Gender and perception of dyspnea: The role of the variation in the forced expiratory volume in one second

during bronchoconstriction women perceive more breathlessness than men. the aims of study were 1) to evaluate if quality of dyspnea in bronchoconstriction was different in women and men 2) to assess if gender difference in the perception of dyspnea could be related to the level of bronchoconstriction. 457 subjects (257 women) inhaled methacholine to a 20% decrease in fev1, or 32 mg/ml. dyspnea was evaluated using the modified borg scale and a list of expressions of dyspnea. borg scores were recorded immediately before the challenge test baseline and at the maximum fev1 decrease. the prevalence of descriptors of dyspnea reported by women and men was similar. dyspnea was related to the level of fev1 (δfev1: or 1.05, 95%ci 1.01-1.09, p 0.0095), females (or 2.90, 95%ci 1.33-6.33, p 0.0072), younger subjects (or 0.93, 95%ci 0.89- 0.97, p 0.0013) and body mass index (bmi) (or 1.11, 95%ci 1.01-1.23, p 0.023). as the fev1 fell less than 20% from baseline, only the δfev1 was significantly associated with dyspnea (δfev1:or 1.15, 95%ci 1.07- 1.24, p 0.0002). instead, if the fev1 fell higher ≥ 20%, the presence of dyspnea was related to the degree of bronchoconstriction (δfev1: or 1.04, 95%ci 1.01-1.09, p 0.0187), females (or 3.02, 95%ci 1.36-6.72, p 0.0067), younger subjects (or 0.92, 95%ci 0.88-0.96, p 0.0007) and bmi (or 1.12, 95%ci 1.01-1.23, p 0.023). the quality of dyspnea during the bronchoconstriction was similar in women and men; women showed a higher perception of dyspnea than men only when the fev1 fell more than 20% from baseline.