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LAM affects different women in different ways. The main problem usually is breathlessness, particularly when women exert themselves. This is due to the effect of the cells on the airways and also to the cysts which take up space in the lungs. Some people are breathless due to the development of fluid around the lung (known as a pleural effusion). The fluid is usually milky (chylous) and occurs when the lymph vessels are blocked. Occasionally some lymph is coughed up as sticky whitish phlegm. Similarly because LAM can affect the blood vessels in the lung some women cough up blood from time to time.
For many women with LAM the first sign of the disorder is when they develop a collapsed lung, known as a pneumothorax. This occurs when one of the cysts bursts and air leaks into the space around the lung. A pneumothorax usually causes sudden breathlessness, often with a sharp pain, and it requires treatment in hospital. If the pneumothorax recurs a small operation is usually needed; this will prevent a further pneumothorax though some women continue to be aware of occasional gurgling in their chest after the operation.