Allergies don’t behave the same in women and men.

After puberty, female hormones quietly reshape the immune system and raise allergy risk for decades. That change manifests as sinus congestion that typically follows your menstrual cycle and asthma that worsens during pregnancy or menopause.

The symptoms feel random, but the pattern isn’t.

Here’s how estrogen and progesterone physically inflame your nose and lungs, and how to stay ahead of flares instead of reacting to them.

Why Allergy Risk Shifts After Puberty

In early childhood, boys actually have more allergies than girls. 

They have more wheezing and asthma, which means more trips to the doctor for breathing treatments. But then puberty hits, and the pattern flips.

Estrogen floods the female body, altering how the immune system responds to irritants. Pollen that once caused a mild sniffle now triggers thick nasal swelling. Dust that never mattered before now tightens the chest.

Testosterone, on the other hand, quiets allergic inflammation. It slows down immune cells that cause swelling in the nose and lungs. That protective effect explains why allergy rates drop in men after puberty while rising in women.

Hormones change how immune cells behave, and that shift can shape allergy symptoms for decades.

Estrogen Turns Up Inflammation

Estrogen does more than regulate periods and pregnancy. 

It actively pushes inflammatory cells into the tissues that matter most for allergies by amplifying what’s called the Th2 immune pathway, the branch of the immune system responsible for allergic reactions. Estrogen receptors sit directly on mast cells and other allergy-driving immune cells, allowing estrogen to intensify allergic reactions at the tissue level.

When estrogen rises, Th2 activity increases. Immune cells move into the lining of the nose, the airways, and even the gut. Those cells swell tissue, thicken mucus, and narrow breathing passages, making a clear nasal passage turn tight and a chest wheeze.

This is why allergy symptoms often worsen:

• Around ovulation
• During pregnancy
• With certain hormone therapies

Estrogen lingers in the body longer than other hormones. Its Th2-driven effects stack over time. That long exposure explains why it plays the biggest role in driving allergy symptoms.

The result is sinus pressure that wakes you at night and asthma flares that interrupt daily routines.

Progesterone Adds Fuel at Specific Times

Progesterone works on a tighter schedule. 

It rises after ovulation and spikes during pregnancy. Its job is short-term, but its immune effects are real, especially through a group of immune cells called ILC2 cells, which respond quickly to inflammation signals. Progesterone enhances ILC2 activity, which increases the release of inflammatory chemicals in the airways. When progesterone overlaps with high estrogen levels, allergic inflammation ramps up fast.

Many women notice this window clearly. A few days of chest tightness before ovulation. A stretch of heavy congestion during early pregnancy. Then relief.

Because progesterone fades quickly, its effects feel temporary. That short duration is one reason the connection often gets missed.

But temporary doesn’t mean insignificant. When progesterone is high, and ILC2 activity rises, allergic reactions hit harder, especially in people who already have asthma or chronic sinus issues.

The Menstrual Cycle Explains Monthly Flares

Most women don’t track allergies the way they track periods, but they absolutely should.

Allergy symptoms usually worsen near ovulation, not during menstruation itself. That’s when estrogen peaks and inflammation climbs, resulting in:

• Sinuses feel blocked for two or three days
• Rescue inhalers get used more often
• Skin rashes itch longer than usual

Because these flares fade, many women never mention them. The body resets and life moves on.

Noting these symptoms helps you spot the rhythm and prepare medication before the flare starts.

Pregnancy Changes Everything, Then Changes It Back

Pregnancy pushes hormones to extremes, and allergies respond in unpredictable ways.

About one-third of women with asthma improve, another third worsen, and the rest stay the same. That’s because hormone levels differ between pregnancies and between women. Estrogen and progesterone rise, but not evenly. The immune system shifts to protect the baby, altering inflammatory responses.

Blood volume also increases by nearly half. 

That extra blood swells the nasal tissue, which is packed with blood vessels. Congestion becomes constant as a result, and mouth breathing replaces nose breathing. Unfortunately, sinus infections become more common.

Some women experience allergies for the first time while pregnant. Others breathe better than ever.

Most return to baseline after delivery. Pregnancy changes the immune system temporarily, not permanently.

Treating Allergies Safely During Pregnancy

Avoiding all medication during pregnancy sounds cautious, but it often backfires.

Untreated nasal inflammation leads to infections, poor sleep, and worsening asthma. Targeted treatment works better than avoidance.

Nasal sprays are usually the safest option because they work directly in the nose and have minimal absorption into the bloodstream. Steroid sprays shrink inflammation, while antihistamine sprays calm irritation without systemic exposure. Oral antihistamines affect the whole body and are used more selectively. 

The key is choosing the right tool with your doctor, so symptoms stay controlled and breathing stays easy.

Perimenopause, Menopause, and Dry Airways

As estrogen declines, symptoms shift again.

Some women improve, while others develop dry nasal passages, sticky mucus, or constant dripping that never existed before. With dry tissue, it clears bacteria poorly, causing the mucus to thicken and sinus drainage to slow. Often, this leads to chest congestion that lingers longer after colds.

Hormone replacement therapy complicates the picture. Replacing estrogen can worsen asthma in one woman and improve it in another. Because the response swings too widely, that’s why estrogen isn’t used as an allergy treatment.

This unpredictability is exactly why treatment focuses on inflammation, not hormone manipulation.

Stay Ahead by Treating Hormones Like a Predictable Trigger, Not a Mystery

Hormones amplify inflammation that already exists. 

Estrogen, progesterone, pregnancy, and midlife shifts act like any other trigger, similar to pollen, a cold, or wildfire smoke. That matters because you don’t need to chase hormones or “fix” your cycle to breathe better. Allergy care works best when it focuses on reducing inflammation you can actually feel and measure.

The most common mistake is waiting until symptoms explode, then scrambling. Or judging progress by how few medications you take instead of how well you function.

A better approach is simple and effective:

• Track symptoms briefly for two cycles to spot patterns
• Keep medications filled before flare windows arrive
• Use nasal sprays correctly and consistently
• Increase doses early when symptoms start, not after wheezing sets in
• Measure control by function, climbing stairs without gasping, sleeping through the night, exercising without chest tightness

When baseline inflammation stays low, hormonal spikes become background noise instead of emergencies. That’s the real win: fewer surprises, fewer flares, and breathing that stays steady through every stage of life.