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Experts say sexual activity can affect breathing patterns and airways. Rg Studio/Getty Images
  • Researchers say sexual activity may be an asthma trigger for some people.
  • They say that’s because sex, like any exercise, can affect airways and breathing patterns.
  • Experts say people with asthma can take precautions during sexual activity, including having an EpiPen nearby.

New research reports that sexual activity can be like climbing two flights of stairs and can be a trigger for asthma.

Researchers presented their study today at the 2022 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting in Louisville, Kentucky.

“We wanted to investigate whether case studies on asthma exacerbations mentioned sexual activity as a possible cause,” said Dr. Ariel Leung, the chief internal medicine resident at Saint Agnes Medical Center in Fresno, California. and lead author of the study.

The abstract is titled “How Allergists are Saving Marriages: A Review on Sexual Intercourse Presenting as Exercise-Induced Asthma.”

The findings haven’t been published yet in a peer-reviewed journal.

“Many people don’t realize that the energy expenditure of sexual activity is about equivalent to walking up two flights of stairs,” Leung said in a statement. “Reported cases are infrequent, possibly because those suffering an asthma flare may not realize the trigger.”

Researchers looked at available literature on sexual intercourse as an underdiagnosed cause of asthma exacerbations.

They searched the National Library of Medicine’s PUBMED database for keywords, including “sexual intercourse OR honeymoon asthma OR sexual behavior AND allergy OR allergic reaction.”

The researchers noted sexual activity could be an even bigger trigger than studies show.

One of the study’s co-authors said in the statement it’s possible the condition is underreported because of the intimate nature of the subject matter.

“People may not be comfortable discussing with their allergist an asthma flare that was caused by sex,” said Dr. A.M. Aminian, an allergist at the Allergy Institute in Fresno. “But allergists are specialists in the diagnosis, treatment, and management of asthma. If anyone would be able to guide a patient in how to avoid an asthma flare in the future, it would be their allergist. When sexual activity-induced asthma is properly identified and treated, allergists are better able to improve their patient’s quality of life.”

Dr. Morris Nejat specializes in adult and pediatric allergy and immunology and owns NY Allergy & Sinus Centers in New York. He told Healthline sexual activity can work like any exercise on the body.

But there also could be a little-known allergy at work as well.

“If sexual activity triggers asthma, there could be two issues,” Nejat said. “If your asthma is not controlled, it can trigger asthma, like any other form of exercise. You should see your allergist to get a better handle on asthma management.”

“Also, some individuals can be allergic to semen and an allergic reaction can be due to exposure to semen,” Nejat added. “Anaphylaxis hives, difficulty breathing, dizziness, lightheadedness, and /or throat tightness can be accompanied by intense itching. If this is suspected, your allergist can do a skin test on your partner’s semen.”

“If a patient is found to be allergic to semen, they should have an EpiPen and they need to discuss options with their doctor,” Nejat noted. “If it is their asthma, they should see an allergist to optimize asthma treatment so they can enjoy this activity without having an asthma exacerbation.”

Or they might just need to keep their inhaler nearby, just in case, said Brian Clark, a registered nurse anesthetist and the founder of the online medical library United Medical Education.

“Sex is a strenuous exercise where our heartbeat rises up and we breathe rapidly,” Clark explained to Healthline. “This might provoke an asthma reaction causing severe breathlessness, coughing, and wheezing. If such an event occurs, one needs to slow down, use the reliever inhaler, and rest for a while. The best way to prevent any asthma triggers is to manage it well at all times.”

Sarah Melancon is a sociologist and sexologist who works as a sexual counselor, researcher, and educator. She told Healthline breathing and sexual function have something in common.

“Breathing is controlled by the autonomic nervous system, as is sexual function,” Melancon explained. “Asthma is hypothesized to be linked with dysregulation in the parasympathetic nervous system and the vagus nerve, which is responsible for narrowing the airways. Relatedly, the parasympathetic nervous system and vagus nerve play a key role in erection, vaginal lubrication, and orgasm – so it is not surprising that sex could trigger an asthma attack.”

Melancon added that the link between sexual issues and asthma goes back to at least the 12th century, “when philosopher-physician Maimonides suggested a bowl of chicken soup before sex for severe asthmatics, among other dietary recommendations for asthma in general.”

Melancon also pointed to a 2019 study, in which participants described having to stop during sex because they can’t breathe.

“Some adapted by using their inhaler or nebulizer during sex, while others are repulsed by the thought,” Melancon said. “Five of nine participants experienced fear that orgasm would lead to severe bronchospasm and require emergency assistance, creating anxiety and limiting sexual pleasure.

“Others reported experimenting with different positions or using pillows as props,” Melancon said. “Some felt these adaptations were positive and a sign of intimacy with their partner. Many, however, felt frustration, guilt, self-loathing, and ‘unintentional pressure’ to have sex. However, almost no participants discussed the issue with their doctor.”

The ACAII says for more information about treating asthma and managing asthma symptoms or to find an allergist in your area, visit AllergyandAsthmaRelief.org.