Asthma: Is the Outlook Better for Older Males?

Hi Ms. Wagner,

I couldn't agree with you more.

Thanks for sharing your thoughts.

J. Thompson, MD

but as i study in the post menuposal female the sympathetic system is overwelming the parasympathetic one that means that Beta 2 receptors are working more that must lead to more bronchodilatation not the opposite 

Hi Neo,

Research articles are important for developing new ideas and strategies for managing diseases. Asthma is one of the most potentially controllable chronic disorders. The majority of asthma patients, male and female, can achieve good control with adequate assessment, environmental controls, medications and follow-up (with their doctor).

Yes, women overall have more severe asthma as adults compared to men, but both groups more often than not, respond to appropriate stepped care treatment.

Asthma that is difficult to control should be managed by an allergist or pulmonologist. If high dose oral or inhaled steroids are frequently required, IgE blocker injections (Xolair) should be considered, according to 2007 NIH asthma treatment guidelines.

Again, most people whether female or male respond to comprehensive asthma management. Don't worry about study results. Talk to your doctor about what is available to better manage your asthma.

Good Luck,

J. Thompson, MD

thanks for your reply but the problem in my case that i can't control the environment around me, especially during spring in egypt the flowers and pollen granes are everywhere, some times the dust in air , the pollution, everything around me have an odour, the antiseptics used in the hospital, and the most anooying thing are smokers they are my desaster.

don't know what to do i guess i'll have to go to an allergist cuz i suffer allergy from many things

Hi again Neo,

I wish you lived in the Chicago, Illinois area. You would still be bombarded by pollens, dust and even more mold and pollution, but, you would also be able to come see me or one of my partners. Furthermore, you would be in a Smoke Free State (Hallelujah!).

I wish you luck in getting to see a certified allergist. Although it is difficult to avoid the outdoor triggers, there are many things you can do once the allergy triggers are identified. Strategic medication adjustment could also be helpful. You really deserve a specialty level of respiratory care.

Best Wishes,

J. Thompson, MD

Hi KT,

Asthma is a complex disease syndrome which has many different characteristics in the way it impacts people. Yes, older women in general have more severe levels of asthma than older males, but treatment guidelines provide a stepped care method of managing patients irrespective of their gender or age.  The goals of asthma therapy are the same for all ages and genders. These include: minimizing day and night time symptoms, eliminating the need for reliever medication, preserving lung function, avoiding activity limitations and meeting the desired goals of the patient/parent.

These goals can be achieved in the majority of people that have asthma.  As you know, we have no control over our age and gender (generally speaking) therefore the focus in treating asthma addresses many other factors. I discuss the age and gender risks with patients on occasion in order to motivate patients and parents to understand the importance of taking medication (controllers) when they are well, in order to stay well. This is sometimes not an easy concept to accept.

I remain enthusiastic about the progress that has resulted in current treatment options for asthma control. I hope to impart this enthusiasm on you and urge you to continue to learn more about this highly treatable disorder, on this site and others.

Good Luck!

J. Thompson, MD

Hi again KT,

I should clarify my comment regarding the NIH guidelines and treatment "irrespective of gender or age". Current and past guidelines recommend specific medications and medication doses based on age. Assessment also differs according to age for many measuring points. My point was, all ages are included in the guidelines, and gender does not play a role in the treatment of asthma with respect to stepped care levels. Of course, after more research, this may change. There are many other questions that must be answered first.

I hope this was helpful,

J. Thompson, MD

Hi Tom,

Thank you for sharing your comments. Asthma that first develops, or is first diagnosed after 30 years of age tends to be more persistent and difficult to control in both males and females.

You are right. You were probably born with asthma genes that remained dormant until later in life. Often an outside event such as the flu, pneumonia or harmful inhalant triggers the first episode.

There are usually exceptions to general principles but you may not necessarily be such an example if we compare you to women that have had their first episode of asthma at the same age. Such a separate group may be worse off than you (but I am not certain of this).

With adequate monitoring, follow-up and appropriate adjustment of your medications your asthma should be better controlled. Many pulmonologist do not order allergy testing. It may be helpful to see an allergist if no allergy work-up and environmental evaluation has been done. You are never too young or old for allergy triggers to be a part of the problem.

Good Luck,

J. Thompson, MD

Thanks Doctor,

I have to say that my pulmonologist has been great about getting me checked out. He has referred me to an allergist (and I have no allergies), an ENT doctor, had a barium swallow test done, and finally sent me to an asthma specialist at the lung center. I must say he has been thorough.

My situation is complicated by other conditions I have and the medications that I take for them. Both the pulmonologist and the asthma specialist say that I have cough variant asthma.

I am much better than I was but still have a loooong way to go. Thanks,

Tom