Lyme and ovulation

I see that this had been mentioned a few times in the past, but wondering if I can get some fresh information about how women dealing with lyme are affected around ovulation. I have noticed terrible flares every month in the days leading up to ovulation. Today I feel super weak, more sensitive to foods (increase in mcas symptoms), high anxiety, inability to cope with stress and significant bloating/abdominal discomfort. Does anyone else notice a very significant flare in symptoms leading up to ovulation? I am seeing my new llmd tomorrow for the first time and will talk about this with him.

Yes, I experience the same symptom flares around ovulation.

Like most doctors, LLMDs are not often well-versed in how ovulation (and other dynamics in the female reproductive system) impacts various body systems, so don't be surprised if your doctor does not have a very nuanced response for you. Ovulation pain (mittelschmerz) is relatively well-known, but the other effects are less well-documented and overwhelming dismissed. The increased estrogen and luteinizing hormones prior to ovulation can cause symptoms, and the inflammation in the area can cause symptoms as well. Pain (in the ovary area or lower back) and digestive issues are the most common, but people also can experience headaches, anxiety, and widespread inflammation. I experience MCAS flares as well during ovulation and any other times of increased inflammation and systemic stress. Related conditions like endometriosis, PCOS, IBS, and IBD can make ovulation more dramatic as well.

Another possibility is that some of your hormones are out-of-whack, most likely low. The hormone systems all interact with one another, so an imbalance in one can create imbalances in others. Sometimes when the body is under-producing hormones (which is common when it's under the stress of chronic illness) even a small hormone spike can produce exaggerated effects, making people think their hormones are high instead of low, so checking with a month or more of saliva tests can be informative. I would recommend testing in a long-term way and adjusting lifestyle factors as much as possible before supplementing hormones or altering them.

I started seeing lots of gynecologists when I got sick with Lyme because suddenly I started feeling ovulation so much more, as well as excruciating ovarian cysts (that apparently are quite common but usually painless). I was diagnosed with HPA axis dysfunction (HPA = hypothalamic, pituitary, adrenal). My cortisol tested normal, but because I was producing almost no estrogen and progesterone, the cortisol was "filling in" for their duties by allowing me to continue ovulating and menstruating. This meant that cortisol wasn't doing its own jobs, thereby giving me symptoms of low cortisol (fatigue) but periodic symptoms of high cortisol because of the exaggerated response I mentioned earlier (like a wave of anxiety each morning when the body produced its normal "get your day started" cortisol surge). I mention this because I think it happens to a lot of people, but most are not seeing a Lyme-literate functional medicine gynecologists like I was who could do proper testing and interpretation.

That said, HPA axis treatment isn't all that complex. The number one thing to do is genuinely manage stress. Also sleep well, eat well, no stimulants, get healthy fats and omega 3 fatty acids, and move your body. If those things don't help your systems to balance and normalize after a few months, or if you know your hormones are in disarray, then adding chaste tree extract (which balances progesterone) or an adaptogen (which balances other hormones, but can take some trial and error to find the one that works best for you) is warranted. If those things don't work, then a topical progesterone cream (like Karuna) or a carefully-customized dosage of bioidentical compounded hormones could be helpful, or an adrenal glandular supplement (like Dr. Wilson's Adrenal Rebuilder). Throwing the full dose of a standard contraceptive hormone pill into the mix with Lyme is not something that ever seemed like a great idea for my sensitive system, but you might try that as well.

If you have HPA axis dysfunction, just keep in mind that nothing you do or supplement is likely to help until you genuinely manage stress. Managing MCAS also will be helpful, since anything else that causes inflammation (like ovulating) can set off those hypersensitive mast cells.

I often thought that if I could just stop the cycling hormone process I could make more progress. One doctor (mainstream GYN) did recommend that, actually - putting my body into artificial menopause with the drug lupron and then taking a consistent dose of synthetic estrogen and progesterone, to keep my system more stable. Seemed too drastic for me, but again, it's an option to consider.

I hope some of my experience is helpful, or that you get some advice that is!

Not sure if my comments will be much help, but I have learned that that mast cells produce more than just histamine. Prostaglandins are also produced by mast cells. Years ago, I read an article in a magazine that said prostaglandins were responsible for some PMS symptoms. I always had moderately painful PMS. When my Lyme doctor tested me indirectly for MCAS, she tested histamine, prostaglandins, and some other stuff. Only prostaglandins was high.

Maybe there’s something that will bind to or lower prostaglandins.

Bartonella, in particular, has a big effect on the reproductive system (look into veterinary studies). Dr M, the bartonella guru, also specializes in MCAS treatment, so bartonella must be a big MCAS trigger.

This article might be helpful.
https://draxe.com/health/how-to-control-prostaglandin-production/#how_to_control_prostaglandin_production

Post Edited (WalkingbyFaith) : 9/28/2021 11:12:26 AM (GMT-6)

I’ve had similar experiences with flares and my period. I should also note that histamine issues get worse when my estrogen peaks in my cycle (twice every month). Mine seems to follow the graph here https://images.app.goo.gl/unmy2KqMj5AJ3VbE6 pretty closely.

Mommati5,

Great update! Thank you! Please do keep us informed of how your treatment goes, if sauna helps symptoms, and your MycoTox and ERMI results when you get them. I have CIRS/mold, too, and it has been a huge blockage to my recovery. I also have worse MCAS now than I did before because of repeated mold exposure.

What you said about your husband is spot on. I can relate 1000% to that.

Yes. I have stiffness pretty much all the time, not just morning. Definitely worse in the morning but also after getting up from sitting or getting out of the car. When I was in my early 40’s, I felt like I was in my 70’s, and that before my symptoms went full blown at 45 following a respiratory infection.

Is he getting a MycoTox test, too? Did he get tested for Lyme/co? If you’re financially able, it would be good to know. If he works outside the home or spends lots of time in a workshop or something, he could be exposed to mold in those places, too.

I should add that I discovered yeast can also cause this. I was quite surprised when I started antifungals Fluconazole and Nystatin that my foot pain, knee pain, joint stiffness, and exercise intolerance notably improved. Unfortunately, I continue to hurt myself with poor diet (sugar and carbs), and have lost what I gained, even though I am still on the meds.

Post Edited (WalkingbyFaith) : 10/2/2021 10:03:15 AM (GMT-6)