Asthma: When You Have Asthma (cont.)

Meyer and a team of co-researchers at the university's Harlem Lung Center drew information from subjects whose symptoms were severe enough to send them to the emergency room. Each participant was asked to complete a quality-of-life questionnaire three weeks after visiting the ER.

Taken together, the answers paint a dramatic picture. Of the 80% who continued to have sex, 58% said asthma limited what they could do in bed. Meyer's team also found that people impaired sexually by their asthma tended to be depressed and to have little sense of control over their health, but it is unclear whether depression limited the sexual activity or the limited activity wrought by asthma led to depression.

Meyer's preliminary findings were reported in May at the 96th International Conference of the American Thoracic Society in Toronto.

What Triggers the Bedroom Attacks?

Increased physical activity during sex may cause the airways to become inflamed, constrict, and even shut down. Chronic shortness of breath may be the reason other asthma patients simply avoid sex. The place where lovemaking typically occurs (the bedroom) may contain asthma triggers for some people, the research team says. "It may be the bedding itself or dust mites in the bedroom," Meyer says. "There's also been discussion of latex-induced asthma."

The latter refers to condoms. Studies of health care providers show that a small percentage have allergic reactions to latex gloves. The same trigger that sets off a skin reaction like hives could set off respiratory problems in others, says Meyer. But due to the lack of formal studies, it's impossible to say for sure.

What You Can Do

Meyer suggests that patients with asthma speak up about any concerns they have about their sex lives if their doctors don't ask. "It shouldn't be painful or embarrassing," he says. "We cannot say asthma is well controlled unless we know it is not impacting the patient's sex life."

If "sexercise" is causing a problem, bronchodilators should be used, if prescribed by a physician. These drugs relax the muscles in the large and small airways, increasing ventilation. They can be taken as pills, liquids, inhalants, or injections, and their optimal effect is felt in about an hour. However, overuse of bronchodilators is dangerous. Check with your physician about the optimal dose and when to take it. Inhaled medications may also be prescribed for daily use for long-term control of asthma.

If the problem is environmental, Meyer says, the agent triggering the attacks should be identified. Is it the sheets, blankets, and pillows? If so, switch to allergy-proof bedding. Talk to your physician or allergist to be sure you are not overlooking some common triggers.

Four Practical Tips

Besides adjusting medicines and environmental triggers, there are other measures you can take to preserve a healthy sex life.

  1. Let your partner take the lead, says Paul Selecky, MD, medical director of the pulmonary department at Hoag Memorial Hospital in Newport Beach, Calif., and clinical professor of medicine at UCLA. Selecky has been a pioneer in the movement to help people with asthma enjoy satisfying sex lives. Being sexually active, he tells his patients, may require a degree of passivity. Anything causing shortness of breath is to be minimized.
  2. Be open to various ways of making love. "People focus on genital activity, on intercourse, but there are other ways of pleasuring each other besides penis-in-vagina," he says. Less vigorous love making, if necessary, can still be pleasurable.
  3. Change the time of day when you make love. Try the late morning or early afternoon, if and when your schedule allows it, Selecky says. These are the times your lungs may be functioning the best. "Generally, the medication has worn off early in the morning, and near the end of the day you're physically tired," he says.
  4. Avoid anything that increases pressure on the lungs. This means that the missionary position, with the woman beneath the man during intercourse, may not be a good choice for people with asthma.