Unlocking the secrets of high oestrogen and histaminosis for PMS and PMDD relief

You may be aware that oestrogen and progesterone are two of the main hormones involved in female reproductive health. But did you know that histamine can also play a role? Histamine is well known as an inflammatory mediator that is released during an allergic response, but it also has a strong relationship with oestrogen. This relationship, and the influence of these compounds on each other, may be one of the hidden factors contributing to your menstrual problems.

‍

‍

What is the role of histamine and oestrogen?

‍

Histamine is an amine found in foods, though it is also produced in our bodies. In women, it’s produced in the female reproductive tract, including the uterus and ovaries. It has many roles including serving as an inflammatory mediator, a neurotransmitter and as a precursor to stomach acid. 

‍

Oestrogen is a hormone, that in females, is predominantly made in the ovaries, but the adrenal glands and adipose tissue (fat cells) also make small amounts. Although oestrogen is one of the main hormones that drives the menstrual cycle, there are oestrogen receptors in many different organs of the body. This means oestrogen's effects are felt across the body, not just in the reproductive system.

‍

‍

The link between histamine, oestrogen and menstrual symptoms

‍

Histamine and oestrogen levels influence one another. High levels of histamine in the body can increase ovarian oestrogen production, and in turn, high levels of oestrogen can increase histamine production. Too much of either can be problematic and too much of both can be even worse. 

‍

There are certain times of the menstrual cycle when this imbalance is most likely to be a problem, such as at ovulation and premenstrually. This can be due to a decreased ability of the body to eliminate oestrogen and/or histamine effectively.

‍

Histamine

‍

Histaminosis is the term used to describe high levels of histamine in the body. These high levels can be overlooked as a contributing factor in menstrual symptoms.

‍

Common causes of histaminosis include:

‍

• Excess dietary histamine intake
• Poor gut health, including intestinal dysbiosis (an imbalance in gut bacteria)
• Excess release of histamine from mast cells and/or basophils
• Reduced ability to metabolise histamine

‍

Menstrual symptoms linked to high histamine levels, include:

‍

• Ovulation pain
• Poor libido
• Breast pain
• Fluid retention
• Cycle related allergies
• PMS (premenstrual syndrome) - particularly anxiety and/ or insomnia. Histamine is an excitatory neurotransmitter, meaning high amounts are likely to cause anxiety and/or insomnia
• PMDD (premenstrual dysphoric disorder) - including mental health conditions and mood. Histamine can contribute to neuroinflammation and it’s known that this inflammation in the CNS (central nervous system) contributes to the development of mental health conditions. PMS and PMDD often cause debilitating changes in mood or heightened anxiety, tension or irritability in the one or two weeks prior to the onset of a period
• Menstrual pain with headaches or migraines
• Nausea and vomiting alongside menstrual pain

‍

Although not all menstrual pain is related to histamine, it has a pro-inflammatory action and can increase pain sensitivity and smooth muscle contraction, resulting in increased period pain (or dysmenorrhea).

‍

‍

What causes high levels of histamine and oestrogen?

‍

The body needs effective detoxification and elimination pathways to metabolise both histamine and oestrogen. The liver and the bowels are particularly important for oestrogen. If these pathways are not working well, then undesirably high levels of oestrogen can result. High oestrogen levels can contribute to premenstrual symptoms but can also have the effect of increasing histamine levels, exacerbating PMS symptoms even further. 

‍

In my article about histamine sensitivity, I discussed the role of the enzyme DAO (diamine oxidase) in the development of histamine intolerance. DAO is mainly located in the lining of the intestines and plays an important role in the degradation and metabolism of dietary histamine in the gut, before it is absorbed and travels to other parts of the body. 

‍

Another enzyme called Histamine-N-methyltransferase (HNMT) is responsible for inactivating histamine that is circulating in the body. It is able to decrease the levels that have escaped the DAO in the intestine and been absorbed. It also moderates and inactivates the histamine our body’s cells produce. HNMT does this via the methylation pathway, relying on S-adenosyl methionine (SAMe) as a methyl donor. 

‍

SAMe is a molecule our body produces as part of the methylation cycle in every cell. Insufficient SAMe levels are associated with poor oestrogen detoxification and the accumulation of histamine. Low levels of SAMe may be due to poor protein intake or nutrient deficiencies such as folate, B12 and choline. 

‍

‍

How to manage menstrual symptoms by decreasing high oestrogen levels and histaminosis

‍

Optimising phase I and II oestrogen detoxification pathways is an essential part of addressing the burden of excess oestrogen. Doing this will in effect help to lower high histamine. This can be done through diet, lifestyle modification and supplementation. 

‍

Some important strategies to improve oestrogen detoxification include:

‍

• Increasing intake of cruciferous vegetables (such as broccoli, cauliflower, cabbage and kale)*
• Increasing allium vegetables (such as onion, leek, and garlic)*
• Ensuring adequate fibre intake
• Ensuring adequate dietary protein
• Minimising alcohol consumption
• Ensuring daily bowel motions
• Functional testing to identify any compromise in the detoxification pathways 
• Supplementing with nutrients that support liver detoxification such as broccoli sprouts, rosemary and curcumin to support liver detoxification pathways
• Supplementing with SAMe. Supporting the body’s production of SAMe and/or supplementing with SAMe can be an effective treatment strategy as it is essential for the deactivation of both oestrogen and histamine. It also affects the production and metabolism of neurotransmitters which contribute to the mental health symptoms experienced in PMS and PMDD

*If able to tolerate high FODMAP foods.

‍

There is a significant, and clinically important, relationship between histamine and oestrogen. For some patients, this could be an important factor in managing hormonal and menstrual symptoms. A functional medicine practitioner is able to assess your histamine and oestrogen levels to determine if they are contributing to your symptoms. A safe and effective treatment strategy can then be put in place.