Quick List: Histamine intolerance and PCOS

  • Jessica Lloyd Lead Naturopath and founder of My Vagina clinic
    Author: Jessica Lloyd
    Senior Vulvovaginal Specialist Naturopath | BHSc(N) | ISSVD, ISSWSH, BSSM, ATMS
Last reviewed: July 2, 2026

This is a quick list of the relationship between histamine intolerance and polycystic ovarian syndrome (PCOS).

  • There is a strong histamine-PCOS connection1–3
  • Oestrogen dominance plays a key role in PCOS, premenstrual syndrome (PMS), uterine fibroids and breast cancer
  • Those with PCOS tend to have low progesterone levels4,5
  • Progesterone is required for the enzyme, diamine oxidase (DAO), that breaks down histamine in the digestive tract and body6,7
  • There is a DAO gene, so a deficiency of DAO can be due to a genetic mutation8,9
  • Without sufficient progesterone, DAO enzyme function is impaired, resulting in excess histamine6,7
  • Oestrogen causes histamine production and release from ovaries and uterus6,7
  • Histamine causes oestrogen production, resulting in a loop6,7
  • Oestrogen dominance may exacerbate PMS symptoms10,11

  1. Erol N. Dangerous triplet: Polycystic ovary syndrome, oral contraceptives and Kounis syndrome. World Journal of Cardiology. 2014;6(12):1285.
  2. Krishna A, Beesley K, Terranova PF. Histamine, mast cells and ovarian function. Journal of Endocrinology. 1989;120(3):363–371.
  3. Azziz R. Polycystic Ovary Syndrome. Obstetrics & Gynecology. 2018;132(2):321–336.
  4. Velija-Ašimi Z. Evaluation of endocrine changes in women with the polycystic ovary syndrome during metformin treatment. Bosnian Journal of Basic Medical Sciences. 2013;13(3):180.
  5. Yang Y, Liu B, Wu G, Yang J. Exploration of the value of progesterone and progesterone/estradiol ratio on the hCG trigger day in predicting pregnancy outcomes of PCOS patients undergoing IVF/ICSI: a retrospective cohort study. Reproductive Biology and Endocrinology. 2021;19(1).
  6. Fogel WA. Diamine oxidase (DAO) and female sex hormones. Agents and Actions. 1986;18(1-2):44–45.
  7. Hamada Y, Shinohara Y, Yano M, et al. Effect of the menstrual cycle on serum diamine oxidase levels in healthy women. Clinical Biochemistry. 2013;46(1-2):99–102.
  8. Okutan G, Ruiz Casares E, Perucho Alcalde T, et al. Prevalence of Genetic Diamine Oxidase (DAO) Deficiency in Female Patients with Fibromyalgia in Spain. Biomedicines. 2023;11(3):660.
  9. Agúndez JAG, Ayuso P, Cornejo-García JA, et al. The Diamine Oxidase Gene Is Associated with Hypersensitivity Response to Non-Steroidal Anti-Inflammatory Drugs. PLoS ONE. 2012;7(11):e47571.
  10. Yen JY, Lin HC, Lin PC, Liu TL, Long CY, Ko CH. Early- and Late-Luteal-Phase Estrogen and Progesterone Levels of Women with Premenstrual Dysphoric Disorder. International Journal of Environmental Research and Public Health. 2019;16(22):4352.
  11. Noviyanti NI, Gusriani, Ruqaiyah, Mappaware NA, Ahmad M. The effect of estrogen hormone on premenstrual syndrome (PMS) occurrences in teenage girls at Pesantren Darul Arqam Makassar. Gaceta Sanitaria. 2021;35:S571–S575.
  12. Arduc A, Aycicek D, Bilmez S, et al. High prevalence of Hashimoto’s thyroiditis in patients with polycystic ovary syndrome: does the imbalance between estradiol and progesterone play a role?. Endocr Res. 2015;40(4):204-210.
  13. Maintz L, Novak N. Histamine and histamine intolerance. The American Journal of Clinical Nutrition. 2007;85(5):1185–1196.


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