Background: Allergic rhinitis (AR), colloquially known as hay fever, is a sinonasal inflammatory disease. Growing evidence suggests that female sex hormones play a significant role in immune-driven conditions. Systemic hormonal contraceptives (SHCs), widely used in reproductive health care, and menopause affect hormonal levels in women, presenting a framework to examine the role of sex hormones in AR. Objective: To assess the associations of SHC use and menopause with AR using a diverse, large, nationally representative database. Methods: This cross-sectional study utilized data from three cycles of the National Health and Nutrition Examination Survey (NHANES). Exposure variables were current SHC use (yes vs. no), duration of SHC use (years), and menopausal status (yes vs. no). The outcome variable was AR, defined as self-reported hay fever episode in the past 12 months (yes vs. no). Covariates considered included age, race/ethnicity, family Poverty Income Ratio, language, health insurance status, general health, alcohol use, smoking, and recreational drug use. A forward selection approach determined the final model. Results: Extended SHC use was associated with increased odds of AR. Current SHC use within one year, however, was not associated with AR. Postmenopausal women did not have a significantly lower risk of AR than premenopausal women. Conclusion: SHC use may have a dose-dependent influence on AR, which highlights a potential relationship between female sex hormones and sinonasal inflammation. Prospective and mechanistic studies are needed to further evaluate this association.
Dick et al. (Sun,) studied this question.