General Medical Information

Hormonal Rhinitis

Shawn D. Newlands

Causes of hormonal rhinitis include hypothyroidism (myxedema) and elevated estrogen levels due to pregnancy, use of oral contraceptives, and the menstrual cycle. High levels of estrogen inhibit acetyl cholinesterase activity and stimulate acetylcholine production in the parasympathetic ganglia, leading to edema, hypersecretion, and vascular engorgement of the nasal mucosa. Pregnancy-induced rhinitis occurs in 20% of pregnancies, frequently with an onset in the second trimester of pregnancy. Swollen, pale, edematous turbinates characterize this condition. Care should be taken in making this diagnosis, however, because other causes of rhinitis, including allergic rhinitis, are common causes among pregnant women. Rhinitis related to hypothyroidism can lead to a diagnosis of that condition, and other symptoms of hypothyroidism should be sought.