Would you believe me if I told you that you could have an allergic reaction to your period? Known as progesterone hypersensitivity (PH), this phenomenon occurs when a woman’s immune system reacts negatively to progesterone, a hormone that increases during the menstrual cycle.
Also known as autoimmune progesterone-induced dermatitis (APD), PH occurs when the body attacks its own hormone, progesterone, explains Dr Kavita Covi, head of obstetrics and gynaecology at Aster Hospital for Women and Children in Bangalore.
“Normally, progesterone levels rise during the luteal phase, preparing the body for menstruation. However, for some people, the body cannot tolerate this hormone, causing unpleasant symptoms. The days before menstruation can be very uncomfortable and can disrupt your normal menstrual cycle,” she told the OnlyMyHealth team.
To better understand this condition, we will explore more about its causes, how to recognize it, and how to treat and control it more effectively.
Read more: London woman discovers she’s allergic to her menstrual cycle; learn all about the diagnosis
What is Progesterone Hypersensitivity?
Dr Deepali Shete, gynaecologist and infertility specialist, Apollo Clinic, Viman Nagar, Pune, defined PH as a rare hypersensitivity reaction to endogenous progesterone, i.e. progesterone present in the body, or exogenous progesterone, i.e. progesterone introduced from outside in the form of injections, gels, capsules, tablets etc.
“This is a heterogeneous response that can begin anywhere from menarche (first menstruation) to menopause, but is more common in the reproductive age group (20 to 30 years),” she says.
PH does not usually affect a patient’s menstrual cycle, but most of these symptoms begin at the beginning of the menstrual cycle due to the release of endometrial progesterone.
Currently, there are no published estimates of the global prevalence of PH, but it is considered rare. In fact, fewer than 200 cases of PH have been reported in the medical literature, as noted in a 2023 study published in the journal Cureus .
Common symptoms of progesterone sensitivity
According to Dr. Covey, PH reactions often cause skin problems such as rashes; systemic reactions such as abdominal pain and headaches; local reactions such as joint pain; and, in severe cases, difficulty breathing.
“Women often suffer from mood disorders and severe headaches called migraines,” she added.
Reactions are not always the same in intensity: some women have minimal or no symptoms, while others experience extreme reactions that prevent them from functioning normally in daily life.
Read more: Are you suffering from terrible menstrual cramps? These healthy habits can help you get instant pain relief.
How to diagnose and treat progesterone hypersensitivity
Explaining the diagnostic process for PH, Dr. Shete said that PH is primarily diagnosed through clinical evaluation and certain tests. Doctors look for typical symptoms, which usually appear cyclically or premenstrual between days 21 and 28 of the menstrual cycle. Symptoms may include an oral or perineal rash, especially in patients who have just started taking oral contraceptives or are undergoing fertility treatments such as IVF, which uses high doses of progesterone.
Common diagnostic tests include measuring IgE or IgG antibodies, which may increase during progesterone surges, particularly during and after ovulation. An exaggerated immune response, characterized by elevated levels of mast cells, basophils, and T cell-mediated immunity, is thought to contribute to the symptoms of PH.
Treatment usually focuses on the severity of the symptoms, Dr. Covey says, noting that in these situations, hormone therapy is often used to avoid or delay menstruation in order to reduce the body’s production of progesterone. Medications such as antihistamines are enough to suppress this type of allergic reaction, but in some cases, your doctor may also recommend other hormone-controlling drugs to help treat the symptoms.
Additionally, lifestyle changes such as stress management through yoga and relaxation techniques may also help, plus tracking your symptoms to find specific triggers may also be beneficial.
