Is there a link between PMDD & MCAS?
When it comes to understanding conditions like Premenstrual Dysphoric Disorder (PMDD), it’s easy to focus on the hormonal shifts and emotional symptoms that define it. But recently, there’s been growing discussion — predominantly anecdotally on social media —about how immune system dysregulation, specifically Mast Cell Activation Syndrome (MCAS), could play a role in PMDD.
Is there a connection here, and if so, what might it mean for managing PMDD? Let’s explore.
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What Is Premenstrual Dysphoric Disorder (PMDD)?
PMDD is a severe cyclical disorder linked to the menstrual cycle. It is characterised by significant emotional, behavioural, and physical symptoms that arise during the luteal phase (the week or two before menstruation) and typically resolve within a few days of menstruation starting. Symptoms can include severe mood swings, irritability, depression, anxiety, fatigue, difficulty concentrating, and physical issues such as bloating, headaches, or breast tenderness. PMDD is not merely an intensified form of premenstrual syndrome (PMS)—it involves sensitivity to hormonal changes that affect the brain and body on a systemic level.
What Is Mast Cell Activation Syndrome (MCAS)?
MCAS is a disorder involving inappropriate or excessive activation of mast cells, which are part of the immune system. Mast cells release chemicals such as histamine, prostaglandins, and cytokines in response to various triggers, which can include allergens, infections, stress, and hormonal changes. In MCAS, this release is dysregulated, leading to a range of symptoms including flushing, hives, gastrointestinal distress, fatigue, brain fog, and mood disturbances. The severity and presentation of symptoms vary greatly between individuals.
Hormonal Sensitivity, Mast Cells, and PMDD
Mast cells are known to be sensitive to hormonal fluctuations, particularly oestrogen. Oestrogen can increase mast cell activation and histamine release, which may exacerbate symptoms during the luteal phase when hormone levels fluctuate significantly. This hormonal sensitivity raises the possibility that individuals with both PMDD and MCAS may experience compounded symptoms, as overactive mast cells could amplify the emotional and physical impacts of PMDD.
The Role of Histamine in the Link
Histamine, a chemical released by mast cells, has drawn attention as a potential factor in PMDD symptoms. Anecdotal reports have suggested that interventions targeting histamine—such as antihistamines or low-histamine diets—may alleviate symptoms for some individuals. While these reports are not yet supported by robust clinical research, they are worth exploring, as histamine can affect mood, pain, inflammation, and other processes that overlap with PMDD’s symptom profile.
Could MCAS and PMDD Be Connected?
The exact relationship between MCAS and PMDD is not yet fully understood, but there are intriguing overlaps. Both conditions involve complex interactions between hormonal, immune, and nervous system responses. For instance:
Hormonal shifts in the luteal phase may worsen mast cell overactivation in those with MCAS.
Excessive histamine release during this time could contribute to PMDD’s emotional and physical symptoms. These connections are still speculative, but they highlight the need for further research into the potential links between the two conditions.
What This Could Mean for PMDD Management
If mast cell overactivation and histamine dysregulation are shown to play a role in PMDD, it could pave the way for new management strategies, such as:
Antihistamines: Medications that block histamine receptors could help reduce inflammation, mood symptoms, or pain associated with PMDD.
Mast Cell Stabilisers: Treatments that reduce mast cell overactivation might ease both MCAS and PMDD symptoms.
Dietary Modifications: Low-histamine diets or identifying specific dietary triggers could support symptom management.
Targeted Therapies: Exploring hormonal-immune system interactions to better tailor treatments for PMDD.
These approaches remain experimental for now, but they offer exciting possibilities for holistic care.
How PTC Supports People with PMDD
At Progressive Therapeutic Collective, we recognise that PMDD is a complex condition requiring an understanding that goes beyond traditional approaches. We provide gender-affirming, neurodivergent-friendly care that acknowledges the unique ways PMDD impacts individuals. Our work is grounded in compassion, advocacy, and a commitment to raising awareness about conditions like PMDD, helping to ensure they receive the attention and resources they deserve.
Whether it’s supporting clients in exploring emerging links like MCAS, or providing personalised therapeutic strategies, we are passionate about offering informed, inclusive care for people navigating PMDD.
If you would like to link in with our work, you can find us here
Final Thoughts
The potential link between PMDD and MCAS is an intriguing area of exploration. While more research is needed to clarify the connection, it raises important questions about the role of the immune system and histamine in PMDD.