Endometriosis and Seasonal Allergies

Now that it’s officially spring, a-choo! is the only sound you’ll be hearing from me ’til October. Like more than 50 million Americans, I have allergies — and this time of year, allergens like grass, ragweed, and pollen are flourishing, leaving my eyes, nose, and throat red, raw, and itchy.

What we call “seasonal allergies” are technically a medical condition called allergic rhinitis. Rhinitis means “inflammation of the nose,” referring to the effect environmental allergens have on the body. When the nose is inflamed, it produces more mucus, which can drip down the back of the throat to cause irritation via postnasal drip. The body reacts to this inflammation by releasing chemicals called histamines, which is why you might hear OTC medications like Claritin and Zyrtec referred to as “anti-histamines.”

“But Haley,” you might be wondering, “what does that have to do with endometriosis?” Well, what I didn’t know until I was diagnosed with suspected endo is that my allergic rhinitis and endometriosis may be linked. According to a study published in the Journal of Obstetrics and Gynaecology, people with endometriosis are significantly more likely to report a family history of allergies.

In a previous post, I explored why endometriosis isn’t an autoimmune disease, but established that it still affects the immune system. You can head to that link for greater detail, but basically, certain immune-mediating cells — like T-cells and white blood cells — don’t function properly in patients with endometriosis. Similarly, allergies are also not autoimmune, but characterized by immune system dysfunction. When someone has allergies, their body overproduces an antibody called immunoglobulin E (IgE), leading to symptoms like sneezing, itching, and swelling.

Because I live with both endometriosis and allergic rhinitis, I know that seasonal allergies can significantly affect your quality of life — especially during a pandemic. More than once, I’ve woke up panicking because my throat hurt, only to remember that “oh yeah, it’s that time of year again.” With that in mind, I’ve decided to delve a little deeper into life with seasonal allergies and how I manage my symptoms on a daily basis.

Facts About Seasonal Allergies

Allergic rhinitis, also called “hay fever,” affects 20 million adults and 6.1 million children in the United States. Though seasonal allergies are a common cause of it, allergic rhinitis doesn’t have to occur exclusively in the summer or fall. This condition can also be caused by exposure to allergens present year-round, called perennial allergic rhinitis, or by the common cold, called infectious rhinitis.

Patients with endometriosis are considered a high-risk population for allergic rhinitis, owing to the heightened inflammatory reaction and decreased immune response associated with the condition. Two early studies found increased rates of allergic conditions such as hay fever, eczema, food sensitivities, and allergic reactions among people with endo. Patients in these studies self-reported their symptoms. Later studies confirmed these findings via allergy testing (a.k.a. “prick testing”).

Seasonal allergies are usually triggered by plant pollen, whether one type of pollen or a combination or several types. Common culprits include:

  • Tree pollen, which begins early in the year.
  • Grass pollen, which peaks during spring and summer.
  • Ragweed pollen, which is the most common cause of fall allergies.
  • Mold, which thrives during a rainy spring and can last through late fall.

Different allergens emerge under different conditions, which is why it’s critical to understand which allergen is causing your symptoms. Tree, grass, and ragweed pollen flourish on cool nights and warm days, while mold grows best in hot, humid conditions. Windy days allow allergens to spread faster, which may trigger an increase in symptoms. Additionally, pollen counts are often highest in the morning, so some people’s allergy symptoms may improve over the course of the day.

Living with Seasonal Allergies and Endometriosis

Living with seasonal allergies in addition to endometriosis can be frustrating. After all, endo already substantially limits one’s quality of life. Pain often prevents me from moving and distracts me from work or hobbies; gastrointestinal symptoms keep me tied to locations close to a bathroom…. the list goes on and on.

Allergic rhinitis only adds more concerns to that list. I have to remember to take my allergy medication every morning from spring until fall, or else become reduced to a sneezing, scratching, swollen wreck. Even then, antihistamines aren’t always enough to take the edge off — or keep it off.

So, what’s a girl to do? As usual, my solution to this problem was to conduct extensive research on the web — and here’s what I found:

  • Request a skin prick. A quick, inexpensive way for your doctor to detect allergens you may be sensitive to is via skin prick test. These tests, performed by a skilled allergist, can detect up to 50 potential allergens at once. An allergist will inject tiny amounts of many potential allergens into your forearm, which allows them to replicate a controlled allergic response, and observe for swelling. This can be performed to determine which seasonal allergen may be causing your symptoms, or to ensure you aren’t confusing seasonal allergies with something more serious, such as a food or drug allergy. However, it’s important to note that as much as 60 percent of all skin pricks show false positive results, indicating you may have an allergy when in fact you do not.
  • Track your allergies. The antihistamine brand Zyrtec offers a free AllergyCast app that can be accessed online or downloaded in the App Store. If you download the iPhone app, you can also track your allergy symptoms, and the app will analyze which pollens are most prominent on your worst days. This can help you identify your specific allergens and better predict when you may suffer from seasonal allergies, as many allergens peak during specific times of year.
  • Understand OTC options. Over-the-counter products are just as effective as prescription allergy medications, but only if you use the right one for you. Certain products are better at relieving some symptoms than others. Oral histamines relieve sneezing, itching, watery eyes, and a runny nose, while nasal sprays like Flonase can target congestion and sneezing in addition to these symptoms. Pseudephedrine (Sudafed) may also relieve a stuffy nose. Just check with your doc to make sure you’re not mixing medications that aren’t compatible.
  • Use a certified air purifier. Many allergens are airborne. If you suffer from seasonal allergies, an air purifier can provide some relief as part of a multifaceted approach to allergy reduction. The Asthma & Allergy Certification Program is a great resource, as it uses strict standards to ensure its products maintain an appropriate level of airborne allergens. These options are expensive, so I would only consider them if you have severe allergic rhinitis.

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