Progesterone Hypersensitivity: Are You Allergic To Periods? A woman suffers from a rare condition that makes her allergic to menstruation. Here's why | – Agency

Aunt Flo's visit is usually a dreadful time for most women. Now, imagine suffering from the usual menstrual cramps intensified by a period allergy. Wait, what? Georgina JelleyA 28-year-old London resident recently revealed her unique medical condition, which causes her to develop an allergy to her monthly menstrual cycle, exacerbating her menstrual problems as her body fights off a hostile invader.
Now, you're probably wondering what can cause a period allergy. Have you noticed that your skin problems or allergic reactions seem to intensify right before your period? This could be a sign of hypersensitivity to progesteronea condition in which the body reacts to increasing levels of progesterone, either from natural hormonal cycles or external sources such as birth control.
While it can develop at any time between menarche and menopause, for some women the symptoms can be as severe as life-threatening anaphylaxis. Understanding the triggers and signs of progestogen hypersensitivity is critical to managing this often-overlooked condition.

Understanding progesterone hypersensitivity

Dr Prachi Sarin Sethi, Senior Consultant, Obstetrician, Gynaecologist and Laparoscopic Surgeon, Motherhood Hospitals, Gurgaon, says, “Progesterone, a steroid hormone derived from cholesterol, plays a crucial role in the menstrual cycle, pregnancy and reproductive health. Progesterone levels rise just before ovulation and peak during the luteal phase of a typical 28-day menstrual cycle, about a week before menstruation. “Progesterone begins to be produced and prepares the uterus for possible implantation of the embryo by promoting endometrial changes. If implantation does not occur, the decrease in progesterone triggers menstruation. Initially produced by the corpus luteum, progesterone is later retained in the placenta during pregnancy, where it supports gestation by reducing immune responses, preventing uterine contractions, and delaying lactation until after birth. In addition, it functions as an anti-inflammatory agent and regulates immune responses.”
This condition can be classified into three distinct types, each with its own unique triggers and manifestations:

1. Hypersensitivity to endogenous progesterone

This type of HP is often related to the body's natural increase in progesterone during the luteal phase of the menstrual cycle, which usually occurs 3 to 10 days before the onset of menstruation. Women with endogenous HP may experience a variety of symptoms, including skin reactions, breathing problems, and other allergic-type responses that correspond with the natural increase in progesterone levels during this phase.

2. Hypersensitivity to exogenous progesterone

This type arises from the use of supplemental progestins, which are often found in hormonal contraceptives or fertility treatments. The symptoms of exogenous HP usually disappear after the use of the progestin-containing medication is stopped, indicating that the hypersensitivity is directly related to the external source of progesterone.

3. Mixed hypersensitivity to progesterone

Mixed hypertension occurs when a woman has symptoms caused by both endogenous and exogenous sources of progesterone. This combination makes the condition more complex to manage, as it involves both natural hormonal fluctuations within the body and reactions to external hormonal supplements.

Causes of hypersensitivity to progesterone

The exact mechanisms behind progesterone hypersensitivity are not fully understood. However, several contributing factors have been identified:

1. Genetic predisposition

Hereditary factors: Some women may be genetically predisposed to progesterone hypersensitivity, making them more susceptible to this condition. The exact genetic markers are still being investigated, but family history may play a role.

2. Hormonal imbalances

Hormonal fluctuations: Hormone levels naturally fluctuate during the menstrual cycle, particularly during the luteal phase. For women with progesterone hypersensitivity, these fluctuations may trigger or worsen symptoms, leading to a more pronounced reaction during periods of high progesterone levels.

3. Stress and its impact on hormones

Stress-induced sensitivity: Chronic stress can disrupt the delicate balance of hormones in the body, which could contribute to progesterone hypersensitivity. Elevated stress levels can lead to increased cortisol production, which in turn can affect progesterone levels and exacerbate hypersensitivity reactions.

4. Underlying medical conditions

Associated disorders: Certain medical conditions, such as thyroid disorders or autoimmune diseases, have been linked to an increased risk of progesterone hypersensitivity. These conditions may alter the body's immune response or hormonal regulation, making it more reactive to endogenous and exogenous progesterone.

Symptoms of progesterone hypersensitivity

Symptoms of progesterone hypersensitivity usually appear three to ten days before your period starts and usually begin to disappear one to two days after your period begins.
HP can present with a variety of symptoms, most of which involve skin reactions. These rashes, while similar to other skin conditions, are distinguished by their cyclical nature, worsening each month as hormone levels rise. Common skin reactions associated with HP include:
Eczema: A red, itchy rash that may be persistent and uncomfortable.
Urticaria: Raised, itchy welts on the surface of the skin.
Fixed drug eruption: A recurring rash that appears in the same place on the body every month.
Erythema multiforme: A skin reaction that usually appears on the hands and arms.
Angioedema: Swelling under the skin that resembles hives.

In rare cases, HP can cause severe symptoms such as anaphylaxis. This potentially life-threatening condition can cause wheezing or asthma-like attacks and could be dangerous if it leads to respiratory collapse. At first, it may not be clear that these symptoms are related to the menstrual cycle. Often, a doctor's opinion is required to recognize the pattern.
Progesterone hypersensitivity is an often neglected condition in women of reproductive age, despite its potential to cause significant health problems. The exact mechanisms behind the syndrome remain unclear, but given the wide range of symptoms experienced by people with progesterone hypersensitivity, it is likely to be a complex disorder. Symptoms can vary widely and may include skin reactions such as dermatitis, urticaria, erythema multiforme, and fixed drug eruptions. In more severe cases, patients may experience bronchospasm or even anaphylaxis, indicating a severe hypersensitivity reaction.
Recognizing progesterone hypersensitivity requires identifying a clear connection between the onset of symptoms and exposure to natural or synthetic progesterone. For affected individuals, especially women concerned about fertility or pregnancy, treatment usually involves medical treatment with corticosteroids or desensitization therapy to mitigate symptoms.