Premenstrual dysphoric disorder (PMDD) and menopause can come with debilitating symptoms, like intense emotional changes and exhaustion. All over social media, women are claiming that a simple hack has helped enormously: a combination of two over-the-counter medications, both antihistamines – typically, the name brands Pepcid AC and Allegra. Almost all women experience symptoms during the dramatic transition to menopause, but only a small portion receive helpful treatment.
Similarly, those with PMDD also contend with dramatic effects, and can have an even harder time receiving effective care. The antihistamine hack seems so simple. Is there science to back it up?
Histamine is a chemical the immune system releases; it has other functions but is primarily known for triggering allergy symptoms. There are four types of histamine receptors in the body. Two are relevant here: H1 and H2.
When activated, H1 receptors are responsible for many classic allergy symptoms, such as itchiness and sneezing. H1 antihistamines, like Allegra, block these receptors and reduce the severity of symptoms. Famotidine is an H2 blocker medication; Pepcid is one of the most common brands.
H2 receptors are mainly in stomach cells. When these are activated, it can lead to issues like increased stomach acid secretion, flushing and headache. Experts say there are plausible reasons to think histamine and perimenopause might be connected, but there’s not enough good evidence to prove histamine is a significant cause of perimenopausal symptoms like brain fog, anxiety and hot flashes.
During perimenopause, ovaries produce fluctuating levels of a form of estrogen called estradiol. Estradiol can stimulate mast cells, which are responsible for releasing histamine. This is why allergy symptoms can flare up during menstrual cycles and perimenopause, says Dr Amy Voedisch, a clinical associate professor of obstetrics and gynecology at the Stanford University school of medicine.
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