. Hersh. But people who have more severe forms of the condition—including those who are having frequent symptoms like shortness of breath and flare-ups—should consider seeing a specialist. Some providers you may want to recruit to your care team include:
- A pulmonologist, a physician who specializes in respiratory conditions such as COPD. This provider can prescribe medications and other treatments, as well as monitor your condition with tests.
- A pulmonary rehabilitation team, which may include doctors, nurses, physical therapists, and respiratory therapists. These specialists can teach you how to breathe more effectively.
- A nutritionist or registered dietitian, who can help you build a meal plan that provides you with healthy sources of carbohydrates, fat, and protein.
- A mental-health professional, such as a therapist, psychologist, or psychiatrist, who can help you manage the emotional aspects of COPD, as well as related conditions such as depression and anxiety.
- A thoracic surgeon, who may recommend performing lung surgery if your symptoms or flare-ups are severe.
- A palliative-care team, which may include doctors, nurses, and nurse practitioners who can help ease the discomfort, pain, and stress that can arise from living with COPD.
- Other specialists, including endocrinologists, cardiologists, or type 2 diabetes educators, depending on whether you have related comorbidities and, if so, what they are.
Life With COPD
Even if you’re taking medication for COPD, you can improve your health and quality of life by making certain lifestyle changes, including:
Smoking cessation
Smoking accounts for about 80% of all COPD-related deaths, according to the Centers for Disease Control and Prevention—and smoking cessation is one of the only things that have been shown to increase a person’s lifespan if they have COPD, says Pushan Jani, M.D., a pulmonologist with UTHealth Houston, in Texas. That’s because the chemicals from cigarettes can continue to damage your lungs and increase your risk of exacerbations, according to the ALA. “It’s never too late to quit smoking,” says Dr. Jani. If you need help getting started, call 1-800-QUIT-NOW (1-800-784-8669).
Fitness
Aerobic exercise, such as walking, can help your body use oxygen more efficiently, while resistance training can help strengthen your muscles—including the ones you use to breathe, according to the ALA. The secret to maximizing your breathing abilities, though, is to learn pursed-lip breathing, a technique that helps keep your airways open so you can remove the air that’s trapped into your lungs. To try it, breathe in slowly through your nose, then breathe out through pursed lips, as if you were going to blow out a candle.
Nutrition
If you have COPD, your muscles may require 10 times more calories to breathe than for someone without the condition. That exertion can take a toll—so much so that nearly 10% of people with COPD are underweight, according to one study. If you’ve lost weight, consider working with a nutritionist who specializes in lung conditions, says Dr. Attaway. Studies show that adding more protein into your diet can help build up your respiratory muscles, which can help you breathe better. Good sources of protein include beans, eggs, fish, meat, milk, peas, and poultry; if you need to gain weight, choose higher-fat sources, such as whole milk and cheese.
Social Support
After being diagnosed with COPD, you may not be able to work or socialize as much as you once did. But it’s important not to let this part of your life go entirely: Research shows that when people with COPD increase their social support, they experience improvements in their breathing ability and quality of life. Try joining a support group, such as the ALA’s Better Breathers Club, an in-person group for people with lung diseases, or the Living With COPD community online group.
Stress reduction
Stress doesn’t just take a toll on your mental health—it can also directly worsen COPD. “If you get anxious, you start breathing faster, which can make it harder to breathe,” says Dr. Hersh. Find ways to lessen your stress by exercising, deep breathing, or practicing relaxation techniques.
While there’s no cure for COPD, maintaining control of the above issues can minimize the symptoms and prevent complications from occurring. Make sure you have the tools you need to do just that. The articles in this guide can help.
Maria Masters
Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and has held positions at Men's Health and Family Circle.
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