PMS Hives

by Christine
(CA)

Hi Wray

Do you have any links to share regarding pre-menstral hives? I’ve seen on several forums that getting hives before your period may be helped by Progesterone Cream. Several people said that the cream eliminated the hives. I’ve been using the cream for two months. I am 41 and had a baby in Oct 2011. About 5 months ago my husband got a vasectomy so I went off the birth control pill. When I was pregnant at about 7 months I started itching on my belly and breasts. I got a very bad rash that the doctors said was PUPPS. They said it was due to a surge in hormones and would go away once I delivered. Well it did get better but since I went off the birth control pill it got so much worse. I’m wondering if this could be a sign of peri-menopause. My question to you is do you think it is a sign of estrogen dominance? If so, why would I get it at 7 months pregnant when progesterone is so high? Do you think it is an imbalance of hormones? I’m so confused and at my wit’s end with these hives. I started the cream at the first of the year. In January I was only using 25mg per day (once a day). In February I increased to 25mg twice a day. The hives are still pretty bad but the good news is that my moods are better and I’m sleeping better. I know you recommend at least 100 mg per day. Do you think I should increase? Or do you think I can actually have a progesterone allergy. I’ve read that is possible too and would explain why I had it so bad and the end of my pregnancy. I’m so confused! Would you be able to give me some insight? Thank you so much!!

Comments for PMS Hives

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Mar 02, 2013
PMS Hives
by: Wray

Hi Christine It's interesting but all the info for PUPPS says 'hormone levels are high', that's it! There is also something called intrahepatic cholestasis of pregnancy (ICP), which causes itching in pregnancy, usually in the third trimester. The itching is not usually associated with a rash. No one knows what causes ICP, one review says "Intrahepatic cholestasis. A puzzling disorder of pregnancy". It certainly isn't progesterone, which is vital for pregnancy. What they have found are elevated disulphated progesterone metabolites, why this is so they don't know. Luckily it's a rare disorder. Oestriol is one possible cause, as levels are highest in the third trimester and this is the most common time it occurs. The incidence of ICP is higher in winter than in summer, which is indicative of a lack of vitamin D. As this is vital for a successful pregnancy, it doesn't surprise me. Interestingly the incidence of ICP is increasing, which leads one to suspect a lack of vitamin D is behind it, as there's now a pandemic of vitamin D deficiency. In fact one study found a low level in women who had ICP. There's evidence that having a leaky gut can contribute to it, drugs induce it, including ethinyl oestradiol. In fact Contraceptives can be hepatotoxic to the liver. So it could well be that the damage was caused prior to pregnancy. Some authorities believe there is a genetic correlation. So it still isn't fully understood or why it occurs, one recent paper says "the pathogenesis of this disease is unknown...". And finally there is something called autoimmune progesterone dermatitis or APD. I feel they are all related. Interestingly when progesterone is used in the third trimester it can cause ICP, I suspect the amount given was far too low and it stimulated oestrogen. As this have been shown to cause cholestasis in animal studies, by reducing bile acid uptake by hepatocytes. Progesterone does rise in the third trimester or should. Oestrogen also rises too. I wonder if it's not the ratio becoming skewed, as happens prior to bleeding. Likewise the APD. I don't believe such a thing as APD exists. For a very simple reason, we make great quantities of progesterone during pregnancy, over 400mg/day in the third trimester. The occurrence of this so called disorder would therefore be far, far higher than it is. But it's extremely rare, which makes me suspect the ratio of the two hormones. Plus I've had women writing in saying their rash cleared while pregnant. It always occurs in the few days before we bleed. Progesterone increases from ovulation, peaking mid luteal phase, then the few days prior to bleeding it starts dropping sharply, please see the Graph we have. It's this drop or withdrawal, which causes all the major symptoms many women suffer from, including the dermatitis. Continued below

Mar 02, 2013
PMS Hives Part 2
by: Wray

Hi Christine The ratio of progesterone to oestrogen becomes skewed during these few days, with oestrogen dominating. One study which blamed progesterone says "The patient... had recurrent cyclic lesions on the skin... that appeared just before regular menstruation and persisted until a few days after." Ironically the anti-oestrogen drug tamoxifen was given to suppress it! Another study mentions "a significant premenstrual flare of skin lesions", but in this case they acknowledged it was caused by oestrogen, which makes a great deal of sense. The paper ends by stating "Women can become sensitized to their own estrogens; the major clue is worsening of the skin problem premenstrually" Again the drug used to suppress it was tamoxifen, see here, here and here. Oestrogen is an inflammatory hormone, increasing the level of free radicals. Another study suggests "the possible impact of estrogen mimetics, in the environment and in food... is associated with mast cell activation" Progesterone inhibits mast cell secretion, see here. Unfortunately coming off Contraceptives can cause worse symptoms than being on it. The ovaries having been suppressed can now start working again. They first produce testosterone and oestrogen, it can be many months before ovulation occurs and progesterone is secreted. I would suggest increasing the amount, but don't think 100mg/day will be enough. You could try that and see. I also feel you should use it daily, through any bleeding until you feel stable enough to follow your cycle again. Continued below

Mar 02, 2013
PMS Hives Part 3
by: Wray

Hi Christine I don't think it's anything to do with Peri-menopause, unless your mother went into early Menopause. Daughters tend to follow their mothers. Let me know if increasing helps. I also suggest you have your vitamin D tested and get your level up high. As I said I feel the three disorders are related, and a lack of vitamin D reduces the benefits of progesterone, see here, here and here. You asked for links to comments, see this one here. Take care Wray

Mar 05, 2013
PMS Hives
by: Christine

Thank you Wray. I appreciate all the time and research that went into your comment. My mother said she started going thru perimenopause in her late 40s and she hit menopause in her early 50s. I also wanted to add that I take 5000 IU of Vitamin D3 daily (Since January). Maybe this isn't enough time for my D levels to be where they should. I actually had the hives while I was still on the Pill. Once I came off of it they were so much worse. I also must add that I've had severe allergies and asthma for about 20 years. The asthma and allergy symptoms improved dramatically each time I was pregnant (with the exception of the hives when I was pregnant with my daughter). I only had hives with my second pregnancy with my daughter. Do you think there is a correlation to a baby girl vs. a baby boy. Did I perhaps have extra doses of estrogen in my system? I've always wondered that but not sure it made any sense. I started using the progesterone cream a couple days ago on Day 12. My period started again once I used the cream. This is the third month in a row that this has happened. I know this is normal. I have increased my dosage to 100mg/per day. Should I increase it again to 200? That's alot of cream. :) I will just use it all over my body now. :) I notice my itching is super bad while I am bleeding. I don't want to go to my allergist or OB regarding this because I know that will just prescribe prednisone. I've taken that twice this year due to respitory infections. I know how dangerous that drug is. Funny thing though, my asthma has been non-exsistent for over a month. Not sure if it is due to the Progesterone cream, the Vitamin D, or maybe I'm just cleared up from the steroid use. I'm so grateful for all of your advise Wray. I look forward to your comments. :)

Mar 08, 2013
PMS Hives
by: Wray

Hi Christine So it's not peri-menopause. 5000iu is a good dose, but it doesn't raise levels very quickly, I would suggest you take 10,000-20,000iu for a month or two, and then have another test done. Very interesting you've had severe allergies and asthma for so long, your vitamin D is definitely too low, please have a test done to check. It helps both, see allergies here, here, here, here and here. And these for asthma, see here, here, here and here. And if you've had a respiratory infection, your vitamin D is too low. I feel the 20,000iu would be a better dose, but please have a test done. Progesterone is vital for normal lung function and also helps asthma, see here and here. You might like to read these comments here. Mateje gained weight simply because the amount she was using wasn't enough to help the asthma and counter the oestrogen effect. You'll notice she had to use 500mg/day to overcome both. I feel you will need at least 200mg/day, if not 400mg/day. This is not much cream if you look here, it's only 3-6ml of cream. Continued below

Mar 08, 2013
PMS Hives Part 2
by: Wray

Hi Christine I don't know enough about hormone levels in girls versus boys during a pregnancy, it's an interesting thought. Very interesting the itching is so bad while bleeding, progesterone has dropped to it's lowest level at the beginning of bleeding and stays low until just before ovulation. Whereas oestrogen doesn't drop as low in many women, it's this skewed ratio which causes us all the problems. Pleased the info is helping you, we just have to make sure it works! Take care Wray

Mar 22, 2013
Follow up
by: Christine

HI Wray,

Since I've been using the progesterone I've been having a period every two weeks and noticed the bleeding is heavy. If I use progesterone while bleeding it help to lighten the flow. My cycle is so messed up now. I wanted to update you. I've gone to the Pulmonologist and the allergist. They are currently doing tons of tests. Funny thing is that when I mention using progesterone cream they just roll their eyes. Well I'm just waiting to see what all the results of their tests bring. I will definitely increase my dose of Vitamin D3 to 10,000. Also I wanted to tell you that I have been taking N-Acety-Cysteine 600mg for a couple days. It has helped tremendously with my chest congestion and asthma. That's powerful stuff. I felt improvement within a few hours. I was hoping it would help with the itching too. Time with tell. I think I will start using progesterone throughout my entire cycles for a few months like you suggested. I wanted to ask. Is there any way for me to test if I have allergic progesterone dermatitis? I just made an observation today. I have been bleeding for about 4 days pretty heavy. Itching was actually not too bad at all. However I decided this afternoon to put on some cream on to help with the heavy flow. Well it did help with the flow but all of a sudden I feel itchy again. I'm so confused Wray. I don't know what to think.

Mar 23, 2013
Follow up
by: Wray

Hi Christine It's typical they would roll their eyes, and yet there are so many studies on it, all they have to do is read them! Very pleased the NAC helped you, it's wonderful for the chest. It's given for cystic fibrosis, lung cancer, pneumonia, bronchitis and more. You'll find the increase in vitamin D will help too. You don't say how much progesterone you're using, the last comment I made I suggested you tried the 100mg/day but didn't think it enough. Evidently it's not if you are using this amount, as you are bleeding every 2 weeks. Please increase to 200mg/day as I suggested. I don't think progesterone dermatitis exists, as I explained previously. It always occurs when progesterone is withdrawing, and oestrogen high. There is no specific test for it, only challenging you with progesterone. But of course they would give you a small amount which would make it worse! The same effect occurs when you increase the progesterone a bit, as you've just done. That small increase will stimulate oestrogen again. Please see our page on Oestrogen Dominance. Please do try using it daily, and the 200mg/day, you might need more. Take care Wray

Apr 29, 2013
NAC worked great for about a month
by: Christine

Hi Wray,

I'm back again. I wanted to update you on a few things. I've been taking NAC for about 5 weeks and it was amazing for my asthma. I was pretty much symptom free. During this time I was not diligently using the progesterone cream. I guess because I really wasn't having too many symptoms except for the itching. During all this time I saw an allergist who did a thorough testing for pollens, foods, molds, etc. Well it came back completely negative. He told me that I had no allergies and to go back to my pulmonary dr. I had my Vitamin D3 and the result was 53 ng/ml. I was pleased although I would like to get it up to 70. When I saw the pulmonary dr he said everything looked good and said to come back in a few weeks. This was during the time NAC was working great for me. Last week I was noticing my asthma symptoms. The last few days have been horrible for me. It hit me! I wasn't using the progesterone cream. I applied some and started feeling some relief. Now I notice that I am spotting. I am still using the cream. It hasn't completely relieved my asthma symptoms yet. Should I stop using it since I am spotting and I want my period to come? Or do I keep using it. I feel like such a fool for not using it like I am suppose to. Now I'm feeling terrible. :(

May 01, 2013
NAC worked great for about a month
by: Wray

Hi Christine Well you did give me a good laugh, it is so easy to forget something when feeling well. I do it to myself time and time again! Although I never forget the progesterone, it's second nature to me now. I'm delighted the NAC helped though, I wouldn't be without it, and I don't have any chest problems. But I don't get any either. Your vitamin D is not very high, only 3ng/ml above the minimum suggested. I really feel you need to get it into the 90ng/ml range, mine is currently 92ng/ml. Please consider taking 20,000iu per day for a month, then reduce to 10,000iu per day. I'm sure it's a lack of this causing the asthma, plus a lack of progesterone too. They both work synergistically anyway. I feel you should continue with the progesterone daily, through any period for about 2-3 months. This will ensure progesterone becomes the dominant hormone, and suppresses any excess oestrogen. Then when feeling stable you can think about following your cycle again. And please use enough, I did tell you one woman had to use 500mg/day for her asthma to clear. Let me know how you get on. Take care Wray

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