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When You Have Asthma

Compromising sexuality?

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.

Samantha's Solutions

Samantha has been living with her asthma and coping successfully for six years. The adjustments haven't been easy, but she's made them. No more smoking. No more red wine, which can trigger her attacks. Regular use of the proper medications (she has three inhalers). Regular planning, too. A peak flow meter, which measures breathing capacity, enables Samantha to predict attacks a day or two before they occur.

It sounds like a lot of effort, but it's not too bad, she says. "Unless I'm really ill, I don't notice the difference."

Her husband has adjusted well to the measures she takes to stay healthy and ready for romance, she says. Above all else, he wants his wife to be healthy. Having a healthy and happy partner isn't the only dividend of patience and understanding. His health has improved, too, Samantha says. "He stopped smoking in the house, in the car, and anywhere near me!" That's better for his health, as well as hers and their child's.

Scott Winokur is a San Francisco Bay Area journalist who often writes about health and human behavior.

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