Asthma Prevention and Treatment

Asthma medicines work by opening the lung airways or by reducing the inflammation in the lungs. Some asthma medicines are pills, but most come from an inhaler (you breathe the medicine in).

Asthma medicines fall into two groups: long-term control medicines and quick-relief or “rescue” medicines.

Long-term control medicines help you have fewer and less severe asthma attacks. But they don’t work to stop an asthma attack that has already started. You take long-term control medicines every day to relieve inflammation and help open the airways.

Common types of long-term control medicines include inhaled corticosteroids and long-acting beta agonists. Inhaled corticosteroids help reduce inflammation in the lungs so that you are less likely to have an asthma attack. They will probably be the first type of long-term asthma control medicine your doctor will give you. If your asthma is not controlled with an inhaled corticosteroid, the Food and Drug Administration (FDA) approves adding a long-acting beta agonist to your long-term control treatment. Beta agonists help open your airways but you should only use long-acting beta agonists alongside an inhaled corticosteroid.

Quick-relief or “rescue” medicines help stop attacks once they start. Quick-relief medicines include short-acting inhaled beta agonists like albuterol. Quick-relief medicines usually make your symptoms go away within minutes. They do this by quickly relaxing tightened muscles around the airways.

Are complementary or alternative therapies safe to treat asthma?

Research has not shown complementary (add-on) or alternative treatments to stop an asthma attack or prevent asthma symptoms. More research is needed about whether complementary or alternative therapies work or are safe for asthma treatment.

What are common asthma triggers?

Many different things can trigger an asthma attack. And what triggers one person’s asthma may not trigger another person’s asthma. Common asthma triggers include:

• Tobacco smoke
• Animal urine, saliva, and dander (dead skin that comes from pets like cats and dogs)
• Dust mites
• Cockroaches
• Air pollution
• Mold
• Pollens and other allergens in the air (such as from trees and grass)
• Fragrances (including personal care products like lotions or household products like candles that have fragrance added)
• Physical activity (called exercise-induced asthma)
• Cold air
• Wood smoke
• Preservatives in alcohol called “sulfites”
• Certain chemicals in cleaning products or other types of chemicals you might use at work or at home

How can I prevent an asthma attack?

You can take medicines to help prevent and stop asthma attacks. You can also help prevent attacks by staying away from asthma triggers and following these steps:⁵

• Monitor the air quality and pollen counts. If you have asthma, get updates on the air quality index and pollen count in your local area. Air quality tells you how much pollution will be in the air based on the weather. Pollen levels are higher during certain times of the year when different types of plants release pollen into the air.
  • Tune in to news media and weather reports on television, the radio, or online for air quality and pollen counts.
  • Download a free app for your phone that tells you what the pollen count is in your community. Search for the keywords, “pollen” or “asthma” in your app store.
• Stay inside when pollen is high or air quality is bad. If you have asthma, you are probably more sensitive to bad air quality and high pollen counts. Bad air quality or pollen may trigger asthma symptoms or an asthma attack. Try not to work or play hard outside when pollen or air pollution levels are high.
• Use air conditioning. If you have air conditioning, use it when outdoor asthma triggers (pollution or pollen) are high or to keep the humidity lower in your home. If mold triggers your asthma, using a dehumidifier to keep the humidity level low (between 30% and 50% humidity) in your home can help prevent symptoms.
• Ask your doctor about taking medicine right before you exercise. This may help you prevent asthma symptoms. Fatigue, wheezing, and coughing brought on by exercise can be signs of asthma that is not controlled. Talk to your doctor or nurse about your symptoms. You may need to adjust your medicine.
• Don’t use household products with chemical irritants. Some cleaners, paints, pesticides, or air fresheners can trigger asthma symptoms. Try “fragrance-free” products if fragrances trigger your asthma.
• Keep cockroaches away. Clean up food spills and clutter right away. Seal cracks that cockroaches and other pests can get through. Keep all food in airtight containers. Use traps or bait, not sprays, to kill cockroaches.
• Vacuum once a week. If you can, use a vacuum with a HEPA (high-efficiency particulate air) filter. Leave the room and have someone without asthma vacuum rugs, upholstered furniture, and curtains. Dust with a damp cloth to trap dust mites.
• Stay away from pet dander. If pet dander triggers asthma, keep your pet out of your bedroom and regularly vacuum areas where they spend time.
• Don’t smoke. Don’t allow anyone to smoke inside your home or car.
• Use the exhaust fan when cooking. The exhaust fan helps move away dangerous gasses created by burning wood, natural gas, and kerosene.
• Wash off allergens or pollutants. Shower after going outside, so that you wash off any allergens or pollution. Wash bedding in hot water regularly to kill dust mites.

How does my menstrual cycle affect asthma?

Changing hormone levels throughout your menstrual cycle may make your asthma symptoms worse during some parts of the cycle.

If your asthma symptoms get worse during certain parts of your cycle every month, track your symptoms and menstrual cycle on a calendar. After a few months, you might be able to predict when your asthma symptoms will flare up based on your menstrual cycle. You can then stay away from other asthma triggers during these times.

Tell your doctor or nurse:

• If your asthma attacks happen during a certain time in your menstrual cycle
• If you take birth control
• If you take any kind of hormones
• About any over-the-counter medicines you take. Some common pain medicines that women take to relieve menstrual cramps, such as aspirin and ibuprofen, can trigger asthma attacks in some women.⁶

How does asthma affect pregnancy?

Many women who have asthma do not have any problems during pregnancy. But asthma can cause problems for you and your baby during pregnancy because of changing hormone levels. Your unborn baby depends on the air you breathe in for oxygen. Asthma attacks during pregnancy can prevent your unborn baby from getting enough oxygen.

Pregnant women with asthma have a higher risk for:⁷

• Preeclampsia
• Gestational diabetes
• Problems with the placenta, including placental abruption
• Premature birth (babies born before 37 weeks of pregnancy)
• Low birth weight baby (less than 5 and a half pounds)
• Cesarean section (C-section)
• Serious bleeding after childbirth (called postpartum hemorrhage)

Pregnancy may also make asthma symptoms seem worse due to acid reflux or heartburn. If you have asthma and are thinking about becoming pregnant, talk to your doctor or nurse. Having your asthma under control before you get pregnant can help prevent problems during pregnancy.

Is asthma medicine safe to take during pregnancy?

Some asthma medicines may be safe to take during pregnancy. Talk to your doctor or nurse about whether it is safe to continue taking your medicine during pregnancy.

Your doctor or nurse may suggest a different medicine to take. Don’t stop taking your medicine or change your medicine without talking to your doctor or nurse first. Not using medicine that you need may be more harmful to you and your baby than using the medicine. Untreated asthma can cause serious problems during pregnancy.

Also, talk with your doctor or nurse about getting a flu shot. The flu can be very dangerous for women with asthma, especially during pregnancy when your immune system is different from normal.

How does menopause affect asthma?

For some women, asthma symptoms do not change after menopause.⁸

However, other women report that their asthma symptoms get better after menopause. Researchers think very low levels of estrogen after menopause may be a reason why asthma symptoms can get better and why fewer women develop asthma after menopause. This may also explain why women who take menopausal hormone therapy for menopause symptoms are at higher risk for developing asthma.⁸

References

1. Zein, J.G., Erzurum, S.C. (2015). Asthma is Different in Women. Current Allergy and Asthma Reports; 15(6): 28.
2. Centers for Disease Control and Prevention. (2017). 2015 National Health Interview Survey Data. Table 4-1.
3. Forno, E., Celedón, J.C. (2009). Asthma and Ethnic Minorities: Socioeconomic Status and Beyond. Current Opinion in Allergy and Clinical Immunology; 9(2): 154–160.
4. Pignataroa, F.S., Bonini, M., Forgione, A., Melandri, S., Usmani, O.S. (2017). Asthma and gender: The female lung(link is external). Pharmacological Research; 119: 384–390.
5. National Heart, Lung, and Blood Institute. (2007). Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. (PDF, 3.87 MB)
6. Levy, S., Volans, G. (2001). The use of analgesics in patients with asthma. Drug Safety; 24(11): 829–41.
7. Mendola, P., Laughon, S.K., Mannisto, T.I., Leishear, K., Reddy, U.M., Chen, Z., Zhang, J. (2013). Obstetric Complications Among U.S. Women with Asthma(link is external). American Journal of Obstetrics & Gynecology; 208(2): 127.e1–127.e8.
8. Baptist, A.P., Hamad, A., Patel, M.R. (2014). Older Women with Asthma: Special Challenges in Treatment and Self-Management. Annals of Allergy, Asthma & Immunology; 113(2): 125–130.