Allergic reactions and menopause
Allergies are usually associated with seasonal changes and immune responses. However, the impact of hormonal changes during menopause (or a combination of these factors) should not be underestimated. Oestrogen fluctuations can cause your body to respond differently to allergens, triggering allergic reactions or worsening existing allergies. This can cause symptoms such as itching, red eyes, fatigue or diarrhoea, or asthma, hay fever, rosacea and eczema.
In my mid-40s, my skin suddenly became more sensitive. I changed to fragrance-free detergent and starting using cotton socks and bed linen. - Pia (age 61)
After puberty, asthma and other allergies become more prevalent and severe in women than men. Asthma in women is clearly affected by hormonal fluctuations: 30 percent of menopausal women with asthma report worsening of symptoms, particularly during perimenopause when hormonal fluctuations are most pronounced.
In postmenopause, once hormone levels remain at a constant low level, asthma symptoms may improve. Mind you, each woman's body is different and no woman's journey through menopause is the same. You may not develop allergies until postmenopause, or you may never develop an allergy. Unsure if your symptoms are allergy symptoms? Then talk to your GP.
What is happening in your body?
Allergies arise if the body's immune system overreacts to foreign substances (allergens) that are usually harmless, such as pollen, food substances or pet dander. The immune system makes antibodies that mark a specific allergen as harmful, even though it isn't. Coming into contact with the allergen causes a reaction, such as eczema, asthma, hay fever, skin inflammation (redness) or digestive reactions (stomach pain, diarrhoea, nausea or bloating).
Hormonal fluctuations around menopause can affect your immune system. Oestrogen’s role is complex and not yet fully understood. However, there seems to be a link between the decline in oestrogen and increased sensitivity to allergens. Oestrogen plays an important role in reducing inflammation. Falling oestrogen levels can make your body react differently to previously harmless allergens.
Synthetic xenoestrogens (endocrine disruptors), for instance in cleaning products, are also thought to induce inflammatory responses. Xenoestrogens make you more susceptible to allergic reactions, triggering or exacerbating symptoms such as sneezing, itching, swelling, excessive tearing or swelling of the eyes.
In addition, before and after menopause, your skin becomes thinner and more vulnerable, making it easier for irritants to penetrate the skin and cause inflammation. This can manifest itself as skin irritation, redness, rash or eczema. For some people, the chemicals in cleaning products and cosmetics can trigger new allergic skin reactions.
Histamine and oestrogen
There also seems to be a connection between high oestrogen and histamine, a chemical your immune system releases. Histamine protects against infections and allergens, among other things. When your oestrogen levels are higher than normal (oestrogen dominance), your body is stimulated to release more histamine.
The higher your oestrogen levels, the more histamine is released, the greater the chance of histamine intolerance and the greater the chance of allergic reactions. Conversely, histamine also encourages greater release of oestrogen from the ovaries, forming a vicious cycle where more histamine leads to more oestrogen and more oestrogen leads to more histamine.
Other causes
We also know that stress (which women are more susceptible to during menopause due to hormonal fluctuations) can also provoke allergic reactions or exacerbate menopausal symptoms. Medication and underlying medical conditions, such as insulin resistance, can also be a factor in developing allergies.
What can you do?
Finding out what triggers an allergic reaction and how to treat it is a personal process and takes time. The same applies to managing allergy symptoms. Understanding how to identify and avoid allergens is key. Here are some tips you may find useful:
- Identify and avoid your triggers. First you need to know what's causing your reaction, whether it's pollen, foods, cosmetics or chemicals. Keeping a detailed symptom diary can be helpful. Your GP can also help identify triggers through allergy tests. Once you know what triggers your allergies, you can take steps to avoid exposure.
- Avoid foods that are high in histamine. Histamine can worsen and trigger allergic reactions. Foods to avoid on a low-histamine diet include red wine, dark chocolate, blue cheese and processed meats. See an allergy specialist to have your symptoms checked out. If you have a histamine intolerance, you can use antihistamines for temporary relief of your symptoms.
- Vitamin C breaks down histamine. On days when your allergies are bad, take 1000 mg of Vitamin C, three times a day.
- Improve your gut health. A healthy gut microbiota can strengthen the immune system and its response to allergens. You can support your intestinal flora by eating fibre-rich foods (such as vegetables, fruit, whole grains), probiotics (such as yoghurt, sauerkraut, tempeh and kimchi) and prebiotics (such as bananas, onions, sweet potatoes, mushrooms and oats). Note: fermented foods are high in histamine and can trigger reactions in people with a histamine intolerance or in people who cannot break down histamine efficiently.
- Reduce stress where possible. Stress can weaken your immune system and make you more susceptible to allergies or worsen existing allergies. Yoga, mindfulness, walks in nature, breathing exercises and reading are activities that are known to reduce stress. Also, take regular breaks and avoid having too much on your plate.
- Keep your skin hydrated. Dry skin is more easily irritated. Use an unscented moisturiser to keep your skin hydrated. Look for a moisturiser that contains ingredients such as hyaluronic acid, glycerin, urea or shea butter. Products with alcohol, parabens and fragrances draw moisture away from your skin and cause it to dry out even more.
- Strengthen your skin’s natural barrier. Choose a skincare product that is specifically formulated to strengthen the skin’s barrier, such as creams with ceramides or niacinamide. Brands like CeraVe, Cetaphil, Avène and La Roche-Posay are good and relatively affordable options. The website of the National Eczema Foundation features a tool that can help you find approved products for sensitive and eczema-prone skin.
- Do you have asthma? Watch your Vitamin D levels. According to experts, people with severe asthma symptoms have low Vitamin D levels. Vitamin D is important for the immune system. Get 20 minutes of sun exposure to your unprotected face, arms or legs every day, or consider taking a daily Vitamin D supplement. Experts recommend that everyone take a daily Vitamin D supplement from October to April to get enough Vitamin D.
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What treatments can help?
If you suffer from mild to severe menopausal symptoms, hormone therapy may help.
Can hormone therapy help?
Hormone replacement therapy (HRT) is a medical treatment where hormones are administered to replace natural hormones that the body no longer produces in sufficient quantities. HRT aims to reduce the symptoms of menopause. Many women experience favourable results from HRT, sometimes within only a few weeks. Hormone therapy is not recommended as a treatment for allergies alone. However, most women going through menopause usually have more symptoms. HRT is an effective way to reduce menopausal symptoms like hot flashes and sleep problems. Do you have other symptoms besides allergies? Then HRT might be an option for you.
Sources
- Bonds RS, Midoro-Horiuti T. (2013). Estrogen effects in allergy and asthma. PMID: 23090385.
- Husemoen LL, Glümer C, Lau C, Pisinger C, Mørch LS, Linneberg A. (2008). Association of obesity and insulin resistance with asthma and aeroallergen sensitization. PMID: 18394132.
- WebMD. (2023). Do I Need Antihistamines for Allergies? https://www.webmd.com/allergies/antihistamines-for-allergies
- Harvard Health Publishing. (2021). Is stress making your allergy symptoms worse? https://www.health.harvard.edu/diseases-and-conditions/is-stress-making-your-allergy-symptoms-worse
- Dave ND, Xiang L, Rehm KE, Marshall GD Jr. (2011). Stress and allergic diseases. PMID: 21094923.
- Bunyavanich S, Berin MC. (2019). Food allergy and the microbiome: Current understandings and future directions. PMID: 31812181.
- Mayo Clinic. (2023). Asthma diet: Does what you eat make a difference? https://www.mayoclinic.org/diseases-conditions/asthma/expert-answers/asthma-diet/faq-20058105
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FAQ
Can menopause trigger a food allergy?
Yes, an increase in food sensitivities is a less well-known symptom of menopause. So it’s possible that foods which previously caused no issues can start to trigger digestive discomfort and other problems. This is due to oestrogen levels impacting your immune system. If you suspect that your problems are related to food allergies, talk to your doctor about allergy testing.
What foods should I avoid if I have a food allergy?
Well, that depends on the food allergy. There's no one-size-fits-all diet. First, you’ll need to identify what foods you are allergic or intolerant to. In general, fruit, vegetables and Vitamin D (from sunlight) can benefit overall health and protect against food allergies. Fibre, prebiotics and probiotics support gut health, decreasing allergic responses. Sulphites might trigger the release of histamine. So it’s better to avoid foods containing sulphites like red wine and dried fruits.
Can hormone therapy help with allergies?
Hormone therapy, or HRT, replaces the hormones that your body isn't making enough of. It is used to alleviate symptoms of menopause such as hot flashes, sleep problems and mood swings. HRT is not routinely recommended to treat allergies alone during menopause, because it may increase the risk of certain allergy symptoms. Eczema is typically treated with topical corticosteroids (steroid creams and ointments). A short course will usually clear a flare-up of eczema. Ask your doctor about the options. More about hormone therapy.
