Mast cell activation and histamine can play a role in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

That’s why both ovulatory and premenstrual mood symptoms can be relieved by over-the-counter antihistamines as well as natural histamine-reducing strategies such as vitamin B6, SAM-e, and a dairy-free diet.

What are mast cells and histamine?

Mast cells are a type of immune cell that release prostaglandins, inflammatory cytokines, and histamine. Histamine is an immune signalling protein that causes allergies and swelling but has lots of other jobs in the body. For example, histamine regulates stomach acid, ovulation, and libido, which is why estrogen increases libido and antihistamines decrease it.

Histamine is also a stimulating neurotransmitter that can cause anxiety and insomnia.

Symptoms of mast cell activation and high histamine include:

urticaria (hives)

nasal congestion

low blood pressure

joint pain

fluid retention

tinnitus (ringing in the ears)

nausea

diarrhea

irritability

insomnia

brain fog

breast tenderness

headaches or migraines.

The final few symptoms of irritability, insomnia, breast tenderness and headaches are all the typical symptoms of PMS which makes sense because histamine rises and falls with estrogen. Histamine is highest just before ovulation and then again during the days before the period.

Is histamine playing a role in your premenstrual mood symptoms?

Histamine is not the only factor in PMS and PMDD. Other factors include high prolactin, iodine deficiency, and “neurosteroid change sensitivity,” which is an abnormal response to progesterone and its neurosteroid metabolite allopregnanolone.

Read:

But if histamine is the main driver of your PMS or PMDD, you will likely have one or more of the following signs and symptoms:

Anxiety and other mood symptoms around the time of ovulation.

Headaches or migraines that are 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.

How to lower histamine and relieve PMS and PMDD

Reduce mast cell-stimulating foods such as cow’s dairy and alcohol. Read What dairy does to periods.

Reduce histamine-containing foods such as red wine, cheese, avocado, tomato, bone broth, and fermented foods (including sauerkraut and kombucha).

Take a histamine-reducing supplement such as quercetin, magnesium, SAMe, or vitamin B6.

Take natural progesterone because it up-regulates the DAO enzyme that clears histamine. 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?