When I was practicing ENT many years ago, one of the OB docs would occasionally send over a pregnant woman with a very stuffy and runny nose. After ruling out other causes of nasal obstruction and allergic rhinitis, I would tell her that the cause of her nasal congestion was pregnancy.
This condition is very common but rarely written about. It is a type of nasal congestion not due to any cause other than pregnancy and it disappears within two weeks of giving birth. It is commonly called rhinitis of pregnancy or gestational rhinitis. It has been recognized since ancient times, but not studied or named until the 1940s.
What Is It?
Gestational rhinitis – or rhinitis of pregnancy – is nasal congestion and runny nose, probably caused by hormone changes during pregnancy. The congestion is worse in the last 6 weeks of pregnancy, but may start after the first trimester. The congestion can be severe enough to interfere with sleep. This can add to pre-pregnancy fatigue. Although there is no evidence that this condition can harm a baby or a pregnancy, it can make a pregnant woman fairly miserable.
Studies show that about 10 to 20 percent of women are affected by this condition. The hormones that may cause it include estrogen, progesterone, and hormones made in the placenta. The only known risk factor is smoking, which you should not be doing.
What Can You Do?
The worst thing you can do is start using an over-the-counter nasal decongestant spray like Afrin or Neo-Synephrine. These sprays make the condition worse. You are going to have the congestion for more than a few days, and using a nasal decongestant spray for longer than a few days will cause congestion to get worse. You could end up with a condition called rhinitis medicamentosa. This condition is even more uncomfortable than pregnancy rhinitis, hard to treat, and will not go away after you deliver.
Other treatments like antihistamine medications, decongestant pills, and steroid nasal sprays don’t work for gestational rhinitis and may not be safe during pregnancy. So here is what you can do:
- Raise the head of your bed. Get the head of your bed up by about 45 degrees. This will help your breathe better at night. You can put some blocks or books under your bedposts or you can buy a wedge pillow for your bed.
- Get exercise. Exercise helps relieve nasal congestion and will help you sleep better.
- Use a saline nasal spray or irrigation. These are sold over-the-counter. They will give temporary relief without any side effects and you can use them often.
- Try a mechanical nasal dilator. These are devices you tape over your nose or place just inside your nostrils to widen your nasal airways. They are sold over-the-counter. A good example is the Breath-Right nasal strip.
Finally, be assured that this cause of nasal congestion will pass. It may be an annoyance, but after a few weeks of bonding with your new baby, it will be a distant memory.
Brazilian Journal of Otorhinolaryngology, Rhinitis and pregnancy: literature review.
Future Medicine, Special considerations in the treatment of pregnancy rhinitis.
Medscape, Pharmacotherapy for Nonallergic Rhinitis.
GPnotebook, Pregnancy rhinitis.