How did you cope with pregnancy rhinitis?

February 10, 2016 8:02 AM

I'm 7 months pregnant and have suffered from a chronically stuffy nose since the first test came back positive. I cannot breathe like a normal person without liberal squirts of Sinex, but obviously I'd like other solutions. Help!

Apparently pregnancy rhinitis is a not-uncommon symptom related to estrogen irritating the nasal passages. It was bad by week 4, and now that I'm in the third trimester it's nigh unbearable. I started out using saline drops, then a nasal rinse, and then steam with peppermint or eucalyptus oil, but nothing works half as well as Sinex. The cold weather helps a little bit, too, but the usual tricks like humidifiers, spicy food, horseradish, and plain old nose blowing (no snot comes out!) do zilch.

Yes, I have spoken to my obstetrician, yes, I plan to make an appointment with an ENT. My obstetrician, who is otherwise wonderful and helpful, was not very useful beyond "yes this is normal, uhhh try saline drops?" He also said that while Sinex use is fine for the baby, it certainly is not an ideal long-term fix since it will further irritate my nasal passages. Almost everything I read about this condition says that the ultimate cure is "having the baby," which is not (fingers crossed) going to happen for another 2 months. At this point I'm utterly dependent on the spray and have likely created a vicious cycle. I have tried cutting back on it over weekends, but being 100% unable to breathe through my nose eventually sends me running back for the bottle after 48 miserable hours. I also need to be able to breathe at work, as I'm a therapist and breathing through my mouth is distracting, dizzying, and looks an awful lot like yawning in session.

It's gotten to the point where I'm using Sinex once per nostril in the morning, midday at lunch, again before bed, and again in the middle of the night. On the few occasions I'm able to get a productive nose blowing, the tissue is pretty bloody. I'm now waking up in the middle of the night completely unable to breathe, and the process of squirting in the Sinex and waiting for it to kick in fully wakes me up and compromises my already poor sleeping.

I know other women suffer from pregnancy rhinitis, though I feel like either through bad luck or my doing my condition is particularly acute. I read this question and will try rhinocourt but would really love other suggestions. Thanks!

posted by zoomorphic to Health & Fitness (19 answers total)

Oh that sounds awful. :(
My sister has always had nasal/sinus problems, and when she was pregnant and contracted a cold, she swore by using a neti-pot. Would that work to clean everything out? It's very gentle.
posted by Dressed to Kill at 8:06 AM on February 10, 2016 [2 favorites]

Neti pot all the darn time, bring a nasal spray in your bag, and use breathe right strips at night (and when you don't mind being seen with them.) Good luck!
posted by chocotaco at 8:13 AM on February 10, 2016 [3 favorites]

Have you tried Breathe-right strips?
posted by amtho at 8:16 AM on February 10, 2016 [1 favorite]

Sinex is a miracle for short-term use, but using it long-term will really jack your sinuses up. And part of that being-jacked-upness is inflammation. I always notice that after using it for the 3 days max that our doctor has finger-wagged about, my nose feels very very stuffy due not to snot but to inflammation of my nasal passages, for about 24 more hours before regulating again. I imagine with longer term use it'd take a lot more time for the inflammation to go down.

I'd recommend a humidifier in all the places you spend time, and take anti-inflammatories as your OB allows (Advil is okay in the third trimester, right? My memory is fuzzy) to see if you can calm your nasal passages down a bit while you try to get off the Sinex. Using that stuff for too long always makes me feel like I've utterly broken my nose.
posted by soren_lorensen at 8:25 AM on February 10, 2016 [2 favorites]

Mucinex? My doctor approved that for my use during pregnancy (in fact, I had a cold while I was in labor, and took Mucinex throughout labor & immediately postpartum) and I've become a solid fan since then. The DM version (guaifenesin only) stops my coughing and my runny nose for 12 hours with no drowsiness. I'm not even breastfeeding anymore, so I could have anything I want, and I still went with Mucinex for my last head cold.

FWIW, I'm sorry. Pregnancy sucks. And I just want to warn you that it might not go away immediately after delivery; some of my pregnancy stuff didn't go away for days or weeks afterwards! And that can really suck when you're hoping it will disappear with the baby's arrival.

Good luck and congratulations!
posted by aabbbiee at 8:46 AM on February 10, 2016

Nthing neti pot, I didn't discover it until after having kids and I really wish I'd discovered it before. As great as it is for my chronic allergies, it would have been sooooo good for those amped-up mucus membranes during pregnancy.

That said, I'd have been even more careful about keeping it sterilized (I'm admittedly loosey-goosey about this) and I would have been prepared for a rogue gag reflex to turn the process into a nightmare.
posted by padraigin at 8:51 AM on February 10, 2016

I spent time using peppermint lotion on my face, neck, and chest. Also sucking on menthol cough drops.
posted by tilde at 9:08 AM on February 10, 2016

I've never been pregnant, but I've got constant rhinitis. Sinex is contraindicated for long term use (more than a few days) because it can cause rebound congestion. Rebound congestion lasts longer than the 2 days you get over the weekend. (Is there a way you could give it a full week off?)

Pseudoephedrine will work (it will reduce the swelling in your nasal passages) but is a definite no in early pregnancy; obviously you'd need an ok from a doc on this. I'd specifically ask your ENT if it is ok in late pregnancy, for your particular level of symptoms.

Lastly, staying really hydrated helps. Breathing with your mouth open dries you out fast, and being dry only further irritates already grumpy nasal passages. Neti pot helps here but you can also drink more fluids (well, bladder size allowing).
posted by nat at 9:25 AM on February 10, 2016

Great advice here, especially re neti pot.

NSAID's (including advil) are contraindicated in the third trimester. Do not take them.
posted by noonday at 10:03 AM on February 10, 2016 [1 favorite]

With long term use (more than a few days), the active ingredient in Sinex will actually cause more swelling in your nasal passages, a problem known as Rhinitis_medicamentosa

The way that oxymetazoline works is to cause the blood vessels in your sinuses to constrict, meaning that less blood is getting through and less fluid can be shunted out to make mucus. Yay - you get some short-term relief of congestion!

After a few days of this, though, your body says "hey, there's something really wrong with the nose, better jack up the production of vasodilators", which cause the vessels to swell even more than they already were. And then you're even more congested than when you started. From this point on, you're caught in a vicious cycle.

The only real solution is to suffer for a few days until the body is able to get back to it's steady state pre-Sinex. You may still be congested at that point, but it'll likely be better than it is now.
posted by chrisamiller at 10:28 AM on February 10, 2016

I used Nasacort AQ with a squirt of Afrin and it worked like a charm. This is what my allergist told me to do at the time, and I never suffered any irritation from it. My next allergist told me that shouldn't really work as well as I said it did, but I swear to you it it worked great, definitely worth trying! Good luck, I know how miserable that is.
posted by rabbitrabbit at 10:29 AM on February 10, 2016

To clarify: you just squirt a little bit of Afrin in the Nasacort bottle and shake it up, and use it that way.
posted by rabbitrabbit at 10:37 AM on February 10, 2016

Best answer: I had the same, minus the blood. I feel you, not being able to breathe through the nose gave me mini panic. I tried many things but only nose spray brought any relief at all. I spaced it out as much as I could, spraying only up one nostril, and used a lower concentration children's spray. It went away a few days after giving birth and I don't seem to have after effects despite the spray dependence over about two months.

Steam actually made it worse, cold air helped.

No ibuprofen during the third trimester!
posted by meijusa at 10:43 AM on February 10, 2016

I came in to say what chrisamiller did. I gave myself rhinitis medicamentosa due to overuse of Afrin nasal spray over several weeks because it was literally the only thing that allowed me to breathe, having absolutely no idea that it had likely become the cause of my problem instead. I weaned off it by switching to use only at bedtime when the situation was most unbearable, and just suffered angrily through the daytime. After a few days of that, I allowed myself a single shot in one nostril, alternating each night. Propping myself upright with pillows to sleep also helped a bit. The worst was over in about a week.

Beware of saline nasal sprays as well. I initially switched to a simple (or so I thought) Target-brand saline nasal spray to try to get off the Afrin, and when the situation was showing zero improvement after a couple weeks, I went researching and discovered that many saline sprays contain additives like benzalkonium that can aggravate congestion and inflammation and were just prolonging my condition. The best ones are simple saltwater, like what you get with the neti pot or Simply Saline.

I'm so sorry! I know how incredibly frustrated and miserable you are right now, and I hope you can get some relief very soon.
posted by anderjen at 10:52 AM on February 10, 2016

Response by poster: Thanks so far, everyone. The Neti pot has not helped a single bit, and I tried for a solid 2 weeks around months 5-6 to detox from the Sinex and rely on that instead. The issue doesn't feel like mucus and never has (even before the Sinex addiction), but rather swollen nasal passages that are irritated by estrogen and, I'm assuming, exacerbated by the Sinex. But I'm wondering that since detoxing from Sinex before did not alleviate my symptoms if this is just going to be an ongoing issue until some time after giving birth.
posted by zoomorphic at 12:25 PM on February 10, 2016

I had a lot of swelling after jaw surgery that caused what you're describing (swollen nasal passages without extra mucus). I used Afrin strictly as directed (2x/day? I don't remember), a humidifier next to my bed, Breathe Right strips (I was shocked how much these helped), and oral phenylephrine (I have no idea if this is safe in pregnancy).
posted by i_am_a_fiesta at 1:39 PM on February 10, 2016

I highly recommend craniosacral therapy. There is a very gentle and highly effective sinus protocol I use in my maternity practice; my clients invariably give it the thumbs up.
posted by sutureselves at 2:04 PM on February 10, 2016 [1 favorite]

I had a horrible stuffy nose/sinus issues throughout my pregnancy. I used a lot of saline-in-a-can but really mostly just suffered. It sucked.
posted by 41swans at 5:47 PM on February 10, 2016

Best answer: I had a horrible several weeks with a stuffy nose and used Afrin, and I got to the point where I could not be without it. It was horrible. Doctor had me fill a half empty bottle of Afrin the rest of the way up with a saline nose spray (not medicated) and keep using it - and when THAT was half empty, fill it up with saline again. Worked in about a week (maybe less) to wean me off the Afrin.
posted by ersatzkat at 7:17 PM on February 10, 2016