Are you suffering from a lingering cough that won’t go away? Our experts reveal some of the frightening potential causes – and why it’s more common than you think

A lingering cough can strike for all sorts of reasons, from a run-of-the-mill virus to something more serious – even your age and sex can play a part.

A chronic cough is ‘defined as a cough that lasts more than eight weeks – and it’s remarkably common,’ says Dr Andrew Chadwick, a respiratory medicine consultant at John Radcliffe Hospital in Oxford.

In fact, official figures show around 10 per cent of the population has a chronic cough – with women (and post-menopausal women, in particular) more affected.

A cause for this might lie with the hormone oestrogen as ‘in trials looking at cough during women’s cycles, it is the lower oestrogen periods of the cycle where cough is worse,’ says Dr Chadwick.

Post-menopause, the theory is that the loss of the calming effects of oestrogen and the other female hormones somehow makes the cough nerve fibres over-sensitive.

Whatever the cause, an enduring cough can be more than a tickle or a minor inconvenience.

‘Based on the quality-of-life score, for people with chronic cough it really does equate to those with chronic pain,’ says Dr Simon Taggart, a consultant chest physician at Spire Manchester, ‘and often no one cares about it – yet these patients really can struggle.’

But at what point does a cough become a cause for concern?

‘Simple dry coughing following recovery from a chest infection with no associated constitutional symptoms – such as weight loss, fever or malaise, for instance – is common and not in itself a major concern,’ says Dr Taggart.

‘Cough associated with other symptoms – such as breathlessness, wheezing, yellow or green phlegm, or blood, chest pain or weight loss – is a serious worry.

‘Unexplained cough of any sort that lasts four weeks or more needs clinical assessment and a chest X-ray. The sooner the patient is seen, the sooner the recovery.’

Before a cough can be treated, the cause needs to be identified, and doing that won’t just alleviate the inconvenience, it can also be life-saving. Here we talk to five people, each with a very different basis for their chronic cough, and ask the experts about the best approach if this should happen to you.

COVID COUGH LED TO MY COLLAPSED LUNG

Mhairi-Derby Pitt, 44, a charity volunteer, lives in Berwick-upon-Tweed. She says:

I cough every day, a wheezing cough that physically hurts. It began in January 2024 after a bout of Covid – my fourth, in fact – and more than a year on, it still won’t budge.

By the spring of last year I hated going out as my cough was so noisy; I started to avoid social situations and stayed home.

I went back and forth to my GP, who in September said it was a result of my Covid infections and gave me steroid tablets to reduce the inflammation and coughing intensity.

But after a few weeks the effects would wear off and the cough would be back. I was given more steroids at higher doses but nothing helped.

Finally in January [2025], I had a scan which showed that I have serious lung damage and in fact my left lung had collapsed from the successive Covid infections.

At home I used to fly up the stairs, now I can barely climb them because I’m so out of breath.

I am awaiting referral to a specialist to see if there is anything else I can do to repair my lung function and stop constantly coughing.

Living with a chronic cough is painful, embarrassing and debilitating. I just hope there is something that can be done.

EXPERT COMMENT: ‘There is a possibility Covid can causes lung damage as the virus directly attacks the lung tissue,’ says Dr Chadwick.

‘But what is more likely is that – because of the Covid – she is now more cough sensitive.

‘Any acute infections in the lung can cause the release of chemicals (called cell mediators) that trigger receptors in the lung – the aim is to clear infections, but the result is the triggering of a cough reflex.

‘After any infection all humans have a heightened cough reflex that normally settles in three weeks. But in some people it will persist.

‘Chronic cough in people who’ve had Covid is an increasing clinical problem, with more referrals to our specialist clinic. We can teach the patient techniques to help control the cough, such as breathing exercises that help control the larynx.

‘Cough is a complex reflex that has both autonomic (i.e. outside out our control, automatic) and somatic (within our control) processes – and with expert help the patient can re-train and modulate this process to reduce their cough.’

COUGH CAUSED MY HERNIA – BUT IT WAS CANCER

Dave Marcus, 57, European client director at a healthcare company, lives with wife Emelie, 35, a sales development representative, in Cheshire. He says:

I am telling my story not to scare people but to make others aware a cough isn’t always innocuous. In my case it turned out to be a sign of lung cancer.

By the time I was diagnosed I had a 7.8cm cancer tumour in my left lung. If it had reached 8cm I was told it would have been untreatable.

When I first got a cough in 2020, doctors suspected it was Covid, but three tests were all negative.

At the time Emelie was undergoing treatment for cancer so I tried to ignore my cough. But it kept on. It was then diagnosed as a chest infection and I was given me antibiotics, but the cough lingered.

Over the next few months I given more antibiotics for suspected pneumonia but it just wouldn’t shift.

One night I coughed so hard I gave myself a hernia – I literally felt it pop out. I had to have it operated on a few weeks later.

At the end of 2020, after seven months of intermittent coughing, I had a video consultation with a GP, as part of my private health insurance, who referred me to a private respiratory consultant to rule anything out.

He did an X-ray and an hour later I went back for the results – he put a hand on my shoulder and said: ‘I promise to give you the best care possible.’

Despite being a lifelong non-smoker, I had lung cancer.

I had surgery to remove half my lung and five months of chemotherapy to clear any remaining cells.

I consider myself lucky. I now have six-monthly check-ups and am doing really well – but my advice is, if your cough doesn’t go, keep pushing for answers.

EXPERT COMMENT: ‘Forty per cent of patients with a new lung cancer come to hospital or to their GP because they’ve got a new, unexplained cough,’ says Dr Taggart.

‘If it’s in a bronchus –- one of many tubes delivering air to the lungs – these can become inflamed and start to produce phlegm, which can be yellow or green but occasionally contaminated with blood.

‘If the lung cancer is growing in the lung tissue itself, it can tickle the cell receptors and trigger a cough.

‘A new, unexplained cough – particularly in a smoker or ex-smoker – that has lasted for three weeks or more needs an chest X-ray. Most of the time it’s nothing sinister, but if cancer is detected early the chances of cure are high.’

REFLUX WAS MAKING ME COUGH

Doreen Bradbury, 69, is retired and used to work with disabled children. The mother of three lives in Bognor Regis. She says:

I started with a hacking cough and soon I had nausea, too. I was coughing a lot every day, and then one evening I had beef with gravy for supper, and within minutes couldn’t stop coughing.

I went to my doctor and when I explained I was getting nauseous too, he said it sounded like acid reflux.

He gave me a prescription for PPIs – proton pump inhibitors – which reduce stomach acid production. They helped a little but not significantly and not straight away.

I’m better than I was but every so often I’ll still have a flare-up of nausea and coughing, which leaves me drained. People also don’t realise how exhausting coughing can be.

EXPERT COMMENT: ‘In some people acid reflux is a trigger for a cough,’ explains Dr Chadwick.

‘That’s because the acidic stomach contents leak out and up the oesophagus, and some get into the lungs, irritating nerves there, resulting in a cough.

‘Reflux can also make the nerves in the lungs that control the urge to cough more sensitive, so if you already have a cough this can further sensitise the cells, triggering coughing up to hundreds of times a day.

‘Proton pump inhibitors, which cut the amount of acid, can reduce reflux. They might not always eliminate the cough completely, but should turn down the volume of that cough – from, say, a seven where it’s unbearable to three, where it’s more manageable.

‘If your chronic cough is caused by reflux, it is helpful not to eat too late at night, so there is less food in the stomach when you lie down and therefore less acid reflux.’

INFECTION FROM 11 YEARS AGO WAS STILL AFFECTING MY LUNGS

Joey Tamburello, 29, lives in Hertford. She says:

Last summer I got a hacking cough out of nowhere that was so forceful I was coughing up blood.

I’ve had asthma since I was a toddler, so I was used to the odd cough, but this was different. I would cough up whole blood clots, which made going out awkward and I became terrified that it was cancer.

After a few days I went to see my GP, who referred me for an X-ray – this highlighted a shadow on my left lung. The respiratory consultant referred me for a CT scan and a bronchoscopy, where a thin, flexible tube with a camera on the end was inserted into my lungs. This found a cavity full of bacteria in my upper left lung.

At first, the infection cavity was thought to have been formed – and still lingered – from the pneumonia I’d had twice aged 17. That had been a really traumatic experience – it left me unable to walk a few steps or keep water down. My body was literally shutting down, it was so scary.

The pneumonia had left some scar tissue, but doctors are still investigating what’s causing my current lung infection and chronic cough. I am now awaiting repeat scans and another bronchoscopy to see if the cavity is getting bigger. It’s possible I will need surgery to remove it.

Coughing is something people think you only have when you catch a cold or virus. For me, it is life-limiting and embarrassing.

EXPERT COMMENT: ‘Almost everyone who has asthma will cough more than those who don’t,’ says Dr Chadwick.

‘There is a subset of people with asthma who have what we call cough-predominant asthma – i.e. they have much more cough than other symptoms, such as wheezing. Regular use of inhalers should help.

‘Asthma increases a patient’s risk of pneumonia, though the reasoning for this and the nuance of it is complex and for many with mild asthma the relative increase in risk is not significant,’ says Dr Chadwick.

‘Pneumonia can lead to long term damage which may increase your risk of further infections, as in this case.’

I COUGHED FOR 20 YEARS BEFORE GETTING A DIAGNOSIS

Nik Scott, 42, a former hairdresser, lives in Manchester. He says:

Working as a hairdresser I spent every day around people and I’d get every bug going – and I’d get a bad chest infection every time, which would last weeks or even months. I’d cough and cough – it was always a dry cough.

In January 2019 I got another bad infection and after three weeks of severe coughing I saw my GP and was given antibiotics. They didn’t work. They gave me more. Still nothing helped.

I saw another GP about nine months later, who looked at my notes and said I was getting these infections too often and sent me for an X-ray. It found a shadow on my right lung.

I had CT scan and bronchoscopy to investigate this further, and in September 2019 I was told the diagnosis: bronchiectasis, a condition where the lungs are damaged from constant infections.

It had caused chronic coughing because the bronchiectasis causes the airway tubes to widen and an excess of mucus.

I spent a year on azithromycin and doxycycline, antibiotics that clear infection and phlegm. They helped a lot. I also have a nebuliser, which I use every morning to clear my lungs of phlegm. It allows me to get through the day.

I have check-ups every six months. If I get a chest infection I am straight back on antibiotics.

Sadly my consultant recommended I quit my job as a hairdresser because I was constantly exposed to people’s infections. I now train in singing to help my breathing.

EXPERT COMMENT: ‘Bronchiectasis is a condition of the bronchial tubes, causing them to become thickened and dilated and produce an excess of mucus,’ says Dr Taggart.

‘In mild cases it produces a few pellets of sputum each day, but in more severe cases it can lead to the production of up to a cup full of thick, sticky phlegm which becomes easily infected.

‘The condition responds well to specialist physiotherapy techniques, such as active cycles of breathing and sputum clearance techniques, which are best taught by a physiotherapist.

‘This can help clear the secretions and can be used in combination with prescribed medications called muclolytics – which can be tablets, sachets or liquid formulations – to loosen the phlegm and make it easier to cough up.

‘In severe cases, bronchiectasis may threaten life during infectious exacerbations. For most patients, with the correct treatment, life expectancy is normal and quality of life is good.

‘However. bronchiectasis is often misdiagnosed due to a failure to recognise the frequency with which someone is having infections.’