PMS symptoms are so common that many women think they are normal and inevitable. This is not the case. PMS symptoms that interrupt your regular life are not normal. 

Fortunately, if you uncover the root cause of your PMS, you can reduce or even eliminate your symptoms. There are many issues that can play a role in PMS symptoms. Histamine intolerance is one of them. In this article, I want to discuss the connection between PMS and histamine. Let’s get into it and learn how you can reduce PMS symptoms by addressing underlying histamine intolerance.

What Is PMS?

Premenstrual syndrome (PMS) is a set of symptoms that many women experience about a week before their period. It affects approximately three in every four menstruating women  (1).

Symptoms of PMS

Symptoms of PMS may include both physical and emotional symptoms. Though for some, symptoms can be mild, for others, they can be more severe interrupting daily life (1).

Physical symptoms of PMS may include:

  • Migraines or headaches
  • Bloating
  • Weight gain from fluid retention
  • Breast tenderness
  • Acne or other skin issues
  • Fatigue
  • Muscle or joint pain
  • Diarrhea or constipation
  • Alcohol intolerance

Psychological symptoms of PMS may include:

  • Mood swings
  • Irritability
  • Crying spells
  • Depression
  • Anxiety
  • Tension
  • Anger
  • Trouble sleeping or insomnia
  • Brain fog
  • Poor concentration
  • Social withdrawal
  • Changes in appetite
  • Cravings, especially for sugar and comfort food
  • Changes in libido

You may continue to experience these symptoms into the first few days of your period along with cramping and pain.

PMDD vs PMS

Some women experience much more than just PMS. Premenstrual dysphoria disorder (PMDD) refers to much more severe and often debilitating symptoms a week or even several weeks before your period. This condition is less common. Only about 5 percent of menstruating women are affected.(2).

Symptoms of PMDD are often similar to PMS but as mentioned they are more severe and usually last longer. Physical symptoms of PMDD may include:

  • Bloating
  • Cramps
  • Headaches or migraines
  • Breast tenderness
  • Acne or other skin issues
  • Fatigue
  • Muscle or joint pain
  • Diarrhea or constipation
  • Weight gain and fluid retention

Psychological symptoms of PMDD may include:

  • Mood swings
  • Depression
  • Anxiety
  • Panic attacks
  • Tension
  • Anger 
  • Crying spells
  • Irritability
  • Despair
  • In some cases, suicidal feelings
  • Fatigue
  • Low energy
  • Poor sleep
  • Brain fog
  • Trouble concentrating
  • Food cravings, especially sugar and comfort foods
  • Binge eating and emotional eating

The Connection Between PMS and Histamine

Histamine intolerance may play a role in symptoms of PMS and PMDD. However, histamine intolerance is often not the only problem behind your symptoms. First, let’s go over what histamine intolerance is, then discuss what’s the connection between PMS and histamine.

Is It Histamine?

If you are not sure if histamine intolerance is your main trigger, you may try taking an antihistamine. If taking an antihistamine helps to relieve your symptoms of PMS, looking into histamine intolerance is a good idea. However, if you are dealing with a combination of issues, antihistamines may not help, even if histamine intolerance plays a role.

Beyond histamine intolerance, potential issues causing or contributing to symptoms of PMDD or severe PMS may include:

  • Estrogen imbalance
  • Abnormal response to progesterone
  • Chronic inflammation
  • High prolactin
  • Iodine deficiency
  • Serotonin changes and imbalances
  • Depression
  • Thyroid imbalances
  • Other hormonal imbalances
  • Certain medication
  • Lack of sleep
  • Poor sleep
  • Inflammatory diet, high in refined sugar, refined fat, and salt
  • Stress
  • Smoking
  • Heavy alcohol use

What Is Histamine Intolerance

Histamine is naturally made by your body to support your immune system and various mechanisms inside your body. It also supports your digestion, brain, and mental health. 

Though histamine is essential for your health, too much histamine can become a problem. Too many high-histamine foods, environmental toxins, stress, and other factors can increase the histamine load in your body. This may be for your body to handle and it won’t be able to break it all down, causing a buildup. Histamine intolerance is essentially a buildup of histamine. Histamine intolerance can affect your entire body and can lead to widespread symptoms.

Symptoms of histamine intolerance may include:

  • Headaches and migraines
  • Eczema, dermatitis, acne, and other skin issues
  • Hives
  • Fatigue and sleep issues
  • Red eyes
  • Dizziness or vertigo
  • Heart palpitation or racing heart
  • Brain fog, confusion, memory issues
  • Irritability and mood swings
  • Anxiety or panic attacks
  • Blood pressure changes
  • Allergies 
  • Asthma
  • Congestion or runny nose
  • Acid reflux, bloating, diarrhea, and other digestive symptoms
  • Abnormal menstrual cycle and premenstrual syndrome (PMS)

How Histamine Intolerance May Play a Role in PMS

Histamine intolerance may contribute to PMS in a variety of ways. Earlier studies have linked histamine intolerance, increased mast cell activation, and menstrual symptoms. A 1987 study published in Medical Hypotheses has found that histamine intolerance may increase the risk of benign fibrocystic changes in the breast (3). This may explain increased breast tenderness and pain during the pre-menstrual phase and menstruation. 

According to a 1990 study published in the European Journal 01 Obstetrics & Gynecology and Reproductive Biology, mast cell activation and a surplus of histamine release may cause excessive uterine bleeding and heavy periods (4). They may increase period pain and cramps before and during menstruation.

Newer research has found a similar connection between PMS and histamine. According to a 2002 study published in Ginekol Poland, histamine receptors play a critical role in the menstrual cycle (5). A chemical called prostaglandin causes your uterus to contract and expel the uterine lining. Higher levels of prostaglandin and these contractions cause pain and cramping. However, that may not be it.

Your body releases histamine before and during your period to aid this uterine contraction. This increased histamine may not cause a major issue for everyone. However, if you already have histamine intolerance or you consume too many high-histamine foods during this time, it can become too much for your body. The higher histamine levels to support uterine muscle contractions can lead to cramps and other PMS symptoms. This may explain the link between PMS and histamine.

Moreover, many symptoms of PMS and symptoms of PMDD, including fatigue, mood swings, anxiety, and brain fog, resemble symptoms of histamine intolerance. Since symptoms can overlap, symptoms of histamine intolerance can amplify similar symptoms of PMS. 

Estrogen Dominance, Histamine Intolerance, and PMS

I’ve already written about why women tend to be more sensitive to histamine and the histamine-estrogen connection in this article. It’s important to mention it again. If you are dealing with both estrogen dominance and histamine intolerance, it can increase your symptoms of PMS.

Estrogen affects your body in many ways. One of these roles is stimulating your mast cells to release more histamine. More estrogen means increased mast cell stimulation, increased histamine response, and a higher risk of histamine intolerance. 

A 2012 study published in Frontiers in Immunology has found that estrogen can trigger your mast cells, causing an asthmatic response (6). According to a 2013 study published in Current Opinions in Allergy and Clinical Immunology, high estrogen may contribute to histamine-related allergies and asthma (7).

Normal estrogen levels combined with a healthy lifestyle can help to keep your histamine levels low. However, if you have estrogen dominance, it increases histamine intolerance and its symptoms. A combination of estrogen dominance and histamine intolerance can seriously increase your risk and symptoms of PMS.

So, increased estrogen in your body will stimulate your mast cell to release more histamine. Increased histamine can cause higher estrogen levels. This excess estrogen will lead to more mast cell activation and more histamine release, leading to even more estrogen. As you see, unless you address the problem, this can turn into a neverending vicious cycle of estrogen dominance, mast cell activation, histamine intolerance, and chronic symptoms.

The link between estrogen dominance and histamine intolerance may explain why you are dealing with uncomfortable symptoms of PMS and PMDD. It may also explain increased histamine-related symptoms during other times of your menstrual cycle, such as cramps at the beginning of your cycle or symptoms during ovulation. It may also explain why women are more vulnerable to histamine intolerance than men.

How to Improve PMS, Histamine Intolerance, and Estrogen Dominance

To break the cycle of PMS, histamine intolerance, and estrogen dominance, I recommend the following:

  • Follow a low-histamine, anti-inflammatory diet: To reduce histamine intolerance, lower inflammation, and support your hormonal health, I recommend eating lots of low-histamine, anti-inflammatory, nutrient-dense whole foods. Avoid refined sugar, refined oil, deep-fried foods, additives, artificial ingredients, overly processed foods, high-histamine foods, DAO enzyme-blocking foods, and histamine-liberating foods. Eat lots of nutrient-dense, low-histamine greens, vegetables, fruits, sprouts, herbs, grass-fed meat, pasture-raised poultry and eggs, and fresh wild-caught fish. To learn more about how to follow a low-histamine diet, I recommend this article.
  • Reduce your histamine bucket: Diet is not everything. I recommend that you reduce your histamine levels and support your health through other healthy lifestyle practices. Get 7 to 9 hours of restorative sleep at night. Move your body regularly. Reduce your stress levels. Reduce your exposure to environmental toxins.
  • Support your gut: Poor gut microbiome health and gut health issues can increase estrogen dominance, symptoms of PMS, and histamine intolerance. Poor gut health can also contribute to loose stool and digestion issues before and during your period. Supporting your gut health with a gut-friendly anti-inflammatory diet, prebiotic-rich foods, and a high-quality probiotic supplement can be helpful.
  • Remove xenoestrogens: Xenoestrogens are hormone-mimicking compounds found in conventional cleaning, body, and beauty products, plastics, perfumes, air fresheners, and other chemical-filled products. They can mimic estrogen, increase estrogen dominance, and related health problems. I recommend that you choose organic and natural options instead of conventional, xenoestrogen-containing, chemical-filled products.
  • Avoid hormonal contraceptives and synthetic hormone replacement therapy, if possible: Hormonal birth control, hormone replacement therapy, and other synthetic hormonal treatment can increase estrogen dominance and related issues. If you are experiencing symptoms of estrogen dominance, histamine intolerance, PMS, or PMDD, talk to your doctor to see if you can reduce or remove these medications and choose hormone-free options instead.

Next Steps

If you are dealing with symptoms of PMS or symptoms of PMDD, I recommend that you follow my tips on reducing histamine intolerance. If you are experiencing symptoms of PMS, PMDD, histamine intolerance, or MCAS, don’t be shy to ask for professional support. Working with a healthcare practitioner knowledgeable about histamine intolerance and MCAS is the best way to get to the root cause of your symptoms and create individualized treatment. I welcome you to start a personalized functional medicine consultation with me for further guidance to improve your health. You may book your consultation here.

Check out my Histamine Intolerance Course here. Learn on your own time, from anywhere. Get an inside look at the most helpful functional medicine tests for pinpointing imbalances, ways to identify and manage the most common (and sometimes surprising) mast cell triggers, and learn what to eat, what to avoid, and why.

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