Pregnancy Rhinitis and 'Pregnancy Nose': Why Your Nose Is Blocked

What is pregnancy rhinitis?

Pregnancy rhinitis is a blocked, stuffy nose caused by pregnancy itself rather than by a cold or an allergy. The definition set out by the Swedish researcher Eva Ellegård is nasal congestion present for at least the last 6 weeks of pregnancy, without other signs of a respiratory infection and with no known allergic cause, which clears up completely within 2 weeks of the birth.

The NHS lists "hormone changes in pregnancy" among the common causes of non-allergic rhinitis, which it describes as the inside of your nose becoming irritated, causing a blocked or runny nose. Other symptoms can include sneezing, a sore throat and post-nasal drip, the feeling of mucus dripping down the back of your throat.

How common is it?

Very. Ellegård puts it at about one in five pregnancies. Estimates vary with the definition used: in a 2021 Croatian study that asked 681 women about nasal symptoms the day after giving birth, 31.86% met the researchers' definition of pregnancy-induced rhinitis, and for 53.9% of those it affected their quality of life.

Ellegård's review names smoking and sensitivity to house dust mites as probable risk factors. The cause is not fully understood, though placental growth hormone has been suggested.

When does pregnancy rhinitis start, and when does it stop?

It can start at almost any point. Ellegård's review says it can appear at almost any week of pregnancy, so it may begin in the first trimester or the third; under her definition it then carries on through at least the last 6 weeks. In the Croatian study, symptoms lasted a median of 4 months.

It goes after the birth. By definition it clears within 2 weeks of delivery, and in the Croatian study most women's symptoms resolved between the 2nd and 16th day afterwards. A blocked nose that carries on well beyond that has another cause and is worth getting checked.

Is "pregnancy nose" real?

The congestion is; a visibly bigger nose is less clear. In a small 2015 study from the US National Institute for Occupational Safety and Health, researchers measured 13 face and head dimensions, including nose breadth, in 15 women who were 13 to 35 weeks pregnant and 15 matched women who were not pregnant. They found no significant differences.

The same paper notes that some women in the 8th and 9th months of pregnancy develop swelling of the face that is most noticeable in the morning, and that facial swelling can also be a sign of illness, including pre-eclampsia. That is why sudden swelling matters: the NHS lists "sudden swelling of the face, hands or feet" as a symptom of pre-eclampsia that needs checking immediately. Our page on sudden swelling in pregnancy explains the difference.

Pregnancy rhinitis vs a cold, sinusitis or hay fever

The clue is what comes with the blocked nose. Pregnancy rhinitis is congestion without infection, so a high temperature or coloured mucus points elsewhere.

The sinusitis column is from the NHS, which notes sinusitis is common after a cold or flu. The NHS also says non-allergic rhinitis is different from allergic rhinitis, which is caused by allergies such as hay fever, so symptoms that come with a known allergy trigger point that way instead. For both sinusitis and non-allergic rhinitis, the NHS suggests a pharmacist as the first stop.

What helps a stuffy nose in pregnancy without medicines?

There is no known cure, but Ellegård's 2006 review lists simple measures that can improve nasal breathing: raising the head end of the bed, physical exercise, salt water nasal rinses and nasal dilators.

• Salt water rinse. The NHS gives a home recipe: boil a pint of water and let it cool, then mix in 1 teaspoon of salt and 1 teaspoon of bicarbonate of soda. With clean hands, pour a little into your cupped palm and sniff it into one nostril at a time, breathing through your mouth and letting it drain into the sink. Make a fresh solution each time, up to 3 times a day.
• Raise the head end of your bed. It is the first of the simple measures on Ellegård's list.
• Keep moving, and watch how your nose responds. Ellegård lists exercise as helping, although the NHS notes exercise can also set off non-allergic rhinitis in some people.
• Nasal dilator strips. These hold the nostrils open from the outside without any medicine.
• Avoid triggers. The NHS lists smoke, perfume and paint fumes, and changes in temperature or humidity, among things that set off non-allergic rhinitis.

For medicines, including sprays, ask a pharmacist and tell them you are pregnant. Ellegård notes that decongestant sprays give good short-term relief but tend to be overused, which causes a rebound congestion of its own, and the NHS lists using decongestant sprays for longer than the packet says as a cause of non-allergic rhinitis. If you get poor sleep from it, see our page on sleep problems in pregnancy.

Nosebleeds and snoring

Nosebleeds are covered on our page on nosebleeds and bleeding gums in pregnancy, including how to stop one and when it needs emergency care.

If a blocked nose has you snoring, it is worth knowing what sleep apnoea looks like. The NHS describes it as breathing that stops and starts while you sleep, with gasping, snorting or choking noises, waking up a lot and loud snoring, and very tired days.

When to see a GP or midwife

• Sudden swelling of your face, hands or feet, a severe headache, or problems with your vision: these are pre-eclampsia symptoms, and the NHS says to call your maternity unit straight away.
• Signs of sinusitis that are not settling: the NHS says to ask for an urgent GP appointment or contact NHS 111 if you are very unwell or symptoms get worse.
• Your breathing stops and starts while you sleep, or you make gasping or choking noises: the NHS says to see a GP.
• Non-allergic rhinitis symptoms that are getting worse, affecting your sleep and everyday life, setting off your asthma, or not helped by pharmacy treatments: the NHS says to see a GP.

Outside the UK, contact your own doctor or midwife; for an emergency call 911 in the US and Canada, 999 in Ireland, 000 in Australia or 111 in New Zealand.

Frequently asked questions

Is pregnancy rhinitis a sign of a boy or a girl?

Not in any useful way. One 2021 Croatian study of 681 women found pregnancy-induced rhinitis was diagnosed more often in women carrying a girl, but that is a single study and it does not let you predict the sex. A stuffy nose is common with either, affecting around one in five pregnancies.

Pregnancy rhinitis vs a cold: how can I tell?

Look at what comes with it and how long it lasts. Pregnancy rhinitis is congestion without signs of infection that continues through at least the last 6 weeks of pregnancy. A high temperature, green or yellow mucus or pain around your cheeks and eyes points to an infection such as sinusitis, which the NHS says usually clears within 4 weeks.

Can pregnancy rhinitis start in the first trimester?

Yes, it can start then. Ellegård's review says pregnancy rhinitis can appear at almost any week of pregnancy. Under her definition the congestion then continues through at least the last 6 weeks, without signs of infection or allergy, so a stuffy nose that clears within days is more likely to be a cold.

How long does pregnancy rhinitis last after birth?

Not long. By definition it clears completely within 2 weeks of the birth, and in a 2021 study of 681 women most had no symptoms by between the 2nd and 16th day after delivery. If your nose is still blocked weeks after the birth, see a pharmacist or GP to look for another cause.