Allergies and menopause: why they can get worse

In short: Many women notice new or worse allergy-like symptoms around menopause, such as itchy skin, rashes, a blocked nose or reacting to products they used for years. Hormones like oestrogen and progesterone do affect the immune cells involved in allergies, and menopause also makes skin drier and more easily irritated, so a link is possible. But research on menopause causing new allergies is still limited, and some "allergy" symptoms at this age turn out to be menopause symptoms or skin irritation instead. A doctor can help you tell the difference with simple tests.

Here's what we know, what we don't, and what you can do.

Can menopause cause allergies?

The honest answer: hormones and allergies are linked, but science hasn't yet shown clearly that menopause itself causes new allergies.

What we do know:

• Allergy cells respond to hormones. Mast cells are immune cells that release histamine and other chemicals during an allergic reaction. A 2012 research review in Frontiers in Immunology explains that mast cells have receptors for oestrogen and progesterone, and respond to these hormones.
• Hormone changes can affect asthma. The same review notes that around 30–40% of women with asthma find their symptoms get worse around their period, when hormone levels are changing quickly.
• Menopause changes your skin. The NHS lists dry and itchy skin among menopause symptoms. Drier skin has a weaker barrier, so soaps, perfumes, detergents and even fabrics can irritate it more easily.

So if your body seems to react differently in your 40s and 50s, you're not imagining it. The reason may be hormones affecting your immune system, changes in your skin, or simply a new allergy that happened to start at this age. If you'd like a refresher on the stages themselves, start with understanding menopause.

Allergy or menopause? Symptoms that look alike

Several menopause symptoms can feel like an allergy. The NHS lists:

• Hot flushes: sudden heat in your face, neck and chest, sometimes with redness and sweating. This can look like an allergic flush. Read more about hot flashes and night sweats.
• Dry, itchy skin.
• Headaches and migraines that are worse than usual.
• Palpitations: a faster or more noticeable heartbeat.
• Vaginal dryness, burning, irritation or itching. This is often blamed on an "allergy" to soap or pads, but it can be a menopause symptom.

Signs that point more towards a true allergy, based on the NHS allergy page:

• sneezing, a runny or blocked nose
• red, itchy, watering eyes
• wheezing, coughing or breathlessness
• a raised, itchy rash (hives)
• swelling of the eyes, lips, mouth or throat
• tummy cramps, diarrhoea or vomiting soon after a particular food
• symptoms that start within minutes to a few hours of contact with something specific

If symptoms appear every time you meet one trigger (a food, a cream, a pet, dust), an allergy is more likely. If they come in waves with no trigger, or come with night sweats and period changes, menopause may be the bigger part of the picture.

Common triggers to watch for at this age

In Indian homes and cities, things that often cause trouble include:

• dust and dust mites, especially during Diwali cleaning or when opening stored razais and blankets in winter
• pollen and air pollution, for example the October–November smog in north India
• mould in damp walls and bathrooms during the monsoon
• fragrances in agarbatti, room fresheners, perfumes, detergents and talcum powder
• hair dye and some cosmetics
• new skincare started to deal with menopause skin changes
• metals like nickel in artificial jewellery
• certain foods; let a doctor confirm a food allergy before cutting out whole food groups

Skin changes after menopause

Many "new allergies" at this age are skin barrier problems. As oestrogen falls, the NHS notes skin can become dry and itchy. Cleveland Clinic also explains that as you age, skin oil glands become less active and skin gets thinner. Here's more on menopause-driven changes in skin and hair.

Thin, dry skin lets irritants in more easily. That's why a soap or cream you used for 20 years may suddenly sting or cause redness. This kind of reaction is called irritant dermatitis. It isn't a true allergy, but it can feel the same.

Gentle steps that help most skin:

• use a mild, fragrance-free cleanser
• keep baths warm, not hot, and short
• moisturise straight after bathing, while skin is damp
• test any new product on a small patch of skin on your inner arm for a few days first
• wear soft cotton next to your skin

What you can do

1. Keep a symptom diary for 2 to 4 weeks. Note what you ate, what you used on your skin and hair, where you were, the weather, your sleep and whether you had a hot flush. Patterns often show up.
2. Track your periods, if you still get them, in a period tracker. Changes in your cycle along with new symptoms help a doctor see the menopause link.
3. Cut back on likely irritants. Switch to fragrance-free soap, detergent and moisturiser for a few weeks and see whether things settle.
4. Reduce dust at home. Wash bedding in hot water, air out stored blankets in the sun, and keep the bedroom as dust-free as you can.
5. Don't self-diagnose food allergies. Cutting out milk, wheat or nuts without testing can leave you short of important nutrients, which matters for bone health after menopause.
6. See a doctor for testing. The NHS says a doctor may arrange allergy tests, such as a skin prick test or blood tests, or refer you to an allergy specialist.
7. Talk about menopause too. If hot flushes, sleep problems and itching are affecting your life, a doctor can explain the treatment options that suit you. The menopause symptoms check on Femease's health checks can help you put your symptoms into words. If you notice new wheezing or breathlessness, tell your doctor, along with any treatment you are already having.

When to see a doctor

Book a doctor consultation if:

• you have new allergy symptoms that keep coming back
• your asthma is getting worse or you have a new wheeze or cough
• you have a rash or itching that disturbs your sleep or daily life
• you react to a food, even mildly
• you have vaginal itching or burning that doesn't settle
• you have menopause symptoms and want to know your options

Get emergency help (call 112 in India) if:

• your lips, mouth, throat or tongue suddenly swell
• you are struggling to breathe, wheezing badly, or feel your throat is tight
• you feel faint, confused or very unwell after contact with a possible trigger

These can be signs of anaphylaxis, a serious allergic reaction that, according to the NHS, happens very quickly and needs urgent help, even if you've never had an allergy before.

Questions women ask

Can menopause cause new allergies?

It might. Allergy cells called mast cells respond to oestrogen and progesterone, and menopause changes skin and hormones. But research hasn't proven that menopause directly causes new allergies. A doctor can test to find out.

Why is my skin itchy during menopause?

The NHS lists dry and itchy skin as a menopause symptom. Lower hormone levels and ageing make skin drier and thinner, so it gets irritated more easily. Gentle, fragrance-free care helps, and see a doctor if itching affects your sleep.

Can menopause make asthma worse?

Hormones do affect asthma for some women; many women with asthma notice changes around their periods. If your asthma changes during perimenopause or menopause, tell your doctor so your plan can be reviewed.

Are hot flushes an allergic reaction?

No. Hot flushes are a common menopause symptom caused by hormone changes. They can look like an allergic flush, but they don't come with hives, swelling or breathing problems. If you have those, it may be an allergy.

What allergy tests can I get?

A doctor may suggest a skin prick test, blood tests, or a special diet supervised by a specialist, according to the NHS. Testing is better than guessing and cutting out foods on your own.

Sources

• NHS: Symptoms of menopause and perimenopause; Allergies; Anaphylaxis
• Cleveland Clinic: Dry skin
• Zierau O, Zenclussen AC, Jensen F. Role of female sex hormones, estradiol and progesterone, in mast cell behavior. Frontiers in Immunology, 2012