Mast cell activation and histamine can play a role in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).
That’s why mid-cycle, premenstrual, and perimenopausal mood symptoms can be relieved by antihistamines and natural histamine-reducing strategies such as quercetin, vitamin B6, SAM-e, and a dairy-free diet.
What are mast cells and histamine?
Mast cells are immune cells that release prostaglandins, inflammatory cytokines, and histamine. Histamine is an immune-signalling amine that causes allergies and swelling, but has many other effects. For example, histamine regulates stomach acid, ovulation, and libido, which is why estrogen increases libido, and antihistamines decrease it.
Histamine is also a stimulatory neurotransmitter involved in mood, sleep, and the stress response.
Symptoms of mast cell activation and high histamine include:
- urticaria (hives), including dermatographia
- nasal congestion
- low blood pressure
- joint pain
- fluid retention
- tinnitus (ringing in the ears)
- nausea or diarrhea
- irritability, insomnia, and brain fog
- breast pain
- headaches, including migraines.
Irritability, insomnia, brain fog, breast pain, and headaches are all typical symptoms of PMS, which makes sense because histamine rises and falls with estrogen. Histamine is highest just before ovulation and during the luteal phase.
Is histamine playing a role in your premenstrual mood symptoms?
If histamine is a driver of your premenstrual mood symptoms, you will likely have one or more of the following signs and symptoms:
- Anxiety and other mood symptoms just before ovulation, when estrogen is high.
- Headaches or migraines that can be relieved by antihistamines.
- Dermatographia, which is the appearance of raised, reddish marks after light scratching of the skin.
- Breast pain, because histamine and mast cells are directly involved in breast pain and fibrocystic breast disease.
- Period pain because histamine causes pain.
The next step is to try over-the-counter antihistamine medication such as diphenhydramine (drowsy), loratadine (non-drowsy), or the antihistamine-type stomach medication famotidine (Pepcid and Zantac) to see if it helps. If it does not help, consider other drivers of premenstrual mood symptoms, such as high prolactin, iodine deficiency, and progesterone sensitivity.
If antihistamine medication does help, then perhaps progress to natural antihistamine treatment.
Natural treatments to lower histamine and relieve PMS and PMDD
- Reduce mast cell-stimulating foods such as alcohol and cow’s dairy. Read What dairy does to periods.
- Possibly reduce histamine-containing foods such as red wine, cheese, avocado, tomato, bone broth, and fermented foods (including sauerkraut and kombucha).
- Take a histamine-lowering supplement like quercetin, magnesium, SAMe, vitamin B6, perilla seed, or other natural bitters. Because bitter constituents can stabilize mast cells.
- Take natural progesterone, as it can calm mast cells and upregulate DAO, the enzyme that clears histamine. Higher-dose progesterone capsules can also overcome the progesterone sensitivity associated with PMDD.
👉 Tip: Histamine reduction is a big part of why magnesium, vitamin B6, and natural progesterone work so well for PMS and other women’s health conditions.
What is your experience with PMS and PMDD?
For more, read:
- High histamine can make for a tougher perimenopause
- Top 6 natural treatments for premenstrual mood symptoms
