Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and sinuses that causes soft growths in your sinuses. Although these growths (nasal polyps) are not usually painful, they can affect your quality of life and cause unpleasant symptoms – especially in women, who are often more severely affected by the condition. Although men are more likely to suffer from CRSwNP, women tend to have more severe symptoms, more cases of co-occurring asthma, and experience greater impairment in their quality of life.
We spoke with Stella Lee, physician, ENT surgeon, and director of the Brigham Sinus Center at Brigham and Women’s Hospital, to find out what you need to know about symptoms, treatment, and living with nasal polyps.
What are common symptoms of chronic rhinosinusitis with nasal polyps?
CRSwNP causes persistent inflammation of the nose and sinuses, resulting in symptoms that last three months or longer. The most common symptoms include:
- Persistent stuffy or stuffy nose
- Difficulty breathing through the nose
- Loss or decreased sense of smell and taste
- Chronic runny nose or postnasal drip
- Pressure or feeling of fullness in the face (less often pain)
- Sleep disorders, snoring or tiredness
Why is chronic rhinosinusitis with nasal polyps often more severe in women?
There are likely many reasons why women have more severe CRSwNP disease, and these reasons are still being investigated. Contributing factors may include:
- Hormonal influences that can affect immune reactions and inflammation of the nasal mucosa
- Differences in immune system regulation, with women suffering more from inflammatory and autoimmune diseases
- Delayed diagnosis because symptoms in women may be normalized, minimized, or due to allergies or stress
- Higher frequency of co-existing medical conditions such as asthma, migraines and aspirin hypersensitivity, which may worsen nasal symptoms
Importantly, women often report greater impairment in quality of life, including fatigue, sleep disturbances, and impaired sense of smell, even when disease severity appears similar.
What treatment options are available for chronic rhinosinusitis with nasal polyps?
Treatment for CRSwNP is individualized and often involves a combination of approaches, including:
- Topical steroid nasal sprays or rinses to reduce inflammation and improve mucus clearance
- Short courses of oral steroids for severe attacks (used cautiously in severe exacerbations)
- Functional endoscopic sinus surgery to remove polyps, restore sinus drainage pathways, and improve medication delivery when medical therapy is insufficient
- Biological therapies that target specific inflammatory pathways in CRSwNP
- Management of associated conditions like asthma or allergies
CRSwNP is a chronic condition, so treatment focuses on long-term control rather than a one-time cure.
What lifestyle changes can women make to improve breathing in chronic rhinosinusitis with nasal polyps?
Although lifestyle changes do not replace medical treatment, they can usefully support symptom control:
- Daily nasal rinses with saline to remove mucus and allergens
- Reducing exposure to irritants such as smoke, strong fragrances and air pollution
- Managing environmental allergies, if any
- Prioritizing sleep, stress reduction, and regular exercise, all of which impact immune system health
- Maintain good control of asthma or reflux when appropriate
Are there specific questions women should ask their doctor about treating nasal polyps?
Yes. Helpful questions include:
- What are my short-term and long-term treatment options? Which treatment options are best for me?
- How do we monitor whether the treatment for my nasal polyps is working?
- How do my other medical conditions (asthma, allergies, migraines) affect my sinus disease?
- What can I do at home or at work to reduce flare-ups and stay in control?
What can women do to advocate for better nasal polyp treatment?
Self-advocacy is important when you have a chronic illness:
- Track symptoms (breathing, smell, sleep, fatigue) and how they affect daily life
- Report if symptoms persist despite treatment. Persistent traffic jams are not “normal”
- Ask for a referral to a sinus specialist if improvement is limited
- Raise concerns about quality of life, not just nasal symptoms
- Look for providers who are willing to discuss all available options, including newer therapies
Women should feel empowered to expect relief, not just reassurance, and to work with their healthcare team in the long-term management of the disease.
This educational resource was created with support from Sanofi and Regeneron.
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