Bronchiectasis: sex and gender considerations

Despite improvements in childhood health-nutrition, immunizations, tuberculosis control-and improved access to antibiotics, chronic pulmonary infections and bronchiectasis remain significant clinical issues worldwide. Chronic pulmonary infections and bronchiectasis act differently in women than in men, particularly in the areas of prevalence, incidence, causative organisms, and etiology. Specifically, cystic fibrosis (CF) and non-CF bronchiectasis follow a more severe course or appear more frequently in women. This article reviews the observed differences between men and women with respect to the related diseases of bronchiectasis and CF and discusses possible explanations for these differences. We provide a general overview of CF and non-CF bronchiectasis and the epidemiology of these disorders. Subsequently, we present the identified and proposed explanations for sex and gender differences in bronchiectasis. Disease-specific information also is presented where available.