TORONTO, May 08 (Reuters Health) - A significant percentage of asthmatics might be experiencing less-than-satisfactory sex lives, Columbia University investigators reported here at the annual meeting of the American Thoracic Society.

According to Dr. Ilan H. Meyer, asthmatics are so worried about their condition being exacerbated by sexual activity, or asthma leaves them so depressed, that they are not interested or able to participate in sexual activities.

According to Meyer, 353 adult asthmatics who came to Harlem Hospital emergency department because of an asthma attack were asked to evaluate their sex lives on a seven-point scale (1=completely limited; 7=no limitation). Nineteen percent of the patients reported that they did not engage in sex at all, 19% said their sex lives were "very or totally" limited, and a further 16% said there was "moderate or some" limitation. Only 34% reported no limitations in their sexual activity.

According to Meyer, patients who were older and who were in lower income groups were most likely to report asthma-related sexual dysfunction. There were no differences between men and women with respect to their lack of sexual activity due to asthma.

"We don't know the causal relationship of depression and limited sexual functioning in asthma," Meyer said. "Maybe patients are depressed because of the limits asthma places on their lives, or maybe the depression itself contributes to the limited activity."

Meyer speculated that the amount of physical activity required during sex might trigger asthmatic symptoms. At the same time, sexual behavior may be limited by chronic persistent asthma symptoms such as shortness of breath. He also proposed two novel possibilities to explain the problem: bedrooms are well-known to be high in dust-mites and other allergens and it could be that having sex in the bedroom sets off an asthmatic attack more readily than having sex in another room. Also, a large number of people with asthma are also allergic to other substances and it could be that some of the people interviewed were allergic to latex found in condoms.

He added that there could be a hormonal basis to the diminished sex drive among these patients, but that theory has not been studied. The findings did not indicate whether the patients' sex lives were any better or worse than other people of a similar age, but only that the patients themselves felt their sex lives were "limited or restricted," Meyer said. Nor, he added, did investigators ask in which way the patients' sex lives were limited.

Dr. Jean Ford, from Columbia University in New York, said that while bronchodilators are often given to athletes to help prevent exercise-induced asthma attacks, he would not recommend this as a "quick fix" for asthma-induced sexual dysfunction.

"The bottom line is that the patient has to discuss this with his or her doctor and get a full clinical history to find out what's going on.... Patients should recognize that any problem with sexual function is a sign of not-good health," Ford said, adding that "if this is a matter of 'sex-ercise', well there isn't any cure for that."

In this case, he said, many of the patients were "very sick" with a number of other conditions such as hypertension, diabetes and obesity.

One useful point to come from the study, Meyer suggested, is that while doctors are often reluctant to address the topic of sex as part of a general patient evaluation, they might consider asking their asthmatic patients about their sex lives as a means of gauging whether the patient's asthma is adequately controlled: a less active sex life might suggest that the patient is either depressed because of the asthma, or that he or she is fearful of the exertion involved.

"Asking the patient about his or her sex life should not be any different than asking them about their ability to climb stairs or to engage in any other form of physical exercise," Meyer said.

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