Asthma negatively affects the sex lives of two-thirds of patients participating in the REACH study (Reducing Emergency Asthma Care in Harlem), to be presented at ATS 2000 in Toronto, the 96th International Conference of the American Thoracic Society. "This is an important part of the quality of life for people with asthma, but researchers, patients and their doctors aren't talking about this much," said lead researcher Ilan H. Meyer, Ph.D., of the Harlem Lung Center at Columbia University's Joseph L. Mailman School of Public Health and Harlem Hospital Center in New York City.
Dr. Meyer and colleagues surveyed 353 adult residents of Central and West Harlem following their visit to the Harlem Hospital Emergency Department for asthma treatment. When they asked about patients' sexual functioning during the two weeks prior to interview, the researchers found that 19% did not engage in sex at all, 47% reported little to total limitation in sexual functioning, and only 34% reported no limitations at all in their sexual activity. Greater sexual limitation was related to older age and lower income, but there were no differences between men and women.
Psychological characteristics including a higher level of depressive symptoms increased the risk that a patient's asthma would impact their sex life, as did having more severe disease. "We don't know the causal relationship of depression and limited sexual functioning in asthma," he said. "Maybe patients are depressed because of the limits asthma places on their lives, or maybe the depression itself contributes to the limited activity."
It is not known for certain why asthma may affect sexual activity, but Dr. Meyer says it is plausible that just as certain types of exercise can induce asthma symptoms, so can having sex. "The physical activity required for sexual behavior may be triggering asthma symptoms," he said. Also, sexual behavior may be limited by chronic persistent asthma symptoms such as shortness of breath. Other theories, such as the possible effects of hormonal changes that occur during sex, have not been studied, he noted.
"Doctors need to address this problem," Dr. Meyer said. "But they often are reluctant to address the topic of sex as part of a general evaluation of patients." He said that researchers need to explore whether taking asthma medications before having sex would help asthma patients in the same way that preventive medication helps patients with exercise-induced asthma to breathe freely while exercising. There is also limited information about how changing sexual positions or activities might impact on asthma symptoms, he added. "Patients shouldn't be shy about bringing up this problem with their doctor," he said. "It's important that patients understand that asthma can have implications for sexual activity. Working with their doctor, they can find solutions."
According to Jean G. Ford, M.D., Director of the Harlem Lung Center, and principal investigator of the NHLBI-funded REACH study, "Our results indicate that sexual dysfunction is common among asthmatic patients. Physicians should ask their asthmatic patients about their sexual functioning, as a potential indicator of asthma that is not well-controlled. Additional research is needed to determine whether such sexual dysfunction simply represents exercise-induced asthma, or whether other mechanisms contribute to it."
Dr. Meyer and colleagues are now conducting further studies to find out more about asthma's effect on sexual activity. "There's a surprising lack of attention to this problem," he said. "With asthma on the rise, the attention to quality of life issues such as sexual activity deserves more attention."
Dr. Meyer will be available for media interviews in the ATS 2000 Press Room, Room 703 of the Metro Toronto Convention Centre. Telephone interviews can be arranged by calling 416-585-3702 beginning Sunday, May 7.
The American Thoracic Society, founded in 1905, is an independently incorporated, inte/rnational educational and scientific society which focuses on respiratory and critical care medicine. Today, the Society has approximately 13,500 members, 25 percent of whom are from outside the U.S. The Society's members help prevent and fight respiratory disease around the globe, through research, education, patient care and advocacy. The Society's long-range goal is to decrease morbidity and mortality from respiratory disorders and life-threatening acute illnesses.