People with PH may have skin problems that get worse three to 10 days before their period. PH may progress to anaphylaxis. This is a sudden, life-threatening allergic reaction.
The symptoms of catamenial dermatosis are similar PH. They happen at the start of your period instead of before. Catamenial anaphylaxis may also occur.
This article looks at the causes, symptoms, and diagnosis of allergic reactions that happen during the menstrual cycle.
Progesterone Hypersensitivity
Progesterone hypersensitivity is a reaction to your own progesterone. Progesterone is a hormone that helps regulate your monthly cycle. PH can also be caused by other sources of this hormone.
Symptoms
Symptoms of PH usually appear between three to 10 days before the onset of your period. They start to go away one to two days after your period starts.
PH can have a variety of symptoms. Most, if not all, include skin rashes. Skin rashes that may be seen with PH include:
Eczema, a skin condition that causes an itchy, red rash Hives, raised bumps that appear on the surface of the skin Fixed drug eruption, a reaction that recurs on the same part of the body Erythema multiforme, a reaction that usually appears on the hands and arms Angioedema, hive-like swelling that occurs under the skin
Anaphylaxis is also possible.
At first, it may not be obvious that your symptoms are related to your period. It often takes a doctor to point out the pattern.
Causes
The cause of PH is unknown. Some researchers think it may be related to hormonal birth control. It could also be related to supplements that contain progesterone.
These exposures may cause sensitization to the hormone. This is when your body becomes sensitive to an allergen, a substance that causes an allergic reaction.
Pregnancy may also cause progesterone sensitization. Pregnancy can affect the immune system. It can also impact a variety of allergic conditions.
Allergic reactions to other hormones like estrogen can also occur. These are far less common, though.
Diagnosis and Treatment
PH is usually diagnosed based on:
SymptomsHealth historyPhysical exam
Some allergists may perform a skin test. This type of testing is unproven, though.
PH can be treated with antihistamines. These drugs block the action of chemicals that cause allergic reactions.
PH may also be treated with oral or injected corticosteroids. These are anti-inflammatory drugs.
Unfortunately, these drugs only treat symptoms. They do not treat the cause of the condition.
Other treatments stop the ovaries from releasing an egg. The prescription drug Eligard (leuprolide) prevents the increase of progesterone that follows ovulation. This is an option if antihistamines don’t work.
Rarely, surgery to remove the uterus and ovaries is needed. This is done in severe cases when medications don’t help control the symptoms.
Catamenial Dermatoses and Anaphylaxis
These conditions are also related to the menstrual cycle.
Fever Wheezing Shortness of breath Facial swelling Rapid heartbeat Nausea Vomiting Fainting
These are all signs of anaphylaxis. Anaphylaxis requires immediate care.
Symptoms
The symptoms of catamenial dermatoses are similar to PH. The timing is different, though. Symptoms occur during your period instead of before. A variety of rashes can also occur.
People with this condition have symptoms at the onset of menstruation. The symptoms continue until flow stops.
Some people may also experience catamenial anaphylaxis. This is a more serious reaction that involves several different parts of the body. Symptoms may include:
Nausea Vomiting Diarrhea Low blood pressure Respiratory symptoms
Causes
Unlike PH, catamenial anaphylaxis is not thought to be a reaction to progesterone. Instead, it may be triggered by prostaglandins. These are hormones that influence processes like pain and inflammation. They are released from the lining of the uterus during your period.
Catamenial anaphylaxis is a more serious reaction that causes multiple symptoms.
Diagnosis and Treatment
Diagnosis of these conditions is usually based on:
SymptomsHealth historyPhysical exam
Because the condition is rare, there is no standard treatment. In one small study, most patients did not respond to antihistamines. Others were successfully treated with hormones.
In severe cases, surgical removal of the ovaries and uterus may be necessary. This is done when medications are unable to control the symptoms.
Summary
Allergic reactions related to the menstrual cycle are uncommon. Symptoms may include worsening skin conditions that can progress to anaphylaxis.
These conditions are usually diagnosed based on symptoms and health history.
PH can be treated with antihistamines or corticosteroids. Treatments that prevent the ovaries from releasing an egg may also help.
Catamenial dermatosis and anaphylaxis may be treatable with hormones.
Rarely, these conditions may require surgical removal of the ovaries and uterus.
