Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory condition of the nose and sinuses that causes soft growths in your sinuses. Although these growths (nasal polyps) are usually painless, they can affect your quality of life and cause unpleasant symptoms — especially for women, who are often more affected by the condition. Although men are more likely to have CRSwNP, women tend to have more severe symptoms, have more cases of co-existing asthma and experience a greater impact on their quality of life.
We talked to Stella Lee, MDENT surgeon and director of the Brigham Sinus Center at Brigham and Women’s Hospital to learn what you need to know about symptoms, treatments and living with nasal polyps.
What are the common symptoms of chronic sinusitis with nasal polyps?
CRSwNP causes ongoing inflammation of the nose and sinuses, leading to symptoms lasting three months or more. Common symptoms include:
- Persistent nasal congestion or obstruction
- Difficulty breathing through the nose
- Loss or reduced sense of smell and taste
- Chronic runny nose or runny nose
- Facial pressure or fullness (less often pain)
- Sleep disturbance, snoring or fatigue
Why is chronic sinusitis with nasal polyps often more severe in women?
There are probably many reasons why women have more severe disease with CRSwNP, and these reasons are still being studied. Contributing factors may include:
- Hormonal effects, which can affect immune responses and inflammation of the nasal lining
- Differences in immune system regulation, with women more likely to have inflammatory and autoimmune diseases
- Delayed diagnosis, as women’s symptoms may be normalized, minimized or attributed to allergies or stress
- Higher rates of co-existing conditions such as asthma, migraines and sensitivity to aspirin, which can worsen nasal symptoms
Importantly, women often report a greater impact on quality of life, including fatigue, sleep disturbance and reduced sense of smell, even when disease severity appears similar.
What kinds of treatments are there for chronic sinusitis with nasal polyps?
Treatment for CRSwNP is individualized and often involves a combination of approaches, including:
- Topical steroid nasal sprays or sprays to reduce inflammation and improve mucus clearance
- Short courses of oral steroids for severe flare-ups (use with caution for severe flare-ups)
- Operative endoscopic sinus surgery to remove polyps, restore sinus outflow tracts, and improve drug delivery when medical therapy is inadequate
- Biological treatments that target specific inflammatory pathways in CRSwNP
- Management of related conditions such as asthma or allergies
CRSwNP is a chronic condition, so treatment focuses on long-term control rather than a one-time treatment.
What lifestyle changes can women with chronic sinusitis with nasal polyps make to improve breathing?
Although lifestyle changes are not a substitute for medical treatment, they can significantly support symptom control:
- Daily saline nasal rinses to clear mucus and allergens
- Reducing exposure to irritants such as smoke, strong perfumes and air pollution
- Management of environmental allergies when present
- By prioritizing sleep, stress reduction, and regular exercise, all of which affect immune health
- Maintaining good control of asthma or reflux, if present
Are there specific questions women should ask their healthcare providers about managing nasal polyps?
Yes. Helpful questions include:
- What are my short-term and long-term treatment options? What treatment options are best for me?
- How will we monitor if treatment for nasal polyps is working?
- How do my other conditions (asthma, allergies, migraines) affect my sinus disease?
- What can I do at home or at work to reduce flare-ups and keep them under control?
What can women do to advocate for better care for nasal polyps?
Self-advocacy is essential when you have a chronic condition:
- Track symptoms (breathing, smell, sleep, fatigue) and how they affect daily life
- Talk if symptoms persist despite treatment. Ongoing congestion is not ‘normal’
- Ask for a referral to a sinus specialist if improvement is limited
- Report quality of life concerns, not just nasal symptoms
- Look for providers who are willing to discuss all available options, including the newest treatments
Women should feel empowered to expect relief, not just reassurance, and to work with their health care team in long-term disease management.
This educational resource was created with the support ofm Sanofi and Regeneron.
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