Manage Your COPD For Better Sex

If you're having trouble breathing from chronic obstructive pulmonary disease (COPD), sex may seem like an impossibility. Fortunately, with treatment and modifications, many men and women with COPD eventually enjoy satisfying sex lives.

COPD is the name given to a group of long-term lung conditions that, according to the Centers for Disease Control and Prevention (CDC), affect more than 15 million Americans. Common symptoms of COPD include difficulty breathing, shortness of breath, chest tightness, chronic cough and fatigue.

The shortness of breath is typically exacerbated by physical exertion, according to Ashlie Arthur, D.O., a pulmonologist with Piedmont HealthCare in Fayetteville, Georgia.

"If you're going to have trouble doing a flight or two of stairs, you're probably going to have some difficulty having the same symptoms with sex," Arthur said, adding that many of her patients are embarrassed to talk about sex at length. But the impacts are still critical.

'In patients with COPD who have shortness of breath with sex, this would be a time to use [the short-acting medicine].'

"They just kind of want to know, 'Can I have sex? Will I be Okay? Is it going to hurt me?'" she explained.

The short answer is: Yes, you can have chronic obstructive pulmonary disease and still have sex. You just may have to make some adjustments according to your specific symptoms.

"There's no reason that you shouldn't be able to have a fulfilling sex life," Arthur said.

Optimizing your disease

Using bronchodilators and inhalers before sex can help your breathing. Many patients benefit from pulmonary rehabilitation, an exercise program intended to build your endurance, helpful for sex and other forms of physical activity.

Patients with COPD may be on long-acting and short-acting medicines, Arthur noted. Long-acting medicine—which you take every day no matter what—can help keep you in the best shape possible. Short-acting medicines can be used at the moment you're experiencing shortness of breath.

"In patients with COPD who have shortness of breath with sex, this would be a time to use [the short-acting medicine]," Arthur said. "We would recommend that they use their short-acting inhaler 15 minutes before any physical exertion. They can use it anytime they feel short of breath."

Some COPD patients have exertional hypoxia, where their oxygen levels are low during physical exertion. Supplemental oxygen is the primary solution to this.

"Any kind of exertion that's requiring their body to need the oxygen, they would have to wear oxygen at that time," Arthur explained.

Chronic obstructive pulmonary disease causes some people to produce excess mucus, leading to a hacking cough. Before these patients engage in sexual activity, Arthur recommends airway clearance techniques to help loosen the mucus and improve lung function.

Tips for better sex

Britney Blair, Psy.D., a San Francisco–based clinical psychologist and co-founder of the sexual health app Lover, said the biggest piece of advice she gives her patients is to "expand your sexual repertoire."

"If you have COPD, you may not be having swinging-from-the-rafters rodeo sex, but maybe you want to have some kind of erotic contact with your partner," she explained.

This could include taking a sensual bath together, making out, mutual masturbation, oral sex or any other erotic act that isn't strenuous.

"Experiment with what feels comfortable," Blair recommended. "For some people with physical limitations or people who are coping or recovering from a sexual dysfunction, there's a wonderful opportunity to explore the range of sensual and erotic activity that doesn't just revolve around kissing for just a minute, some genital touch and then intercourse—a lot of couples fall into that rut."

Eating a healthy diet and following the exercise program recommended by your pulmonologist can help you get the most out of your sex life.

"I always say whatever is good for the body is good for your sex," Blair said.

COPD and ED

In a 2012 study published in Lung, 74 percent of male chronic obstructive pulmonary disease patients had at least one type of sexual dysfunction, with erectile dysfunction (ED) being the most common at 72 percent. Most men in the study were dissatisfied with their current sexual function.

A 2019 meta-analysis in the Internal Journal of Impotence Research indicated COPD patients had a "significantly increased susceptibility to moderate and severe ED."

"Erectile dysfunction is extremely common with folks with COPD and penises," Blair said. "It's more common if folks have COPD and smoke because there's a very high correlation between smoking and erectile dysfunction."

Blair's advice: If you're smoking, quit.

"Oftentimes, people won't quit smoking until they realize they're going to lose their erection," Blair said.

Keep in mind there are plenty of sensual activities you can do with your partner that don't require an erection, and not obsessing about said erection can take the pressure off.

"Certainly, decreasing focus or emphasis on an erect penis is probably great for everybody," she explained.

Share your limitations

Arthur noted it's critical to have open communication with your partner and to listen to your body. "If you need a break, you take a break," she said.

If you have COPD and you're with a new partner, Blair suggested providing them with information about what the disease is and what your symptoms are.

"Share your limitations before having sex but do so in a positive light," Blair said.

Blair encourages COPD patients to reframe the disease as a "real opportunity to discover ways of connecting erotically with your partner that doesn't involve vigorous thrusting."

"Don't be afraid to experiment and think outside the box," she said.