A new study is shedding light on a potential connection between hormonal contraception and chronic rhinosinusitis, a common inflammatory condition affecting the sinuses. Published in the February 2026 issue of Otolaryngology–Head and Neck Surgery, the research suggests that estrogen-containing hormonal contraceptives may be associated with a lower risk of developing chronic rhinosinusitis without nasal polyps (CRSsNP) in women.
The study, which analyzed data from nearly 240,000 women participating in the National Institutes of Health’s All of Us Research Program, represents the first of its kind to specifically examine the relationship between hormonal contraceptive use, menopause, and chronic rhinosinusitis within a large U.S. Population. Researchers found that women using estrogen-containing contraceptives had a 29% lower odds of developing CRSsNP compared to women who did not use hormonal contraception. The odds ratio was 0.71, with a 95% confidence interval of 0.64-0.80.
“We know that inflammation differs between the biological sexes and that sex hormones play a role in inflammation – a relationship has been well established in asthma and other inflammatory diseases,” explained Dr. Victoria S. Lee, Associate Professor and Director of Research with the Department of Otolaryngology at the University of Illinois College of Medicine, and senior author of the study. “Relatively little research, however, has examined the role of biological sex and sex hormones in CRS, another inflammatory airway disease.”
Chronic rhinosinusitis is characterized by inflammation of the sinuses, leading to symptoms such as nasal congestion, facial pain, and loss of smell. CRSsNP specifically refers to the condition without the presence of nasal polyps, which are growths in the nasal passages. While the exact causes of chronic rhinosinusitis are complex and not fully understood, inflammation is a key component.
The study’s findings build upon previous research indicating that CRSsNP is more prevalent in women during their reproductive years. This new analysis sought to understand whether hormonal factors might contribute to this observed difference. Interestingly, the research found no significant association between menopause status and the development of chronic rhinosinusitis.
The mechanism behind the potential protective effect of estrogen-containing contraceptives isn’t fully clear. However, research suggests estrogen interacts with receptors in the nasal tissues, influencing blood vessels and mucus production. Estrogen receptors are found in the turbinates, structures inside the nostrils, and in glandular cells that produce mucus. When estrogen binds to these receptors, it can alter nasal tissue and potentially modulate inflammatory responses.
Previous studies have demonstrated changes in nasal tissue among women using birth control pills, including swelling and increased tissue growth. Other research has shown that menopausal women may have fewer mucus-producing glands in their noses compared to younger women. These findings suggest a dynamic relationship between estrogen levels and nasal health.
It’s important to note that this study demonstrates an association, not causation. This means that while the data suggest a link between estrogen-containing contraceptives and a lower risk of CRSsNP, it doesn’t prove that the contraceptives directly prevent the condition. Other factors could be at play, and further research is needed to fully understand the relationship.
The findings also highlight the importance of considering sex hormones when studying and treating inflammatory airway diseases like chronic rhinosinusitis. As Dr. Lee noted, the role of biological sex and hormones in CRS has been relatively under-examined until recently.
For women experiencing persistent sinus problems, especially if symptoms seem to fluctuate with their menstrual cycle or hormonal medication use, a collaborative evaluation with both an ear, nose, and throat (ENT) specialist and a gynecologist may be beneficial. This integrated approach can help balance hormonal management with optimal nasal health, ensuring that any changes in medication – such as birth control or hormone replacement therapy – are carefully considered alongside sinus treatment strategies.
While the study offers promising insights, it’s crucial to remember that individual experiences can vary. Anyone concerned about chronic rhinosinusitis should consult with a healthcare professional for personalized evaluation and management.
