Does use of the combined oral contraceptive pills cause changes in nasal physiology in young women?

C.M. Philpott (1), C.R. Wolstenholme (1), G.E. Murty (1), E.J. Oloto (2)

Department of Otorhinolaryngology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK (1); Contraception, Sexual & Reproductive Health Services, St Peter’s Health Centre, University Hospitals of Leicester NHS Trust, UK (2)

Introduction: Previous work in this area demonstrated changes in nasal physiology during pregnancy ¹ and at ovulation ². The effect of combined oral contraceptive pills on nasal physiology, to our knowledge, has not been investigated.

Objective: To demonstrate whether the use of combined oral contraceptive pill influences nasal physiology.

Design & Methods: Female volunteers seeking to commence combined oral contraceptive pills (cocp) were recruited from a community family planning clinic. Measurements of the nasal airways were made at day 1 and at mid-cycle of their periods prior to the commencement of the cocp and then repeated at the same timings once on the pills. These measurements included anterior rhinoscopy, peak inspiratory nasal flow, acoustic rhinometry and anterior rhinomanometry. Symptomatic measurements were by saccharin tests and rhinitis questionnaire scores. Results were analysed using paired t-tests.

Results: The research is in progress but the preliminary analysis of the results suggests that there are no significant differences in the measurements before and after commencing cocp. However, there are differences between the day 1 and mid-cycle readings before commencing cocp (anterior rhinoscopy and rhinitis questionnaires were nearest to statistical significance), which is in agreement with the work previously conducted by Philpott et al ².

Conclusions: An influence of endogenous hormones in a cyclical manner is evident, but the continuous pulse delivery of hormones provided by the cocp does not appear to influence nasal physiology significantly. This may provide complexities with the pharmacological antagonism of oestrogens in managing rhinitis.

1. Philpott C., Conboy P., Al-Azawi F., Murty G. Nasal physiological changes during pregnancy. Clinical Ortorlaryngology and Allied Sciences, 2004. In progress.

2. Philpott C.,El-Alami F., Murty G. The effect of the steroid sex hormones on the nasal airways during the normal menstrual cycle. Clinical Ortorlaryngology and Allied Sciences, 2004. In progress.