The influence of female sex hormones on nasal reactivity in seasonal allergic rhinitis

Background: This study aimed to investigate whether the hormone peaks of es trogen and progesterone could influence the extent of the allergic reaction in grass-pollen-allergic women. Methods: Twenty-three allergic women with seasonal allergic rhinitis due to grass pollen were included in this trial. Twelve were taking oral contrace ptives (OC) (control group), and 11 were taking no pill (target group). The subjects were challenged with grass pollen by nasal provocation test aroun d day 14 of their menstrual cycle (ovulation day) and again at the end of t he cycle (day 27). The primary criteria were the subjective nasal symptoms rhinorrhea, nasal blockage, itching, and sneezing. A further criterion was the objectively measured nasal mucosal swelling, assessed by active anterio r rhinomanometry. All criteria were evaluated before and 15 min after provo cation, and the hormone status was determined on each investigation day. Results: Comparisons of symptoms between the groups resulted in P values of >0.05 for all symptoms at both visits except the symptom blocked nose, whi ch was significantly lower (P=0.03) in the patients with OC intake at visit 2, and the symptom sneezing, which showed a significantly (P=0.02) higher increase in patients taking OC at the end of the cycle. The flow decrease r eached a greater extent in the target group than in the controls. Conclusions: These results indicate a correlation of the hormonal situation and the nasal allergic reactivity. OC intake led to an intensifying of neu rogenic symptoms near the end of pill intake, a result which could be due t o a protective effect of the endogenous progesterone, in contrast to the or ally administered hormones.