Asthma

Battling for breath?

Did you know that after age 20, women are more likely than men to have asthma for the first time?

PHOTO: BHAGYA PRAKASH K. 
 
DURING PREGNANCY Inhalers are safe

Shiney is struggling to breathe. There is construction going on near her office and the dust has triggered off her asthma. She has used her inhaler but is not getting better. She knows she will have to go to the hospital for further treatment.

Even though asthma is more common in little boys as compared to little girls, this trend reverses after puberty. After age 20, women are more likely than men to have asthma for the first time. Women also have more problems with asthma, as compared to men. Due to hormonal changes around the time of the periods, women may find an exacerbation of the disease during that time. Pregnancy too, can make asthma worse, and moreover it may complicate pregnancy. Between the ages of 20 and 50, women are nearly three times more likely than men to be hospitalised for asthma.

Not having asthma as a child is no guarantee against getting it as an adult. 30 to 40 per cent of people suffering from asthma will get it as adults.

In mild cases, the chest feels tight, but in severe cases there can be an intense feeling of suffocation. Being unable to breathe or feeling like you can’t breathe is one of the single most frightening situations to find oneself in.

What causes asthma?

The basis of an asthma attack is inflammation of the bronchioles, which are the narrow tubes which carry air into the lungs. The inflammation leads to constriction and narrowing of the bronchioles and results in wheezing, tightness of the chest and a persistent dry cough. Substances like dust, mold, pollen and smoke trigger cell inflammation and mucous production. The basis for this is an allergic reaction. People who have a tendency to have allergies have a greater chance of developing asthma

All asthma is not triggered by allergies. Women can also have asthma attacks after taking drugs like aspirin or ibuprofen. Some women develop asthma in the workplace due to exposure to certain chemicals or other substances. Some women have asthma which is triggered by exercise. Exercise-induced asthma is caused by dry air coming into the lungs or a change in the fluid balance of cells. Within five to ten minutes after beginning exercise, individuals experience asthmatic symptoms such as chest tightness, coughing or wheezing.

Breathing exercises like pranayama are excellent for asthmatics and complement medical treatment.

Developing asthma in adulthood

Adults will often develop asthma soon after a respiratory infection. Women who are prone to allergies may develop asthma when they move to a place where there is more dust, pollution or an allergy stimulating environment.

Asthma attacks can be unpredictable. A woman may get an attack when she is least expecting it. That is why all asthmatics are advised to always keep their medications with them. Asthma can also be exhausting. Women may find that they have no energy to carry on their daily routine after having spent a night fighting an attack. It also prevents women from exercising, leading to an increase in weight which in turn worsens the condition.

Asthma can sometimes be so severe that it requires hospitalisation. Oxygenation of the brain can be hampered and in rare cases asthma can actually be fatal.

Asthma and the menstrual cycle

More women have an asthma attack around the beginning of their period than at other times in the menstrual cycle. At this time, the oestrogen level in the body is very low and this may trigger the attack. 75 per cent of adults hospitalised for asthma are women. The hormonal changes in women may account for this.

Pregnancy and asthma

A particular concern for women is how pregnancy will affect their asthma. Some women find their symptoms get worse, while others find their symptoms stay the same or get better. Women with more severe asthma are more likely to have their asthma worsen during pregnancy than women with milder forms. Inhalers (both steroid and bronchodilators) are safe in pregnancy. Oral medications may be taken under physician supervision.

Most women with mild to moderate asthma can go through a pregnancy without complications. Women with severe, poorly controlled asthma may have the risk of delivering babies with low birth weight and premature babies.

(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women’s health issues.)

GITA ARJUN