You are not sick, but you cannot breathe through your nose. Pregnancy rhinitis affects up to 1 in 3 pregnant women and is caused by rising estrogen and progesterone causing the blood vessels in the nasal lining to swell. Unlike a cold, it comes without fever, sore throat, or body aches - and it can last the entire pregnancy.
What Causes It
Estrogen increases blood flow everywhere in the body, including the delicate blood vessels inside your nose. This causes the nasal lining to swell and produce more mucus. The effect can start as early as the first trimester and often gets worse as hormone levels rise through the second and third trimester.
| Factor | Effect on Nose |
|---|---|
| Rising estrogen | Swells nasal blood vessels |
| Increased blood volume | More congestion, nosebleeds more likely |
| Progesterone | Relaxes smooth muscle, allows more swelling |
| Lying flat | Gravity makes congestion worse at night |
What Is Safe to Use
Many decongestants are not safe in pregnancy. Always check with your doctor or pharmacist before using any nasal spray or tablet.
- Saline nasal spray - completely safe, use as often as needed
- Steam inhalation - boil water, lean over bowl with towel over head for 5-10 minutes
- Nasal strips (like Breathe Right) - safe, mechanical, helpful for sleeping
- Humidifier in the bedroom - adds moisture to dry air
- Elevated pillow - sleeping at a slight incline reduces overnight congestion
What to avoid
Oxymetazoline sprays (like Otrivin or Afrin) should only be used for a maximum of 3 days and only on doctor advice during pregnancy. Oral decongestants like pseudoephedrine are not recommended in the first trimester.
When to See a Doctor
See your GP if you develop a fever above 38°C (which suggests infection, not rhinitis), if you have facial pain suggesting sinusitis, or if the congestion is so severe you cannot sleep or eat. After birth, rhinitis almost always resolves completely within 2 weeks.