Heavy Breathing: Asthma and Your Sex Life
Asthma, like many chronic diseases, can adversely affect your sex life. But there are ways to cope with it and lessen its effects.
For an increasing number of Americans, wheezing, shortness of breath and chest tightness make breathing an everyday challenge. Millions suffer from asthma, a chronic lung disease with sudden, acute episodes that can limit their ability to climb stairs, work, exercise, and experience sexual satisfaction.
In a study conducted by New York's Harlem Hospital Center and Columbia University's Joseph L. Mailman School of Public Health, two-thirds of the patients studied said they experienced sexual limitations related to their asthma, says Ilan H. Meyer, PhD, the lead researcher.
Researchers questioned 353 emergency room patients about the degree to which they had been limited by their asthma in "having sex" during the two weeks prior to the interview. About 19% percent had skipped sex altogether and 47% said they had some degree of or total limitation. Only 34% reported having no asthma-related sexual difficulties.
Factors that increased a patient's likelihood of decreased sexual satisfaction included age, depression, lower income, more severe asthma, and more household exposures to mold and mice. However, the study found no difference between men and women.
"Sexual function has been neglected in quality-of-life issues. It is really a part of the overall limitation with asthma. ...It's an important area that needs to be addressed," said Dr. Meyer.
Cultural inhibitions hamper open discussions between physicians and patients, who Meyer suspects may be too embarrassed to raise the issue with busy doctors. Dr. Meyer's study examined the number of people dealing with an asthma-related sexual problem, but not the cause of the problem. An additional study is under way.
"There is no one solution, because asthma is a varied disease. It's not the same for each person," he explains. "This is something that should be discussed with the doctor, and it's okay to talk about it. It's an important area of life." Accordingly, Dr. Meyer doesn't recommend that people with asthma forego sex or accept limitations as a normal part of living with the disease.
Does Sex Trigger Asthma?
The link between sexual activity and asthma dates back more than 800 years, yet little quantitative information exists. During the 12th century, as a preventative measure to control asthma, Egyptian and Syrian physician Moses Maimonides suggested that his patient Prince Al-Afdal moderate sexual and other activities.
The concept that sex can trigger an asthma attack is not farfetched or limited to ancient times. In a 1976 letter to the journal Lancet, researchers by the names of Symington and Kerr described "sexercise-induced asthma." In other words, an asthma attack brought on by sex.
For many asthma sufferers, exercise and physical activity can jump start an episode of breathing difficulty. The physical requirements of sex might also provoke an episode. For some, emotional excitement is enough to bring on or exacerbate the condition.
"There are people who say sexual difficulties may be related to exercise-induced asthma," Meyer says. "People with exercise-induced asthma are often told to take their bronchodilator, the medication that opens up the lungs—a 'rescue' medication. They are often taught to take it in advance as a prophylactic. For instance if they are going to play basketball, take it before going to the game."
Taking a prescribed medication prior to intimacy may help people with asthma cope with sexual difficulties, just as it aids those who take it before other types of physical activity.
Chronic respiratory difficulties, brought about by poorly controlled asthma, contribute to impaired sexual performance and quality of life.
"The more severe your asthma, the more likely you are to have limitations," Meyer says. "It's not a coincidence that these people are complaining. It's related to their asthma."
Better asthma control should improve a patient's sexual functioning and all aspects of life. Working with a doctor, patients can discover which triggers set off an attack and how to avoid these triggers. Additional or different medications may be needed to reduce the chance of an attack and quickly stop one if it occurs. Patients can also learn to measure how well they are breathing through routine use of a peak flow meter, which can indicate an impending episode before the patient becomes aware of physical warning signs.
"We think sex may be a good motivator for people," Meyer adds. "If they get better control of their asthma and follow the most effective therapies, they can improve their quality of life."
The Mental Connection
Psychological factors and hormonal changes during sex may also play a part. Patients reporting sexual difficulties experienced more depressive symptoms. They also looked more to others than to themselves for control of the disease.
According to Meyer, researchers don't yet know the exact relationship between sex-related asthma and depression. It could be that the difficulty people with asthma have in their sex lives causes depression, or it could be that depression over asthma causes decreased libido.
Symptoms of asthma are brought on when the airways react to triggers. A trigger is often an allergen, such as dust or pollen. Exposure to allergens in bedding could exacerbate the problem. Some experts think that latex condoms may play a role for individuals sensitive to latex. By reducing triggers, people with asthma may enjoy a more satisfying sex life.
Changing positions may also help, because the typical "missionary" position might exert too much pressure on the chest. If this occurs, talk about it with your partner and experiment to find something more comfortable.
Meyers notes that some patients may not even realize that their sexual problems are related to their asthma and encourages patients to bring up the topic with their physicians.
"For most people, there are ways to address it," Meyer concludes. "The purpose of asthma control is to improve the quality of life," and that certainly includes your sex life.
American Academy of Allergy, Asthma, and Immunology
American Thoracic Society
Your Asthma Can Be Controlled: Expect Nothing Less. National Heart, Lung, and Blood Institute
Allergy Asthma Information Association
The Canadian Lung Association
National Asthma Education and Prevention Program: Expert panel report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051). Full text available online: www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm Accessed September 1, 2007.
Last reviewed May 2008 by Marcin Chwistek, MD
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