4. Menstruation
Some women experience anaphylaxis just before or during their menstrual cycle. Known as catamenial anaphylaxis, this rare disorder often goes unrecognized.
"Most patients, and even health-care providers, aren't aware of the association between anaphylaxis and the menstrual cycle," says Cindy Bauer, M.D., a clinical assistant professor at University of Arizona College of Medicine in Tucson.
In some cases, the culprit is a medication or a food consumed around the time of menstruation.
At other times, however, no cause can be found, according to a 2013 study published in the Annals of Allergy, Asthma & Immunology.
The eight women followed in that study experienced hives, flushing, chest tightening, low blood pressure, lightheadedness, unconsciousness, abdominal pain, diarrhea, facial swelling, throat constricting, wheezing and difficulty swallowing.
For some women, the anaphylaxis didn't recur when they were given a hormone called medroxyprogesterone, which regulates ovulation and menstruation. And one patient found relief from recurrences after a salpingo-oophorectomy, a procedure in which the fallopian tubes and ovaries are removed.
If you suspect you have catamenial anaphylaxis, you should be evaluated by an allergist, Dr. Bauer recommends. Your physician's questions may help uncover the link between anaphylaxis and your menstrual cycle.
"Sometimes, creating a diary of anaphylactic events and menstrual cycle can clarify the association," Dr. Bauer says.
You should also carry an epinephrine auto-injector.
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