Causes and Symptoms of Asthma

What is asthma?

Asthma is a chronic lung disease that affects the bronchial tubes. Your bronchial tubes carry air into and out of your lungs. When you breathe, your lungs take in oxygen. The oxygen travels through your bloodstream to all parts of your body.

In people who have asthma, the lungs and walls of the bronchial tubes become inflamed and oversensitive. When people with asthma breathe in “asthma triggers,” such as smoke, air pollution, cold air, mold, or chemicals, the bronchial tubes tighten in response. This limits airflow and makes it difficult to breathe. Asthma triggers may be different for each person and may change over time.

Who gets asthma?

Before age 15, asthma affects more boys than girls. After age 15, asthma is more common among girls and women than among boys and men.

Researchers believe the hormones estrogen and progesterone might affect women’s airways. Changing hormone levels throughout the menstrual cycle and during pregnancy and menopause may affect airways in women with asthma.¹

Some women are more at risk for asthma:

• African-American and Puerto Rican women. Asthma is more likely to affect Puerto Rican and African-American women than women of other racial and ethnic groups.²
• Women who live in cities, especially in low-income areas. Air pollution, indoor allergens (such as cockroaches), and tobacco smoke are more common in urban, low-income areas.³

How does asthma affect women?

Studies show that asthma may affect women differently than men.⁴

• Women may experience more asthma symptoms than men do. Women with asthma go to the hospital for asthma treatment more often and use more quick-relief or “rescue” medicines than men with asthma do.¹
• Women with asthma report more trouble sleeping and more anxiety than men with asthma do.¹
• Women’s lungs are smaller than men’s. This may make women more sensitive to asthma triggers and make it harder for women to breathe during an asthma attack.⁴

What are the symptoms of asthma?

Asthma symptoms include:

• Wheezing
• Coughing
• Shortness of breath
• Chest tightness

You may have only one or two of these symptoms, or you may get all of them. You may also get asthma symptoms only at night or in cold weather. Or you may get asthma symptoms after exposure to an allergen or other trigger, or when you have a cold or are exercising.

How is asthma diagnosed?

Many people develop asthma during childhood, but asthma can happen at any age. Asthma can be difficult to diagnose. Asthma symptoms can be similar to those of other conditions, such as chronic obstructive pulmonary disease (COPD), pneumonia, bronchitis, anxiety disorders, and heart disease.

To diagnose asthma, your doctor or nurse may:

• Ask about your symptoms and what seems to trigger them
• Ask about your health history
• Do a physical exam
• Ask about your daily habits
• Ask what types of allergens or irritants might be in your workplace or home that could trigger your asthma symptoms

Your doctor or nurse may also do tests including:

• Spirometry. A machine called a spirometer measures how much air you can breathe. It also measures how fast you can blow air out. Your doctor or nurse may give you medicines and then retest you to see if the results are better after you take the medicines.
• Bronchoprovocation. Your doctor or nurse tests your lung function using spirometry. During the test, you will put stress on your lungs by exercising or breathing in increasing doses of a special chemical or cold air.

Your doctor or nurse may want to test for other problems that might be causing your symptoms. These include sleep apnea, vocal cord problems, or stomach acid backing up into the throat.

How is asthma treated?

Asthma is a chronic disease. This means that it can be treated but not cured. However, some people are able to manage asthma so that symptoms do not happen again or happen rarely.

You can take steps to control asthma and prevent problems by:

• Working with your doctor or nurse to set up and follow a personal asthma action plan
• Taking medicines as your doctor or nurse prescribes them for you
• Staying away from your asthma triggers
• Getting a flu shot. The flu can be very dangerous for women with asthma.

What is an asthma action plan?

Your doctor or nurse will work with you to come up with an action plan for treating your asthma. The action plan includes:

• What medicines to take
• When to take your medicines
• How to monitor your asthma, such as with a special tool called a “peak flow meter,” which measures how well air is flowing out of your lungs
• Ways to stay away from asthma triggers
• When to call your doctor or nurse or go to the emergency room

What types of medicines treat asthma?

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.