Link Between Asthma “Blue” Inhalers and Infertility

​According to a recently published study in the European Respiratory Journal of the European Respiratory Society, ​the use of commonly sold inhalers (also known as “blue” inhalers) was associated with decreased fertility.

In a large study that included 5,617 asthmatic women, researchers found that those who used “blue” inhalers had a 30% increased risk of failing to get pregnant within one year.​

On the other hand, the use of “brown” inhalers were not associated with reduced fertility.

Blue Inhalers Vs Brown Inhalers: The difference?

Blue inhalers, known scientifically as short-acting β-agonists, provide rapid/intermittent relief of asthma symptoms. They are the rescue medications that you take when you have an asthma attack.

Brown inhalers are used to decrease asthma symptoms and prevent further attacks. Brown inhalers contain a low dose of corticosteroids to help decrease airway inflammation​.

An example of a blue inhaler is salbutamol. Examples of brown inhalers include Easi-Breathe and Autohaler (breath actuated inhalers), Accuhaler and Easi-Breathe (dry powder inhalers) and metered dose inhalers (which deliver medication directly to the lungs via inhalation).​

How Inhalers Affect Fertility

​Investigators analyzed data from the SCOPE study of pregnancy screening and found that women who used only blue inhalers had a 15% lower fecundability rate than non-asthmatic women.

The rate of fertility was not different between users of blue inhalers and former asthmatic patients or users of brown inhalers.

The time to conception (in months) was longer among women taking blue inhalers compared to non-asthmatic women. The differences remained even after the investigators adjusted for confounders. Conversely, there was no difference in time to conception between users of blue inhalers and former asthma patients or users of brown inhalers.

Overall, asthma was associated with decreased fertility, but the impact was highest among women receiving blue inhalers. Although the researchers could not explain the exact mechanism underpinning their observations, they speculated that asthma decreases blood flow to the uterus, make it harder for implantation to occur. ​​

The lack of an association between reduced fertility and the use of brown inhalers suggested that these medications may improve asthma control and decrease associated systemic inflammation that can potentially impair fertility​.

​Should You Take Your Inhalers When Trying to Conceive?

Definitely. If you are trying to conceive, you should discuss with your doctor to understand why it is important to get your asthma controlled. Brown inhalers will help protect you from future asthma attacks and will less likely affect your fertility. If you’re not using a brown inhaler, it is advisable that you discuss this with your doctor.

In addition to inhalers, there are also other steps you can take to help get your asthma under control.  Of course you should always consult your doctor before making any changes.  Eliminating everyday asthma triggers in your home can help to alleviate asthma symptoms.  Using a true HEPA air purifier has been proven to treat asthma symptoms effectively.  You can also consider using a portable humidifier to assist breathing if you are experiencing a cold. In some cases you can even install a whole house humidifier, which are great if you know your asthma symptoms get worse with dry heat in the winter.  However, it’s important to make sure these machines are clean and free of mold or bacteria.

Further Reading

  1. ​Gade EJ, Thomsen SF, Lindenberg S, et al. Asthma affects time to pregnancy and fertility: a register-based twin study. Eur Respir J 2014; 43: 1077–1085.
  2. ​Gade EJ, Thomsen SF, Lindenberg S, et al. Fertility outcomes in asthma: a clinical study of 245 women with unexplained infertility. Eur Respir J 2016; 47: 1144–1151.
  3. ​Grzeskowiak LE, Smithers LG, Grieger JA, et al. Asthma treatment impacts time to pregnancy: evidence from the international SCOPE study. Eur Respir J 2018; 51: 1702035 []

I’m Princila, founder of Check Ovulation and a proud mom of two. I’m an alumna of James Lind Institute. After working in clinical jobs, my passion for writing took its toll, and I ended up switching careers to work in the medical publishing industry. I also have a passion for healthy food, which prompted me to take several online courses in nutrition and health offered by Wageningen University. (I still haven’t completed the courses thanks to my busy mommy schedule!). When I’m not writing/editing scientific and medical manuscripts or taking care of my family, I use my free time to research, learn, and write about healthy living. I have also authored a few books in the self-help niche using the pen names Princila Murrell or PN Murray. Protection Status