Otolaryngol Head Neck Surg

Estrogen‑containing contraception: Lower risk of chronic rhinosinusitis without polyps?

March 4, 2026

A cross-sectional analysis of nearly 240,000 participants from the All of Us Research Program found that use of estrogen-containing contraceptives (ECCs) was associated with 29% lower odds of chronic rhinosinusitis without nasal polyps (CRSsNP) compared with no hormonal contraceptive use. Progestin-only contraceptives showed no association with CRS, and menopause status didn't affect CRS risk. Biomarker analysis revealed that ECC users had significantly lower serum neutrophil concentrations, suggesting a potential anti-inflammatory mechanism. The protective effect was specific to CRSsNP, with no significant association found for CRS with nasal polyps (CRSwNP).

Clinical takeaway: When counseling female patients about contraceptive options, consider that estrogen-containing formulations could offer additional benefit for those with or at risk for CRSsNP, though further research is needed to clarify mechanisms and establish causality.

Source:

Ahn A, et al. (2026, February). Otolaryngol Head Neck Surg. Association of Menopause and Hormonal Contraceptive Use With Chronic Rhinosinusitis: An "All of Us" Analysis. https://pubmed.ncbi.nlm.nih.gov/41221974/