Clinically Speaking: Questions and Answers about Living with Nasal Polyps

What are common symptoms of chronic rhinosinusitis with nasal polyps?

CRSwNP causes ongoing inflammation of the nose and sinuses, leading to symptoms that last three months or longer. Common symptoms include:

• Persistent nasal congestion or blockage
• Difficulty breathing through the nose
• Loss or reduced sense of smell and taste
• Chronic runny nose or postnasal drip
• Facial pressure or fullness (less often pain)
• Sleep disturbance, snoring or fatigue

Why is chronic rhinosinusitis with nasal polyps often more severe in women?

There are likely many reasons that women have more severe disease with CRSwNP, and those reasons are still being studied. Contributing factors may include:

• Hormonal influences, which can affect immune responses and nasal lining inflammation
• Differences in immune system regulation, with women being more likely to have inflammatory and autoimmune conditions
• Delayed diagnosis, as women’s symptoms may be normalized, minimized or attributed to allergies or stress
• Higher rates of coexisting conditions such as asthma, migraines and aspirin sensitivity, which can worsen nasal symptoms

Importantly, women often report a greater quality-of-life impact, including fatigue, sleep disruption and impaired sense of smell, even when the severity of the disease appears similar.

What types of treatments 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 irrigations to reduce inflammation and improve clearance of mucus
• Short courses of oral steroids for severe flares (used cautiously for severe exacerbations)
• Functional endoscopic sinus surgery to remove polyps, restore sinus outflow tracts and improve medication delivery when medical therapy is insufficient
• Biologic therapies that target specific inflammatory pathways in CRSwNP
• Management of associated conditions such as 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 with chronic rhinosinusitis with nasal polyps?

While lifestyle changes don’t replace medical treatment, they can meaningfully support symptom control:

• Daily saline nasal rinses to clear mucus and allergens
• Reducing exposure to irritants such as smoke, strong fragrances and air pollution
• Managing environmental allergies when present
• Prioritizing sleep, stress reduction and regular exercise, all of which influence immune health
• Maintaining good control of asthma or reflux, if applicable

Are there specific questions women should ask their healthcare providers about management of nasal polyps?

Yes. Helpful questions include:

• What are my short-term and long-term treatment options? Which treatment options are best for me?
• How will we monitor whether treatment for my nasal polyps is working?
• How do my other conditions (asthma, allergies, migraines) affect my sinus disease?
• What can I do at home or work to reduce flares and maintain control?

What can women do to advocate for themselves to get 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
• Speak up if symptoms last despite treatment; ongoing congestion is not “normal”
• Ask for referral to a sinus specialist if improvement is limited
• Bring up quality-of-life concerns, not just nasal symptoms
• Seek providers who are willing to discuss all available options, including newer therapies

Women should feel empowered to expect relief, not just reassurance, and to partner with their healthcare team in long-term disease management.