Sex Differences in Respiratory Physiology - Current Thoughts & Future Directions

Overview

This course explores emerging evidence on sex differences in respiratory physiology and the clinical implications for assessment, exercise performance, and patient management. Historically, much of respiratory physiology research has been conducted predominantly in men, shaping long-standing assumptions about ventilatory capacity and exercise limitation. This course challenges those assumptions.

Participants will examine structural and functional differences between males and females, including variations in lung size, airway dimensions, rib cage morphology, work of breathing, oxygen consumption by respiratory muscles, and dyspnea perception. These physiological distinctions may contribute to differences in ventilatory constraint during exercise and have implications for athletes, older adults, and individuals with cardiopulmonary conditions.

Through evidence-informed discussion, this course equips clinicians with the knowledge to integrate sex-specific considerations into respiratory assessment and exercise prescription.

Learning Objectives

By the end of this course, participants will be able to:

1. Describe key structural differences in lung size, airway dimensions, and thoracic morphology between sexes

2. Explain how airway size influences airflow resistance and work of breathing

3. Discuss sex-based differences in breathing patterns during exercise

4. Interpret how respiratory muscle oxygen consumption may influence exercise capacity

5. Recognize qualitative and quantitative differences in dyspnea reporting

6. Apply sex-specific insights to cardiorespiratory assessment and rehabilitation planning

Audience

This course is designed for:

• Physiotherapists and physical therapists

• Cardiorespiratory clinicians

• Respiratory therapists

• Exercise physiologists

• Sports physiotherapists

• Rehabilitation professionals

• Healthcare professionals working with athletes, older adults, or cardiopulmonary populations

Why This Course Matters

The long-standing belief that the respiratory system is rarely a limiting factor in exercise performance is increasingly being reconsidered. Emerging evidence suggests that women may be more susceptible to ventilatory constraints during high-intensity exercise due to smaller lung volumes and airway diameters—even when matched for height.

Key physiological considerations include:

• Approximately 30% smaller airway luminal area in women

• Higher airway resistance and increased work of breathing

• Greater oxygen consumption by respiratory muscles during intense exertion

• Rapid, shallow breathing strategies during exercise

• Greater and qualitatively different experiences of dyspnea

These findings are clinically relevant. They influence how we assess exercise tolerance, interpret pulmonary function data, design rehabilitation programs, and counsel patients reporting breathlessness.

Incorporating sex-specific physiology into practice supports more precise assessment, individualized care, and improved performance outcomes.

About the Presenter

Andrew Ramsook, PhD Candidate

Andrew Ramsook is a PhD Candidate in the School of Rehabilitation Sciences at the University of British Columbia. His current research is aimed at understanding how respiratory muscle fatigue affects men and women, with a special interest in understanding how this can affect the perception of breathlessness.