Do You Get Rashes With Your Period? It Could be Progesterone Hypersensitivity

Symptoms, Causes, and Treatments for Rare Allergic Reaction

Progesterone hypersensitivity (PH) is a condition that triggers an allergic reaction in the skin ahead of your period beginning and then improves once it's over. This reaction is caused by a rise in progesterone that naturally occurs during the menstrual cycle.

Symptoms of the skin include rashes, hives, swelling, itching and flaking. More severe symptoms can also develop such as open sores and anaphylaxis. Treatment involves managing the symptoms and medications that can lower progesterone levels or block the production of it completely.

Another cause of allergic reactions leading up to and during your period is catamenial dermatosis which causes similar skin problems and anaphylactic symptoms to appear. Catamenial dermatosis begins at the start of your period rather than before. Both conditions are believed to be rare.

This article looks at the causes, symptoms, and diagnosis of allergic reactions that happen during the menstrual cycle.

autoimmune progesterone dermatitis symptoms

Verywell / Andrea Hickey

What Is Progesterone Hypersensitivity?

Progesterone hypersensitivity is a reaction to your own progesterone. Progesterone is a hormone that helps regulate your monthly cycle. PH can also be caused by other sources of this hormone.

Symptoms

Symptoms of PH usually appear between three and 10 days before the onset of your period. They start to go away one to two days after your period starts.

PH can have a variety of symptoms. Most, if not all, include skin rashes. These rashes may resemble those of other skin conditions but will be cyclic and aggravated each month in response to the rising hormone levels. Skin rashes that may be seen with PH include:

  • Eczema, a skin condition that causes an itchy, red rash
  • Hives, raised bumps that appear on the surface of the skin
  • Fixed drug eruption, a reaction that recurs on the same part of the body
  • Erythema multiforme, a reaction that usually appears on the hands and arms
  • Angioedema, hive-like swelling that occurs under the skin

Anaphylaxis is also possible. Wheezing or asthma-like attacks occur which could be sudden or life-threatening if it results in respiratory collapse.

At first, it may not be obvious that your symptoms are related to your period. It often takes a doctor to point out the pattern.

Causes

The cause of PH is unknown. Some researchers think it may be related to hormonal birth control. It's possible that contraceptive pills can cause a rash that could be mistaken for an allergic reaction. Research also shows that progesterone-only birth control is linked to progesterone hypersensitivity, which can cause dermatitis and hives.

It could also be related to supplements that contain progesterone.

These exposures may cause sensitization to the hormone. This occurs when your body becomes sensitive to an allergen, a substance that causes an allergic reaction.

Pregnancy may also cause progesterone sensitization. Pregnancy can affect the immune system. It can also impact a variety of allergic conditions.

Allergic reactions to other hormones like estrogen can also occur. These are far less common, though.

Diagnosis and Treatment

PH is usually diagnosed based on:

  • Symptoms
  • Health history
  • Physical exam

Some allergists may perform a skin test. This type of testing is unproven, though.

Treatment of progesterone hypersensitivity is based on managing the symptoms such as rash, swelling, itching, and hives. Antihistamines, which block the action of chemicals that cause allergic reactions, can help alleviate the symptoms.

Medication may stop the production of progesterone or keep it from being active in the body. Anti-inflammatory drugs such as oral or injected corticosteroids may also be used.

Unfortunately, these drugs only treat symptoms. They do not treat the cause of the condition.

Other treatments stop the ovaries from releasing an egg. The prescription drug Eligard (leuprolide) prevents the increase of progesterone that follows ovulation. This is an option if antihistamines don't work.

Rarely, surgery to remove the uterus and ovaries is needed. This is done in severe cases when medications don't help control the symptoms.

When to Go to the Emergency Room

It is important to see a doctor for any type of allergy. Some allergic reactions are emergencies. Call 911 or seek emergency care if you have a rash with any of these symptoms:

These are all signs of anaphylaxis which requires immediate care.

Catamenial Dermatoses

Catamenial dermatoses refer to another set of reactions to hormones produced during the menstrual cycle.

The symptoms of catamenial dermatoses are similar to PH. The timing is different, though. Symptoms begin during your period instead of before. "Catamenia" refers to the phase of your cycle that is menstruation. A variety of skin eruptions may be present among them itchy welts, eczema patches, and blisters.

People with this condition have symptoms at the onset of menstruation. The symptoms continue until the flow stops.

Like progesterone hypersensitivity, treatment options are generally centered around managing the onset of symptoms such as with antihistamines or suppressing the production of progesterone with medication. Diagnosis will focus on a physical exam and analysis of clinical history.

Catamenial Anaphylaxis

Some people may also experience catamenial anaphylaxis. This is a more serious reaction that involves several different parts of the body. Symptoms may include:

Unlike PH, catamenial anaphylaxis is not thought to be a reaction to progesterone. Instead, it may be triggered by prostaglandins. These are hormones that influence processes like pain and inflammation. They are released from the lining of the uterus during your period. Diagnosis is based on health history and physical examination. In some cases, allergy testing will be used to exclude other possible causes.

Because these conditions are rare, there is no standard treatment. In one study, there were varying outcomes among patients when different treatments were tried. Most patients outside of one did not respond to antihistamines and success with hormonal suppression therapy also varied.

As is true with a hypersensitivity to progesterone, in severe cases of catamenia dermatoses, surgical removal of the ovaries and uterus may be necessary. This is recommended when medications are unable to control the symptoms.

Summary

Allergic reactions related to the menstrual cycle are uncommon but do occur. Symptoms may include worsening skin conditions that can progress to anaphylaxis.

These conditions are usually diagnosed based on symptoms and health history. 

Progesterone hypersensitivity can be treated with antihistamines or corticosteroids. Treatments that prevent the ovaries from releasing an egg may also help.

Catamenial dermatosis and anaphylaxis may be treatable with hormones. Rarely, these conditions may require surgical removal of the ovaries and uterus.

With the start of menopause and the cessation of menstruation, these allergic reactions will end.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Daniel More, MD
Daniel More, MD, is a board-certified allergist and clinical immunologist. He is an assistant clinical professor at the University of California, San Francisco School of Medicine and formerly practiced at Central Coast Allergy and Asthma in Salinas, California.