New study explores link between hormonal contraceptives and chronic rhinosinusitis in women

A comprehensive new study analyzing data from nearly 240,000 women has found that estrogen-containing hormonal contraceptives are associated with a significantly lower risk of chronic rhinosinusitis without nasal polyps (CRSsNP), while menopause status showed no significant association with the condition.

“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. Relatively little research, however, has examined the role of biological sex and sex hormones in CRS, another inflammatory airway disease,” said Victoria S. Lee, MD, senior author of the study and Associate Professor and Director of Research with the Department of Otolaryngology at the University of Illinois College of Medicine.

The research, published in the February 2026 issue of Otolaryngology–Head and Neck Surgery, represents the first study to specifically examine the relationship between menopause, systemic hormonal contraceptive use, and chronic rhinosinusitis (CRS) among U.S. adults using data from the National Institutes of Health's All of Us Research Program.

“To address this knowledge gap, our research team previously showed that CRSsNP more commonly affects women than men during the reproductive years. Building on this work, the present study extends these findings by looking at the influence of sex hormone-based contraceptives and menopause, an estrogen-deprived state. Ultimately, this work has the potential to improve risk stratification and inform hormone-related therapy recommendations for women with CRS,” said Dr. Lee.

Chronic rhinosinusitis affects approximately 2.1% to 13.8% of adults in the United States and accounts for over $10 billion in annual healthcare costs. The condition is characterized by persistent inflammation of the nasal and sinus passages lasting at least 12 weeks, causing symptoms such as nasal obstruction, drainage, impaired sense of smell, and facial pain or pressure.

The study analyzed two distinct cohorts: 38,749 women aged 40-60 for the menopause analysis, and 44,280 women aged 20-40 for the hormonal contraceptive analysis. Researchers found that women using estrogen-containing contraceptives had 29% lower odds of developing CRSsNP compared to those not using systemic hormonal contraceptives. However, no significant association was found between these contraceptives and CRS with nasal polyps (CRSwNP).

The researchers noted that future longitudinal studies are needed to better understand how hormonal changes throughout a woman's life may influence CRS development and progression.

Reference:

Abraham Ahn, Richard G. Chiu, Kamal Eldeirawi , Association of Menopause and Hormonal Contraceptive Use With Chronic Rhinosinusitis: An “All of Us” Analysis, Otolaryngology, https://doi.org/10.1002/ohn.70067