Should You Say No to Sex If You Have Asthma?

In case you were wondering, yes, sexual intercourse can trigger an asthma attack. This is because the act puts as much strain on your body as walking up two flights of stairs, according to a 2022 study published in Annals of Allergy, Asthma & Immunology.

"Exercise-induced symptoms have been attributed to 40 to 90 percent of asthmatic patients," the study reported. "However, sexual intercourse is uncommonly associated as exercise."

Cases reported in the literature of sex-triggered asthma are infrequent, according to the study's researchers. As for the reasons causing this underreporting, they pointed to the intimate nature of sex. You may feel uncomfortable talking to a physician or may not realize sex was the trigger.

This doesn't mean you should remain silent, anxious, embarrassed or afraid. It's possible to have a healthy sex life while living with asthma as long as you ask for help in the right places.

"If a person has asthma attacks during sexual activity, it's time to talk to an allergist to help to identify the trigger and treat you so that you can have a better quality of life," said Priya Bansal, M.D., who is board-certified in internal medicine, allergy and immunology, and based in St. Charles, Illinois.

A specialist can advise you to eliminate the trigger—similar to what you might do if you had a latex allergy, for example—or give you a preventive treatment in the case of exercise-induced asthma, she added.

Asthma in your life

"Asthma is a lung disease characterized by chronic inflammation of the airways, with clinical manifestations which vary in intensity over time," said Rossana Suárez Parra, M.D., a specialist in internal medicine based in Valencia, Venezuela.

The most common symptoms of asthma include:

• Chest tightness
• Coughing
• Shortness of breath
• Variable airflow limitation
• Wheezing

Asthma is not the same for everyone and symptoms vary from person to person, Bansal said. She added that knowing what your particular triggers are can help you realize when you need to use an inhaler.

"When asthma affects your sex life, it could indicate that asthma isn't well managed," Suárez Parra explained. "That is, if you comply with treatment and know your triggers, you can enjoy these experiences in a similar way to other people."

Self-confidence problems related to asthma

Some people may lack confidence during sex due to asthma, which can lead them to avoid or not enjoy sex. A survey by Asthma + Lung UK revealed 73 percent of respondents felt embarrassed about using their inhaler during a sexual encounter. Meanwhile, 46 percent said they would be more confident about sex if they didn't have asthma.

"The last thing you need when it's hard to breathe is to be worrying about what your partner will think," said Rachel Zar, L.M.F.T., a family and sex therapist in Chicago.

With your partner's support to pause if you need to, you can spend less energy analyzing your sexual performance and focus on being in your body and experiencing pleasurable sensations, she added.

"It's important to be kind to yourself if asthma symptoms are triggered during sex and not be afraid to take breaks during sex," explained Jasmine Richardson, M.S., a licensed professional counselor and specialist in sex and relationship therapy in Philadelphia.

Communication with your partner is a key factor

"Having the conversation prior [to sex] will help get out ahead of any added anxiety. Remember, everyone has sexual boundaries, needs and asks during a sexual experience," Zar said. "This one just happens to be about your health."

The conversation about sexual boundaries and needs is better to have before you get hot, she recommended. That way, you'll be able to hold a thoughtful talk, have time to process the information and come to agreements.

If you know you may need to pause either to check your body, catch your breath or reach for your inhaler, Zar suggested establishing a safe word with your partner. Some of the options she mentioned include:

• A funny word. One you'd never say otherwise, such as iguana or hullabaloo.
• A red/yellow/green stoplight system. Yellow means "Slow down, I need to check in with my breathing," and red means "Stop the action for a minute so I can reach for my inhaler."
• A nonverbal signal. Such as three taps on their arm, in case your loss of breath makes it hard to speak.

Talk to your doctor

Treatment can help you maintain your quality of life. However, if you don't adhere to an individualized therapeutic plan, the condition can worsen, Suárez Parra said. She stressed the importance of a good doctor-patient relationship as part of asthma management, one where education is prioritized.

"Asthma triggered by sexual activity may be very difficult to bring up with your doctor," Bansal said. "Make sure that you have a good partnership with your physician where you can be honest about your concerns."

Healthy sex with asthma occurs if asthma symptoms are under control, Richardson noted. For this reason, she encourages her patients to find an asthma specialist they feel safe and comfortable talking to, so they can ask all the questions they may have and receive the medical support they need.

Tips to enjoy sex while living with asthma

"Enjoying sex with asthma may look different from person to person," Richardson said. "It can look like talking with your partner and trying different positions to find ones that are enjoyable but also allow for the partner with asthma to do less activity and be able to breathe easily."

"Because sex requires essentially the same effort as walking up two flights of stairs, if you can generally do that without reaching for your inhaler, you probably don't have to change anything," Zar said. "So knowing your body is essential."

Richardson and Zar offered some advice for the next time you're between the sheets with your lover:

• Add tools. Try including vibrators in your sexual activity. They may lighten the load on your body.
• Avoid pressure. Don't get into positions that can put pressure on your chest.
• Explore on your own. Identify normal changes in your breathing and differentiate them from potentially dangerous ones.
• Move at a slower pace. Enjoy each moment instead of racing toward the finish line.
• Talk. Don't be afraid or embarrassed to communicate your needs.
• Try a more receptive position. For example, on your back, where your partner is taking on more of the physical work. This way, you can lower the strain on your body.
• Use an inhaler if necessary. Keep the inhaler within easy reach.

Allergy and asthma patients need to pay attention to all kinds of triggers. According to research published in 2017, more than 64 percent of people with asthma reported one or more types of adverse health effects from fragranced products, including respiratory problems (43.3 percent), migraine headaches (28.2 percent) and asthma attacks (27.9 percent).

If scents tend to exacerbate your symptoms, tell your partner to eliminate surprises that might include scented candles, lotions and massage oils to set the mood, Zar recommended.

"Remind yourself: You are deserving of having the most stress-free and pleasurable sexual experience possible," she said. "And any partner who's worthy of inviting into that space will not just be OK with that, they'll embrace it."