Stuffy nose during pregnancy

Nose all stuffy? It's common to have pregnancy rhinitis – congestion or a stuffy nose caused by pregnancy, not a cold or allergies.

woman blowing her nose
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Got an extra-stuffy nose during pregnancy that sometimes even messes with your sleep? You may be experiencing what's known as pregnancy rhinitis – or pregnancy-induced nasal congestion.

Congestion during pregnancy is a very common complaint. Fortunately, there are steps you can take to manage it. Here's why pregnancy congestion happens and how to ease stuffiness and breathe better.

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What is pregnancy rhinitis?

Pregnancy rhinitis is congestion or a stuffy nose that starts during pregnancy, lasts for at least six weeks, and isn't caused by an infection or allergies. Although it may feel similar to the stuffiness you experience when you have a cold, pregnancy congestion occurs simply because you're expecting.

Is having a stuffy nose common in pregnancy?

Around 30 percent of pregnant women experience pregnancy rhinitis, making it one of the most common pregnancy symptoms. It can occur any time during pregnancy but tends to crop up between the third and seventh months, often getting worse as you near your due date.

So why is congestion linked to pregnancy? No one knows for sure, but hormonal changes during pregnancy can cause the lining of the nasal passages to swell and produce more mucus. You also have more blood circulating during pregnancy, which can make the tiny blood vessels inside your nose swell, leading to nasal congestion. Exposure to cigarette smoke and dust mites increases the risk of pregnancy rhinitis.

The good news is, nasal congestion during pregnancy doesn't affect your baby, should ease up soon after you give birth, and be gone completely within two weeks of delivery.

Is it pregnancy rhinitis or something else?

If congestion and possibly a runny nose are your only symptoms, then you probably have pregnancy rhinitis. Other symptoms may indicate another condition, such as:

  • Allergic rhinitis. If allergies are the cause for your stuffy nose during pregnancy, you'll almost always also experience sneezing and/or itchiness in the eyes, nose, or throat. Keep in mind that preexisting allergies are unpredictable during pregnancy and may improve or get worse. You may also experience allergies for the first time during pregnancy.
  • Cold or flu. If you have a stuffy nose as well as sneezing, coughing, a sore throat, mild aches and pains, swollen glands, muscle or body aches, or a fever, it's more likely you have a cold or the flu than pregnancy rhinitis.
  • Sinusitis. Viral and bacterial infections that cause a stuffy nose can lead to sinusitis, i.e. a sinus infection. With sinusitis, you'll usually experience other symptoms beyond stuffiness including fever, headache, green or yellow mucus, facial pain or pressure (which may feel worse when you bend forward), an ache in the upper jaw, or a reduced sense of smell.
  • COVID-19. Although COVID-19 can cause pregnancy congestion, you're more likely to have a fever, cough, and fatigue. That said, some research suggests that pregnant women may actually be less likely to experience COVID-19 symptoms, even though they're at greater risk of severe COVID-19 complications. Bottom line: While it's not likely that you have COVID-19 if you're just experiencing congestion, it can be hard to tell the virus apart from other conditions – so if you're concerned, get tested.

Of course, you won't always be able to tell what's causing your congestion during pregnancy, and it's possible that there's more than one cause. For example, you could have allergies and pregnancy rhinitis.

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Pregnancy rhinitis: Treatment options for a stuffy nose

Nasal congestion during pregnancy can lead to anxiety, trouble concentrating, and headache, all of which can make you feel miserable. Fortunately, there are many natural ways to relieve pregnancy rhinitis, including exercise and elevating your head when you sleep at night.

For most women, pregnancy congestion is just one more annoying pregnancy symptom. But sometimes, it warrants extra attention. Talk to your doctor if pregnancy rhinitis consistently disturbs your sleep, especially if you or your partner notices that you're snoring. Snoring (and sleep apnea, in particular) has been linked to pregnancy complications including high blood pressure, preeclampsia, and intrauterine growth restriction, so your doctor will work with you to come up with a treatment plan. For severe cases of congestion during pregnancy, they may recommend a short course of medication.

How can I manage pregnancy rhinitis?

To ease congestion and other symptoms of pregnancy rhinitis, try these tips:

  • Pregnancy-safe exercise is one of the best ways to relieve pregnancy rhinitis. (Skip exercise outdoors on days when there's a lot of air pollution, because this may make congestion worse.) Exercise can also help keep your pregnancy weight gain in check, which helps minimize pregnancy congestion.
  • Elevate your head with extra pillows when you lie down to rest or sleep, which can help ease pregnancy rhinitis.
  • Stay hydrated by drinking plenty of fluids. Just be sure to focus on water (add fruit slices for flavor), and try to minimize sugary beverages like juice and soda.
  • Take a warm shower and linger in the steamy bathroom. Steam is soothing and temporarily relieves congestion.
  • Soak a washcloth with hot water, hold it up to your face, and breathe.
  • Try using saline nose drops or saline nasal spray three to four times a day to clear your nasal passages. They're available over the counter at drugstores, or you can make a saline solution at home using 1 cup of warm water, 1/2 teaspoon of salt, and a pinch of baking soda.
  • Apply nasal strips – also available OTC at your local drugstore – to the bridge of your nose at night, which widen your nasal passages and can make it easier to breathe.
  • Use a humidifier or vaporizer in your bedroom when you sleep to add moisture to the air. (Follow the cleaning instructions that come with your humidifier, because it can become a breeding ground for bacteria.)
  • Avoid cigarette smoke and any other potential irritants that seem to trigger your symptoms.

Be sure to let your doctor know if you have a fever, nasal discharge that smells bad or is any color other than white or yellow, facial swelling, blurred vision, or a cough that lasts longer than 10 days or produces yellow-green or gray mucus. And never hesitate to get in touch with your practitioner if you have any other symptoms that concern you: It's always best to side with caution when you're expecting.

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Can I take medication for a stuffy nose during pregnancy?

It's generally best to only take medications that are necessary, especially during your first trimester of pregnancy (since that's when your baby's organs are forming). But if pregnancy rhinitis is severe, your doctor may suggest taking a short course of a specific decongestant, particularly if you're further along in your pregnancy.

Never use OTC decongestants without getting your doctor's OK first. Some research suggests that decongestants may lead to birth defects, especially if taken for longer periods of time and in the first trimester. What's more, they can cause you to experience rapid heartbeat, anxiety, tremors, and insomnia and even make congestion worse. Your doctor will weigh the risks and benefits of decongestants and likely only recommend occasionally taking the lowest dose possible for a few days max.

Other drugs that are sometimes used to treat congestion, including corticosteroids and antihistamines, are usually only recommended to treat stuffiness linked to other causes (such as allergic rhinitis). There's little evidence on their safety or effectiveness at treating pregnancy rhinitis, so they usually aren't recommended.

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Colleen de Bellefonds
Colleen de Bellefonds is a freelance health and lifestyle journalist. She's raising her toddler daughter and newborn son with her French husband in Paris.