Congestion and Other Nasal Symptoms During Pregnancy

Pregnancy rhinitis is inflammation of the mucous membranes in the nose causing congestion or a stuffy nose in pregnancy. Pregnancy rhinitis isn't linked to an infection or allergy, and lasts for at least six weeks. This common condition is also called non-allergic rhinitis.

If you had underlying conditions such as asthma or allergies prior to becoming pregnant, you 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.

Pregnant woman blowing her nose in bed
baona / Getty Images 

Rhinitis of Pregnancy

To be considered true rhinitis of pregnancy, 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 people who are pregnant. In severe cases, it can be dangerous for the fetus (particularly if the pregnant person has underlying asthma).

Some research suggests that approximately 39% of people who are pregnant 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 people 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.

Nasal irrigation with a neti pot is the first-line treatment. Be sure to use distilled or boiled (and cooled) water rather than water that is straight from the tap.

Some tips for managing congestion during pregnancy include:

  • Drinking plenty of water
  • Using a cool-mist humidifier by your bed when you sleep
  • Participating in light exercise (but you should not engage in new types of exercise while pregnant without prior approval from your healthcare provider)
  • Keeping the head of your bed elevated with an extra pillow or a wedge
  • Using a saline nasal spray to keep secretions thin
  • Avoiding known allergy triggers, polluted air, chemicals, or cigarette smoke

Medications for More Severe Cases

If the measures above are not sufficient to keep your symptoms under control, you can talk to your healthcare provider about using one or more of the following medications, which may help you manage more severe cases of pregnancy rhinitis.

Nasal (Inhaled) Corticosteroids

Inhaled nasal corticosteroids are often used to control asthma during pregnancy. They may be used in some cases to control pregnancy-induced nasal symptoms.

The first choice is Rhinocort (budesonide), as studies show it is generally safe to use during pregnancy. However, if budesonide is not effective other nasal corticosteroids may be used.

Nasal Decongestants

Most nasal decongestants are not considered safe during the first trimester of pregnancy. 

Nasal decongestants such as Afrin (oxymetazoline) are very effective at temporarily relieving congestion. However, they should be used sparingly if at all during pregnancy and not during the first trimester, as animal studies have shown potential risks to the fetus.

In some cases, using nasal decongestants to treat pregnancy rhinitis actually may make symptoms worse, especially if used for a prolonged period. 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—such as herbal supplements, homeopathics, and other dietary supplements—without specific approval from your healthcare provider.

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 healthcare provider so that symptoms can be properly managed.

Frequently Asked Questions

  • What are the third trimester symptoms?

    Potential third trimester symptoms of pregnancy can include:

    • More frequent leg cramps, need to urinate, and vaginal discharge
    • Reduced blood pressure and libido
    • Swelling in the face, hands, and ankles
    • Stretch marks on the breast, buttocks, stomach, and thighs
    • Hair growth on the face, arms, and legs
    • Continuation of heartburn, indigestion, constipation, and dry or itchy skin
    • More severe or regular hemorrhoids, varicose veins, and backaches
    • More noticeable skin pigmentation leading to dark spots on the face
    • Leakage of colostrum (a sort of pre-milk) from nipples
    • Irregular false labor leading up to childbirth
  • How do you treat a sinus infection while pregnant?

    You may be able to treat a sinus infection while pregnant by using either cefprozil (Cefzil) or amoxicillin-clavulanate. To relieve pain and headaches caused by the infection, using Tylenol (acetaminophen) may be effective. However, these medications are not always safe for everyone. A healthcare provider can help find the treatment that works best for you.

  • Is it common to have congestion during pregnancy?

    Yes, it is common to have congestion during pregnancy. One study found that 65 percent of 2264 women had congestion at least once while they were pregnant. Some reports claim that pregnancy rhinitis occurs in about 30 percent of all pregnant women.

  • Is sore throat a sign of pregnancy?

    No, a sore throat is not a sign of pregnancy specifically, but it can be a symptom of the flu, which is easier to catch if you are pregnant. Common signs of pregnancy include more frequent urination, a missed period, nausea, fatigue, and tender or swollen breasts. These symptoms can occur between one to three weeks of conception.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Cleveland Clinic. Nonallergic Rhinitis.

  3. Pray WS. Self-care of rhinitis during pregnancy. US Pharm. 2014;39(9):16-23.

  4. Gluck PA, Gluck JC. A review of pregnancy outcomes after exposure to orally inhaled or intranasal budesonide. Curr Med Res Opin. 2005;21(7):1075-84. doi:10.1185/030079905X50570

  5. American College of Allergy, Asthma & Immunology. Pregnancy and Allergies.

  6. Johns Hopkins Medicine. The Third Trimester.

  7. American Pregnancy Association. Sinus Infection While Pregnant.

  8. Kellie FJ. Non‐surgical interventions for nasal congestion during pregnancy. Cochrane Database Syst Rev. 2017;(8):CD011653. doi:10.1002/14651858.CD011653.pub2

  9. MedlinePlus. Pregnancy and the Flu.

  10. American Pregnancy Association. Early Signs of Pregnancy.

Additional Reading

By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.