Sexual intercourse may trigger asthma exacerbations

LOUISVILLE, Ky. — Much like exercise-induced asthma, sexual intercourse can also trigger asthma exacerbations, according to study results presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

By investigating sexual intercourse as a possible trigger for asthma exacerbations, allergists can help improve their patients’ quality of life, according to the researchers.

“The pathophysiology of sexual intercourse-induced asthma mirrors exercise-induced asthma, so it makes sense that its treatment is similar,” Ariel Leung, MD, chief resident, internal medicine at Saint Agnes Medical Center, told Healio. “We recommend that patients take their short-acting beta agonist, most likely their albuterol inhaler, 30 minutes prior to sexual intercourse to prevent an asthma attack. Some patients might think it takes away from the romance, but nothing is more romantic than taking care of yourself and not having your partner observe an asthma attack.”

Approximately 40% to 90% of patients with asthma experience exercise-induced symptoms, but sexual intercourse is not often thought of as exercise, according to the researchers.

Leung and colleagues sought to investigate sexual intercourse as an underdiagnosed asthma trigger based on personal patient interactions and curiosity.

Ariel Leung

“We recently have been meeting several patients who, although would be defined as living a ‘sedentary lifestyle,’ are actually more active in the romantic sphere and experience asthma exacerbations, we just didn’t know it initially,” Leung said. “We realized building rapport and consistent follow-up allowed us as allergists an invitation to the private lives of our patients. Seeing firsthand how proper diagnosis of sexual intercourse-induced asthma improved the general quality of life of our patients, made us want to explore how often cases like these are reported and discussed in literature.”

The researchers conducted a literature review using PubMed and although they found 168 studies on seminal plasma hypersensitivity and 39 on contact allergy during intercourse, they only found seven case studies reporting post-coital asthma exacerbations. In comparison, there were 1,806 case studies or journal articles discussing exercise-induced asthma.

However, incidence of sexual intercourse-induced asthma is likely underreported, Leung said.

“Reporting of symptoms during sexual intercourse relies on the patient’s comfortability with their provider and the provider’s awareness of characterizing sexual activity as exercise,” she said. “This becomes a two-part limiting factor. The exact prevalence of sexual intercourse presenting as exercise-induced asthma is not known, but it can be deduced that patients with exercise-induced asthma likely would also experience coitus-induced asthma.”

Moreover, as exercise-induced asthma affects about 5% to 20% of the general population, it is likely that a large proportion of people would also be affected by sexual intercourse-induced asthma, Leung said. Researchers noted that sexual intercourse can require the energy expenditure equivalent to walking up two flights of stairs.

Ultimately, allergists should ask their patients about all asthma triggers, including sexual intercourse, to better control their patients’ asthma and improve their quality of life, according to the researchers.

“Future studies may investigate how frequently allergists are discussing sexual intercourse during their patient encounters and also gauging the comfort level of allergists in talking about sexual intercourse, sexual intercourse induced asthma and its treatment,” Leung said.

Reference:

• New study identifies sexual activity as asthma trigger. https://annualmeeting.acaai.org/2022/asthma-trigger.cfm. Published Nov. 10, 2022. Accessed Nov. 10, 2022.

For more information:

Ariel Leung, MD can be reached at arielleung01@gmail.com.