Food Allergies and Women's Health

Adult-Onset Allergies Are More Common in Women

In childhood, boys are slightly more likely than girls to have food allergies. That flips in adulthood. Large U.S. surveys have found that adult women report food allergies more often than adult men, and many of those allergies start after age 18. Shellfish, tree nuts and fish are among the most common adult-onset allergies.

Researchers are still working out why. Hormones are one likely factor, since estrogen appears to influence how mast cells, the cells that release histamine, respond to allergens. Whatever the cause, it means new symptoms after a meal shouldn't be dismissed just because you never had food allergies as a child. Our guide to food allergy vs. food sensitivity can help you figure out what kind of reaction you might be having.

Celiac Disease and Gluten Reactions

Celiac disease is an autoimmune condition, not a food allergy, but it's often confused with wheat allergy and gluten sensitivity. It's diagnosed two to three times more often in women than in men. Symptoms can be digestive, but they can also show up as fatigue, iron-deficiency anemia, irregular periods or fertility problems. If you plan to get tested for celiac disease, keep eating gluten until testing is done, because cutting it out first can cause a false negative.

Food Allergies During Pregnancy

Pregnancy doesn't usually cause new food allergies, but it can change how your body handles existing ones, and it raises practical questions. If you have a known food allergy, keep your epinephrine auto-injector with you throughout pregnancy. Epinephrine is still the first-line treatment for anaphylaxis during pregnancy, because a severe reaction is more dangerous to both mother and baby than the medication.

Many expecting mothers wonder whether they should avoid peanuts, eggs or other allergens to protect their baby. Current guidance says no: avoiding allergens during pregnancy hasn't been shown to prevent allergies in children, and cutting foods unnecessarily can make it harder to get the nutrients you need.

Breastfeeding and Introducing Foods to Your Baby

The same goes for breastfeeding. Unless your baby has a diagnosed allergy and your provider recommends changes, there's usually no need to avoid common allergens in your own diet.

When it's time for solids, the advice has changed a lot in the past decade. A National Institutes of Health expert panel issued guidelines on introducing peanut-containing foods early, as early as four to six months for some high-risk infants, to reduce the risk of peanut allergy. Babies with severe eczema or an egg allergy should be evaluated by their pediatrician or an allergist first, sometimes with a blood test or skin prick test.

Avoiding Dairy? Protect Your Bones

Women already face a higher risk of osteoporosis than men, especially after menopause. If a milk allergy or lactose intolerance means you've cut out dairy, make sure you're still getting enough calcium and vitamin D from fortified plant milks, leafy greens, canned fish with bones or supplements your doctor recommends. A registered dietitian can help you build a plan that covers the gaps.

Hormones, Your Cycle and Allergic Reactions

Some women notice their allergy symptoms, including hives and food reactions, feel worse at certain points in their menstrual cycle or during perimenopause. The research here is still early, but if you see a pattern, write it down. A symptom diary that tracks meals, symptoms and where you are in your cycle gives your allergist far more to work with than memory alone.

When Women Should Get Tested

• You've developed hives, swelling or stomach symptoms after foods you used to eat without trouble.
• You're planning a pregnancy and have had unexplained reactions in the past.
• You have fatigue, anemia or digestive problems that haven't been explained.
• Your baby has severe eczema or has reacted to a new food.
• Your reactions seem to follow your cycle or have changed around menopause.

If your reactions happen mostly with raw fruits and stay in your mouth and throat, read our guide to fruit allergies and oral allergy syndrome. And for the men in your life, we cover food allergies and men's health too.