Menopause and allergies - what's the link? | Stella
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8 mins

Menopause and allergies – what’s the link?

byDr Lucy Wilkinson

Have you noticed you’ve been sneezing more recently, have itchy skin, teary eyes or even a new food allergy? Is there a link between menopause, hormones and allergies? Stella’s clinical advisor, Dr Lucy Wilkinson, shares her expertise.

What are allergies?

Allergies are essentially a malfunction of your immune system.

Your immune system usually does a fantastic job of identifying and removing threats, including harmful germs like bacteria and viruses, as well as damaged cells within your body.

Sometimes this process goes wrong and your body may have an unnecessary reaction to a harmless substance. This may be anything from pollen to peanuts, and reactions can range from annoying to life-threatening.

Allergies can affect many different parts of your body, including:

  • Skin (rashes)
  • Lungs (allergic asthma) 
  • Upper airways (hayfever)

Symptoms may include:

  • Severe reactions including low blood pressure, lip or tongue swelling and breathing difficulties – also known as anaphylaxis
  • Rashes – often itchy and with a typical appearance known as urticaria or hives
  • Sneezing, congestion or a runny nose
  • A cough or wheeze

Hayfever and food allergies are a normal part of life for many of us, but some develop new or different reactions during menopause.

There is no conclusive evidence just yet and doctors are still debating if there is a link.

Anecdotally, some people notice a change to their allergies at menopause. Some develop a new allergy to pollen, food or something else entirely. Others may find that pre-existing allergies change or get worse.

There is not yet enough scientific data to know for sure whether menopause is the cause, or if it is simply coincidence.

Does menopause affect asthma?

The possible link between allergic asthma and menopause has been most closely investigated although evidence is still lacking. One thorough review article found mixed evidence about the links between menopause, HRT and allergy symptoms. 

Despite the uncertainty around menopause and allergy, there is a general consensus that hormonal factors do affect the immune system. This is thought to be due to the complex way in which oestrogen acts on the body. More research is needed for us to understand this fully.

What is histamine intolerance?

Histamine intolerance (also known as histaminosis) is slightly different from a true allergy. Rather than a reaction to a specific trigger, histamine intolerance is caused by a build-up of histamine in the body. 

Histamine is a chemical which plays an important role in many processes within your body. It is an important component of immune responses, particularly allergies and allergic-type reactions. If your body incorrectly identifies a substance as a threat – for example, grass pollen in hayfever sufferers – histamine is released. This in turn causes itching eyes, sneezing and a runny nose – all the symptoms of an allergy.

Histamine levels are usually kept in check by your body. Cells produce histamine as needed and release it into the bloodstream, before it is broken down and removed from the body.

What causes histamine intolerance?

Histamine intolerance happens when histamine builds up without being removed. Diet can be a factor as a wide range of foods contain high levels of histamine and can cause build-up. This leads to symptoms similar to those seen in allergic reactions or even the menopause itself. These include: 

  • Rashes, itching and hives
  • Flushing and palpitations
  • Tiredness, sleep problems and low mood
  • Runny or blocked nose, asthma
  • Abdominal symptoms including pain, bloating, diarrhoea or constipation

If you have noticed a link between your menopause and food allergies, or menopause and skin allergies, it might be worth considering histamine intolerance as the symptoms can be very similar.

How can you treat histamine intolerance?

The main treatment for histamine intolerance is a low-histamine diet. Low-histamine foods are generally fresh, unprocessed foods. High-histamine foods include fermented foods like cheese, yoghurt, cured meats and alcohol among others. A four-week trial of a low-histamine diet is actually considered the best way to diagnose this condition, as other tests can be quite unreliable. Currently, this condition is poorly understood and rarely diagnosed although is thought to affect around 1 in 100 people.  

How can you diagnose histamine intolerance?

The symptoms are wide-ranging and quite vague. This means that it is important to speak to your doctor for an accurate diagnosis and to ensure that there is no other cause for your symptoms. While there are no accurate tests for histamine intolerance, your doctor may still want to run some checks to rule out other conditions.

Can menopause cause histamine intolerance?

We know that histamine levels peak at times when your oestrogen levels are high.  It’s worth noting then that in perimenopause spikes in oestrogen levels are common. While menopause alone does not cause histamine intolerance, it could contribute to the build-up of histamine and symptoms of histamine intolerance.

Menopause and skin allergies

While research into the link between menopause and allergies is ongoing, many symptoms caused by hormonal changes can be incorrectly blamed on allergies.

These include:

If you have any signs of skin allergies, speak to your doctor for a diagnosis. If things aren’t improving as expected, it might be worth asking whether menopause could be the underlying cause of your symptoms.

What treatments are available for allergies and menopause?

Treatments for allergies at menopause are the same as for allergies experienced at any other time of your life. Depending on which part of your body is affected, your doctor may recommend tablets, creams, inhalers or other treatments.

The exception to this is if you have histamine intolerance. If this is the case, a low-histamine diet is likely to be the recommended treatment.

Speak to your doctor to find out which is the best option for you.

Would hormone replacement therapy (HRT) help?

HRT is not routinely recommended for allergies at menopause. This is because we do not yet have enough evidence that there is a link between the two. We are well aware of the risks of HRT, including a slight increased risk of breast cancer and blood clots for some forms of the treatment. The risks are thought to outweigh the benefits. Likewise, HRT is not a treatment for histamine intolerance. 

It’s worth noting that HRT is a highly effective treatment for menopause symptoms, including hot flushes, poor sleep and mood changes. Speak to your doctor or take Stella’s free online menopause assessment if you would like to find out whether HRT is a recommended treatment option for you.

Read more about the risks and benefits of HRT.

Can antihistamines help with menopause?

Antihistamines are useful in treating a number of medical conditions including allergies and itch. They are not generally used to treat menopause symptoms. Your doctor will be able to advise on the best treatment options for you.

Final word

While hormonal changes may be linked to allergic conditions, evidence is still emerging about the exact nature of this relationship. If you are struggling with any allergy symptoms, see your doctor for advice on diagnosis and treatment options.