Debilitating symptoms lead some to try over-the-counter medications Allegra and Pepcid due to a social media trend
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.
“When people are suffering from bothersome symptoms, and the strategies offered to them don’t seem to help, it makes sense for them to look elsewhere,” says Dr Alison Huang, a professor and director of the Women’s Health Clinical Research Center at the University of California, San Francisco.
The antihistamine hack seems so simple. Is there science to back it up? Here’s what experts say.
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.
Despite this known link between female sex hormones and histamine, it doesn’t prove that perimenopausal symptoms – as opposed to allergy symptoms – are related to histamine. The current expert consensus is that perimenopausal symptoms are not histamine-driven, says Huang.
Regardless, the thinking behind the online trend is that if histamines do make these perimenopausal symptoms worse, then taking medications that block histamine receptors will in turn improve the symptoms, explains Voedisch.
There are anecdotal reports of women who, after being prescribed Allegra or Pepcid for hives or reflux, noticed improvements in their hot flashes.