The Influence of Gender on Cough Reflex Sensitivity*

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BackgroundThe more common occurrence in women of cough due to angiotensin-converting enzyme inhibitors raises the possibility of gender-related differences in the sensitivity of the cough reflex. Of two recent studies that evaluated cough response to inhaled capsaicin in normal subjects, one demonstrated heightened sensitivity of the cough reflex in women compared with men, while the other revealed no gender-related differences. To further investigate this question, we reviewed our experience with cough challenge testing in normal volunteers.Study objectiveTo compare cough reflex sensitivity in healthy adult female and male subjects.DesignRetrospective data analysis.SettingAcademic medical center.ParticipantsOne hundred healthy volunteers (50 male, 50 female).InterventionsSubjects inhaled capsaicin in ascending, doubling concentrations until the concentration inducing five or more coughs (C5) was reached. In addition, the concentration inducing two or more coughs (C2; cough threshold) was measured.ResultsMean log C5 was significantly lower in women than in men: 1.02 +/- 0.09 (SEM) [micro sign]M vs 1.41 +/- 0.08 [micro sign]M, respectively (p=0.002). Log C2 (cough threshold) was also significantly lower in female subjects: 0.534 +/- 0.068 [micro sign]M vs 0.870 +/- 0.065 [micro sign]M in male subjects (p=0.00058).ConclusionHealthy women have a more sensitive cough reflex than do healthy men. The reasons for this significant gender difference remain to be elucidated, but may involve a heightened sensitivity, in women, of the sensory receptors within the respiratory tract that mediate cough.

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