Can hormonal changes during PMS worsen nasal polyps?

Question

Hi doctor,

I am a 35-year-old woman experiencing persistent sinus congestion, facial pressure, and a diminished sense of smell. I have recently been diagnosed with nasal polyps. In addition, I have multiple allergies and mild asthma.

I would like to know whether there is any connection between hormonal fluctuations and the development or worsening of nasal polyps. I have observed that my symptoms tend to worsen during the premenstrual phase of my cycle.

Furthermore, is surgical intervention the only treatment option available, or are there newer, non-surgical therapies that are effective, particularly for women who wish to avoid surgery?

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Thank you for reaching out. I hope you are doing well.

Nasal polyps are benign (noncancerous) growths that develop within the nasal passages or sinuses. They can cause symptoms such as nasal congestion, facial pressure, and a reduced sense of smell, all of which you are currently experiencing. These polyps are commonly seen in individuals with chronic inflammatory conditions such as allergic rhinitis and asthma.

About your question about hormones, there is emerging evidence suggesting that hormonal fluctuations, particularly those occurring during the premenstrual phase, may exacerbate nasal inflammation. This may help explain why your symptoms seem to worsen around that time of the month.

Fortunately, surgical intervention is no longer the only available treatment option. Several non-surgical approaches have shown promise in managing nasal polyps, especially in patients who also have coexisting asthma or allergies:

Topical corticosteroids: Intranasal corticosteroid sprays or irrigations are typically the first line of treatment to reduce inflammation and shrink polyps.
Biologic therapy: Newer biologic agents, such as Dupilumab, have been approved specifically for the treatment of nasal polyps in patients with comorbid allergic or asthmatic conditions. These medications target key inflammatory pathways and can significantly reduce polyp size and symptom severity over time.

It is important to consult both an otolaryngologist (ENT specialist) and an allergist to develop a personalized and comprehensive treatment plan. Proper control of underlying allergic or asthmatic conditions will also contribute to better outcomes in managing nasal polyps.

With modern treatment strategies, many individuals experience substantial improvement without the need for surgery.

I hope this answer helps you.

Thank you.