Question: Do I have to take steroids to control my asthma, and, if so, are steroids safe?
Answer: The control of asthma is important. And by control we mean the ability to live one's life normally, without or with a minimum of symptoms with of course the minimum of medication.
Inhaled steroids are excellent treatment choices for the control of asthma. And they are very safe.
There is data that there is a very minimal increased risk of cataracts and glaucoma with long-term use of inhaled steroids. And for a time we were concerned about growth in children, although that appears not to be a worry. Theoretically, osteoporosis in adults can be conceivably exacerbated by the use of inhaled steroids, but that too has not seemed to be a major problem.
Oral glucocorticoid medicines which are occasionally used in burst form for severe asthmatic episodes do, as a long term treatment, have a number of side effects, such as propensity to diabetes, difficulty with fighting infection, osteoporosis and other disorders. However, most physicians use these drugs sparingly and only in acute short-term bursts.
I would say that most physicians feel that the control of asthma is clearly worth the risks and side effects of inhaled glucocorticoid drugs.