Would you believe it if we told you that it's possible to be allergic to your own period? This phenomenon, known as Progesterone Hypersensitivity (PH), occurs when a woman's immune system reacts negatively to progesterone, a hormone that rises during the menstrual cycle.
Also referred to as an autoimmune progesterone dermatitis (APD), PH is a condition that arises when the body attacks its own hormone, progesterone, explained Dr Kavita Kovi, Head of Department - Obstetrics and Gynaecology, Aster Women and Children Hospital, Bengaluru.
"Usually, progesterone levels increase in the luteal phase to prepare the body for menses. However, in some individuals, their body is unable to tolerate this hormone, causing uncomfortable symptoms. This can be very distressing in the days leading up to periods and can even bring disturbance in the regular cycle," she told the OnlyMyHealth team.
To understand the condition better, we delved deeper into why it occurs, how to recognise it, and ways to treat and manage it more effectively.
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What Is Progesterone Hypersensitivity?
Speaking with us, Dr Deepali Shete, Gynaecologist and Infertility Specialist, Apollo Clinic, Viman Nagar, Pune, defined PH as a rare hypersensitivity reaction to either endogenous, i.e., own body progesterone, or exogenous, i.e., progesterone given from an external source in the form of injection, gels, capsules, ablets, etc.
She said, "It is a heterogeneous reaction and can start from the first period (menarche) to menopause but is more common in the reproductive age group (20–30 years)."
PH generally doesn’t affect the menstrual cycle of the patient. But most of these symptoms start at the onset of the menstrual cycle due to the release of endometrial progesterone.
While currently there are no published estimates of the prevalence of PH worldwide, it's considered to be rare. In fact, there are fewer than 200 reported cases of PH in the medical literature, as mentioned in a 2023 study published in the journal Cureus.
Common Symptoms Of Progesterone Hypersensitivity
According to Dr Kovi, PH reactions commonly lead to skin problems such as rashes; systemic reactions such as abdominal pain or headaches; localised reactions such as joint aches; and, in severe instances, difficulty breathing.
“It is common for women to have mood disturbances and even debilitating headaches known as migraines,” she added.
The intensity of the response does not hold constant—there are situations within which a woman will have minimal, if any, symptoms, and at the other end of the spectrum there are those women who cannot function normally on a day-to-day basis due to the extreme reactions they experience.
Also Read: Dealing With Intense Menstrual Cramps? These Healthy Practices Will Give You Instant Relief
How To Diagnose And Treat Progesterone Hypersensitivity
Explaining the diagnosis process for PH, Dr Shete shared that PH is diagnosed primarily through clinical evaluation and specific tests. Doctors look for typical symptoms, which often appear cyclically or premenstrually, usually between days 21 and 28 of the menstrual cycle. Symptoms can include rashes in the oral cavity and perineal area, particularly in patients who have recently started contraceptive pills or are undergoing fertility treatments like IVF, where higher levels of progesterone are administered.
Common diagnostic tests include measuring IgE or IgG antibodies. These antibodies may be elevated during the progesterone rise, especially during ovulation and the postovulatory phase. A hyperactive immune response can be observed, characterised by increased levels of mast cells, basophils, and T-cell-mediated immunity, which contribute to the symptoms of PH.
The treatment usually focuses on the severity of the symptoms, said Dr Kovi, highlighting that in this kind of situation, generally hormonal therapy is used to avoid or delay the menstrual cycle so that less progesterone is produced by the body. Medicines like antihistamines would be sufficient to control this type of allergic reaction, and in some instances, your physician would recommend other hormonal control medicines to help treat the condition.
Additionally, lifestyle changes, like stress management through yoga or relaxation techniques, can help. Moreover, it can be beneficial to track your symptoms to find any specific triggers.