Perimenopause? Allergies? What’s going on?

It’s that time of year. It’s that time of life… One of the more unexpected things that can happen in perimenopause is that allergies get worse.

There’s a complicated relationship between our immune system and our hormones. It’s all to do with pregnancy and the need to make sure that our system doesn’t treat a growing child as an intruder — and that it can be strong enough to clear out any infections between pregnancies.

When we reach menopause and our hormones start to fluctuate and drop we can become more prone to infections and more prone to allergies and inflammation — and even auto-immune conditions.

It doesn’t seem to make sense that our immune system can be both under-active and over-active. That’s because nothing about the immune system makes sense if you consider it as a single thing.

There are all sorts of different cells and different chemicals involved. One set of cells — the regulator white blood cells are the ones that tell the other white blood cells when it’s time to pack up and go home. If they’re affected then you might experience what seems to be an over-sensitive immune system.

I’ve talked to a number of women who have found that asthma has got worse in perimenopause, presumably for very similar reasons. If that’s the case you are going to have to talk to your doctor about how to deal with your asthma, whether perimenopause is a root cause or not.

For me, the change in my immune system showed itself in dermatographia — where a relatively light pressure on the skin leaves a raised red mark — and there are still days when you can literally write on my skin. That’s probably to do with high histamine levels.

Histamine which is a chemical involved in the immune response. It actually does lots of lovely things in your body like helping you with your sleep cycle and lowering blood pressure.

It’s also an important part of our immune system. And as you know it can make you itch and make your nose and eyes stream. That’s actually a good thing if your body is trying to wash or scratch an irritant away.

But sometimes it’s not actually something our body need to react to quite so strongly. Our body does have a system for breaking down the histamine as soon as the irritant goes away. But as we get older that may not work as well as it used to and we can become histamine intolerant.

When our oestrogen levels are high — as they can sometimes be in perimenopause when our hormone levels are fluctuating wildly — we produce a lot of histamine. When that is coupled by a decrease of our ability to get rid of histamine it can be a problem.

If you’re histamine intolerant it may make allergies worse — or more likely it will cause unpleasant symptoms regardless of allergies. It’s likely if this is the case that you’ll want to reduce the amount of histamine in your diet and take anti-histamines. The best place to learn about this is probably this booklet — https://www.balance-menopause.com/menopause-library/histamine-intolerance-addition-booklet/

Sometimes HRT helps — but sometimes to be honest for some people it makes things worse. There’s always a need to try things and see, and to balance the pros and cons of any particular treatment.

Anti-histamines are the go to treatment — and your doctor may be able to stronger better ones than those over the counter. If it’s your nose that’s being bothered then nasal sprays and decongestants might help.

It may be worth pursuing a low-histamine diet if you are histamine intolerant — but if you aren’t it probably won’t make any difference to your allergies. Your body will make all the histamine it wants to when it feels it has to react to something.

Otherwise it’s down to old-fashioned avoidance. Which means figuring out what you are reacting to and avoiding it. Doctors may be able to help with that. I spent a week with little metal cups of potential irritants stuck to my back — and discovered that I need to avoid sulphur dioxides and sulphites. I also avoid necklaces, labels and scratchy fabrics.

Otherwise I recommend keeping a diary of symptoms and looking for patterns that will help you identify allergens. There’s are some tracking tools here that should help. https://bit.ly/perimapping

For some of us it might be about keeping an eye on the pollen count. It may mean thinking about what you can do about the air quality at home by dealing with dust, experimenting with air, or treating yourself to a really good vacuum cleaner. (You can tell you’re perimenopausal when you use the words ‘treat’ and ‘cleaner’ in the same sentence!)

The good news is that much of this passes as we transition from perimenopause into menopause and our immune system settles down.

In the meantime I’m afraid allergies are always tricky. And writing this has made me particularly itchy, so I’m off to have a shower, wash off any irritants and distract myself with the sensation of water!

Originally published at https://www.linkedin.com.