What causes adult onset asthma?
It is thought that asthma is a condition you get when you are a child and for many, asthma does start in childhood. In some cases however, some people are diagnosed with asthma for the first time later in life. This is known as 'adult onset asthma'.
Symptoms that could trigger this are:
- flu, colds or other viral infections
- exercise
- laughing or getting excited
- depression or anxiety
- some medicines
- irritants such as cigarette smoke, cold air, perfumes, chemical fumes
For older people, shortness of breath may be the only symptom. However it can be difficult to tell the difference between asthma and other conditions that cause similar symptoms, such as bronchitis, emphysema, heart disease and chronic obstructive pulmonary disease (COPD) so it is sometimes difficult to diagnose asthma in older adults.
Asthma and women
Asthma and periods
Some girls find that their asthma is worse around the time their periods start, although this usually settles down as their menstrual cycle becomes established.
However, women with severe asthma may find that their symptoms are worse just before or during menstruation. Keeping a peak flow and/or symptom diary will help you clarify whether this is an issue for you. If you don’t already have one, talk to your doctor about an asthma Self Management Plan, and whether it could include taking extra preventer treatment during the week before your period.
Some medications used for period pain (aspirin and other non-steroidal anti-inflammatory tablets, eg Nurofen, Ibuprofen and Ponstan) can induce an asthma attack in some people. Paracetamol is usually safe. The oral contraceptive pill has no effect on asthma.
Asthma during pregnancy
Around one third of women find their asthma improves in pregnancy, one third stay the same and one third find their asthma gets worse. If your asthma gets worse you may need to increase your medication, and to revise your asthma Self Management Plan with your doctor. You will also need to discuss your plans for the delivery of your baby. If your asthma is severe the delivery may be best handled in a hospital environment in order to access appropriate support if required.
Inhaled asthma treatment will not harm your baby during pregnancy. Controlling asthma during pregnancy is important for the health and wellbeing of the mother as well as for the health development of the baby. It is also very important not to smoke and to limit exposure to asthma triggers.
A very small minority of women with severe asthma need to take steroid tablets during pregnancy. Using steroid tablets for long periods of time or repeatedly during pregnancy can increase the risk of your baby being born underweight. However, the risk to the baby of uncontrolled asthma is potentially much more harmful. You and your doctor need to weigh up the risks against the benefits.
During labour and delivery you have the same choice of pain medication as any woman. If you do happen to have an asthma attack at this time, treat it as you would normally.
Asthma and menopause
As at any time when hormone levels are fluctuating, menopause may have an effect on your asthma.
The use of steroid tablets or very high doses of inhaled steroids for a number of years may increase your risk of osteoporosis. You can reduce this risk by using a spacer to take your inhaled medications, and rinsing your mouth out after taking it. The risk of osteoporosis can also be reduced by ensuring that you have a diet high in calcium (eg yoghurt, cheese, milk) and regular weight bearing exercise (walking is ideal), that you don’t smoke, and that you drink only moderate amounts of alcohol.
