That-Time-of-the-Month Hives: What Women Need to Know

We all have those days when we just want to scream and bury our faces in our pillows. For some women, these days tend to coincide with that particular time of month. Chronic hives, or urticaria, is twice as common in women as in men. For some women, their hives seem to be connected to their menstrual cycle. But what causes hives on the skin to flare during that time of the month?

Premenstrual Syndrome, or PMS, refers to the physical and emotional symptoms that occur a week or two before a woman’s period. These symptoms include mood swings, bloating, weight gain, and acne, among others. They are influenced by hormones that fluctuate throughout the month. So if you notice hives during your cycle, it may be that certain hormones are triggering this allergic reaction. This also clearly answers the often-asked question "Are hives contagious?"

Autoimmune Progesterone Dermatitis (APD)

Autoimmune progesterone dermatitis or APD, is a rare condition where the menstrual cycle is linked to chronic hives. It occurs as a result of an allergic reaction to a woman’s own progesterone. With APD, hives and skin rashes usually appear three days to a week before menstruation, and will either greatly improve or completely go away shortly after her period when progesterone levels fall (pictures of hives in these cases are found below). Women who initially have taken medication with progesterone over a prolonged period, such as birth control pills or postmenopausal hormone therapy, are at higher risk for developing APD. 

When it comes to searching for urticaria treatment and or reducing the symptoms, using antihistamines and oral or injected corticosteroids may be effective. There are also therapies such as leuprolide, that suppresses ovulation, and in rare cases, surgical removal of ovaries and uterus may be required when the medications are unable to control the symptoms.

Important Note: Only take doctor-prescribed medications.

Catamenial Anaphylaxis

This condition is also related to the menstrual cycle. Women who have this condition experience anaphylaxis symptoms as soon as the menstrual flow begins and continues until the menses flow stops. It not an allergic condition, but is rather caused by prostaglandins released from the uterus lining, which may be absorbed into the bloodstream.

When to get immediate medical care

Seek emergency care or call 911 if the rash is accompanied by fever, wheezing, shortness of breath, facial swelling, rapid heart rate, nausea, vomiting, or fainting, which are all signs of anaphylaxis.

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