Congestion and Other Nasal Symptoms During Pregnancy

Pregnant woman blowing her nose in bed

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Many women feel more congested during pregnancy. This condition is sometimes referred to as pregnancy rhinitis or non-allergic rhinitis. Women who had underlying conditions such as asthma or allergies prior to becoming pregnant may find that their symptoms get worse during pregnancy, particularly during the third trimester. Nasal symptoms caused by pregnancy typically resolve within about 10 days after you have your baby.

Pregnancy Rhinitis

To be considered true pregnancy rhinitis no other known causes such as allergies or an upper respiratory infection can be causing your symptoms. Symptoms of rhinitis during pregnancy include:

Studies have shown that pregnancy-related nasal congestion can decrease the quality of life in pregnant women and in severe cases be dangerous for the fetus (particularly in pregnant women with underlying asthma). 

Some research suggests that approximately 39 percent of pregnant women experience nasal congestion and other symptoms of rhinitis.

The cause of pregnancy-induced nasal symptoms is not entirely understood but has long been thought to be caused by changing hormone levels, particularly estrogen and progesterone. This theory might be supported by the fact that some women report nasal symptoms which coincide with their menstrual cycles. Symptoms of non-allergic rhinitis have also been reported with the use of birth control pills.

Managing Congestion

Congestion can lead to more serious conditions such as sinus infections or ear infections, which need to be treated with antibiotics. Keeping congestion under control can prevent these infections. Some tips for managing congestion during pregnancy include:

  • Drinking plenty of water
  • Using a cool-mist humidifier by your bed when you sleep
  • Light exercise (you should not engage in new types of exercise while pregnant without prior approval from your physician)
  • Keeping the head of your bed elevated
  • Using a neti pot or saline nasal spray to keep secretions thin
  • Avoiding known allergy triggers, polluted air, chemicals, or cigarette smoke

Medications for More Severe Cases

If these measures are not sufficient to keep your symptoms under control you can talk to your doctor about using one or more of the following medications, which are considered reasonably safe for use in pregnant women:

  • Nasal (inhaled) corticosteroids: Often used to control asthma in pregnant women but may be used in some cases to control pregnancy-induced nasal symptoms. The first choice is Entocort (budesonide) because the FDA has rated this medication as a pregnancy category B drug. However, if budesonide is not effective other nasal corticosteroids may be used.
  • Nasal decongestants: Nasal decongestants such as Afrin (oxymetazoline) are very effective at temporarily relieving congestion. However, they are generally a pregnancy category C and should be used sparingly if at all during pregnancy and not during the first trimester. Using nasal decongestants for more than three days in a row can lead to rebound congestion.

To avoid unnecessary risk to your baby do not use any new medication, whether available by prescription or sold over-the-counter, without specific approval from your doctor.

A Word From Verywell

While the idea of using any medication can be frightening for many pregnant women you must remember that leaving your symptoms untreated can lead to other more serious conditions that may pose a threat to your baby's health. Therefore, pregnancy rhinitis should always be reported to your physician so that symptoms can be properly managed.

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Article Sources

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  5. American College of Allergy, Asthma & Immunology. Pregnancy and allergies. April 17, 2018.

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