PG 2025: Pulmonary Literature Review and Interactive Complex Case Presentations (PG)-Levine Pulmonary literature Review Update Women’s Health and PregnancyPG 2025 Part 1

Levine Pulmonary literature Review Update Women’s Health and PregnancyPG 2025 Part 1

Pdf Summary

This literature review by Dr. Stephanie M. Levine updates recent findings on pulmonary diseases with a focus on sex/gender differences in epidemiology, outcomes, and treatment relevant to women’s health.<br /><br />Lung cancer remains the leading cause of cancer deaths among women in the US and ranks second worldwide behind breast cancer. Women may experience worse health-related quality of life (HRQoL) after lung cancer surgical resection, with more postoperative pain, insomnia, and psychosocial issues compared to men. Women have higher rates of lung cancer among never-smokers and show distinct molecular profiles, including higher EGFR mutations. Screening detects more lung cancers in women, but smoking cessation rates are lower.<br /><br />Chronic obstructive pulmonary disease (COPD) shows a decreasing mortality trend in men but an increasing or stable trend in women in the US. Worldwide, many COPD cases in women arise from biomass exposure rather than smoking. Female sex appears protective against COPD-related hospital readmissions. Differences in lung anatomy, hormonal changes (e.g., menopause), and immune factors may explain sex differences in COPD presentation and progression.<br /><br />Pulmonary embolism (PE) treatment and outcomes also differ by sex. Women with acute PE have higher in-hospital mortality rates and are less likely to receive advanced interventions like catheter-based therapies. Possible reasons include atypical symptoms, sociocultural factors, and implicit bias.<br /><br />Pulmonary arterial hypertension (PAH) is more prevalent in women globally but has similar mortality rates between sexes, suggesting a “sex paradox” where the disease is more common but potentially less fatal in women.<br /><br />Women admitted to ICUs with interstitial lung disease (ILD) show lower mortality and shorter hospital stays than men, possibly due to protective hormonal effects and earlier care-seeking.<br /><br />Lymphangioleiomyomatosis (LAM) is a rare cystic lung disease almost exclusively affecting women of childbearing age. Diagnostic criteria have evolved to allow non-invasive diagnosis without biopsy. Sirolimus (an mTOR inhibitor) is FDA-approved for treatment; recent studies show that nintedanib, a kinase inhibitor, may stabilize lung function as a second-line option.<br /><br />In summary, sex and gender profoundly influence the prevalence, clinical course, and treatment responses of major pulmonary diseases in women. Clinicians should incorporate these differences to optimize care and improve outcomes for female patients.

Keywords

pulmonary diseases

sex differences

gender differences

lung cancer in women

COPD in women

pulmonary embolism sex outcomes

pulmonary arterial hypertension sex paradox

interstitial lung disease ICU outcomes

lymphangioleiomyomatosis treatment

women's respiratory health