Catamenial anaphylaxis: what to know

Catamenial anaphylaxis describes anaphylaxis occurring in a recurring relationship with the menstrual cycle. Episodes may involve hives, flushing, swelling, wheezing, throat tightness, vomiting, dizziness, or fainting. Symptoms can overlap with other allergic or medical conditions, so the timing pattern alone does not confirm the diagnosis.

Possible influences include changes in reproductive hormones, an allergy trigger that is more likely at a particular time, or another condition that follows the cycle. Food, medicines, insect stings, latex, and exercise may also be relevant. Keep a record of symptoms, bleeding, medicines, foods, activities, and exposures.

Treat breathing difficulty, throat or tongue swelling, faintness, or rapidly worsening symptoms as an emergency. If you have been prescribed an adrenaline auto-injector, use it as directed and call emergency services. Lie down with legs raised if tolerated; sit up if breathing is difficult, and do not walk around alone.

Emergency care is needed even if symptoms improve. Do not rely on antihistamines alone for breathing or circulation symptoms. A clinician may create a written plan and consider [Anaphylaxis Emergency Treatment](/treatments/acute-and-urgent-care/anaphylaxis-emergency-treatment/).

Call emergency services immediately for wheezing, throat tightness, voice change, swelling of the mouth or tongue, trouble breathing, repeated vomiting with other allergic symptoms, confusion, collapse, or pale and clammy skin. Read about [Wheezing](/symptoms/wheezing/) as a symptom that can accompany a severe reaction.

Arrange specialist assessment for any repeated reaction around menstruation, even when symptoms have settled. An allergist or relevant clinician may review [Allergy Testing](/treatments/diagnostics-and-screening/allergy-testing/) and coordinate care with a gynaecology team.

Ask whether the episodes meet criteria for [Anaphylaxis](/conditions/anaphylaxis/), which triggers should be avoided, whether an adrenaline device is appropriate, and how to handle future periods, medicines, exercise, and planned procedures. Bring a symptom diary and every product taken before an episode.