From the Research
Yes, Mast Cell Activation Syndrome (MCAS) and dysautonomia may potentially contribute to early onset perimenopause, though research in this area is still evolving. Both conditions involve dysfunction in regulatory systems that can influence hormonal balance. MCAS causes inappropriate mast cell activation, releasing inflammatory mediators that may affect the hypothalamic-pituitary-ovarian axis, potentially disrupting normal reproductive hormone production 1. Similarly, dysautonomia affects the autonomic nervous system, which plays a role in regulating ovarian function. The chronic inflammation and stress response associated with these conditions can potentially accelerate ovarian aging and follicle depletion.
Key Considerations
- MCAS is a multisystem disorder that has been historically underrecognized due to its estimated high prevalence 2
- The condition often overlaps with other disorders such as gastric dysmotility, dysautonomia, joint hypermobility disorders, and autoimmunity 2
- Treatment of MCAS and associated conditions can be complex and requires a comprehensive approach, including mast cell stabilization and management of associated symptoms 2
Management and Treatment
- Women with MCAS and dysautonomia who experience irregular periods, hot flashes, night sweats, or mood changes before age 45 should consult with both their immunologist/autonomic specialist and a gynecologist familiar with these complex conditions
- Management typically involves treating the underlying MCAS or dysautonomia while addressing perimenopausal symptoms, which might include hormone therapy if appropriate 1
- Lifestyle modifications such as stress reduction, anti-inflammatory diets, and regular gentle exercise may help manage both the underlying conditions and perimenopausal symptoms 1
Recent Findings
- A recent case report highlighted the importance of careful history taking and clinical suspicion in diagnosing and managing MCAS and associated conditions 2
- The report also demonstrated the effectiveness of mast cell stabilization with ketotifen and remission of SIBO with low-dose naltrexone (LDN) in a patient with MCAS and associated conditions 2