MCAS & Triggers: “So, How’s Your Sex Life?”

It was my family doctor who first posed the question about my sex life.

My hubby and I had spent over an hour with him describing my disease in detail and he was incredibly fascinated with every aspect of it and took it all in. He knew my health history better than anyone and knew I struggled with endometriosis and birth control, among so many other things, so it all made sense to him and I could tell he really understood this disease when I explained it to him.

He really got it.

Towards the end of our conversation we talked about how his own wife was having problems with HRT and exogenous estrogens, much like I was, and when I told him that even my own hormones trigger me he couldn’t help but ask me how my disease affects our sex life. I was surprisingly not at all offended or embarrassed. Mast cell disease affects every system in the human body, including our reproductive one, and for many of us it definitely has an impact on our sex lives.

“It’s much better now, thanks to the medicines!” I told him.

I went on to explain that from the beginning of our relationship (we’ve been married 26 plus years now) sex was something I both craved and dreaded. My libido was (and still is) always in overdrive* (see below), which makes the hubby happy, but the act itself was often painful and uncomfortable for me. I just didn’t realize just how bad it was until I finally found the right medications that calmed everything down and I finally felt what “normal” was like.

I had no idea that it wasn’t supposed to feel the way it did. That was my normal!

Aside from the physical pain and discomfort, I sometimes suffered from what I term “emotional seizures” during or just after sex. A flood of emotions would take over and I would end up crying uncontrollably, much to my husband’s dismay, but I assured him it wasn’t him. It was me.

I didn’t know why it happened, it just did.

Now I know it’s because my mast cells are hyper-reactive and are triggered by things like hormone fluctuations, physical activity and stimuli of all kinds so it’s no wonder that a lovemaking session would be highly triggering. It still can be, but it’s not nearly as bad as it was. Keeping my mast cells in check definitely helps.

There’s scientific data to back this up, of course:

Female sex hormones have long been suspected to have an effect on mast cell (MC) behavior. This assumption is based on the expression of hormone receptors in MCs as well as on the fact that many MC-related pathophysiological alterations have a different prevalence in females than in males. Further, serum IgE levels are much higher in allergic female mice compared to male mice. Ovariectomized rats developed less airway inflammation compared to sham controls. Following estrogen replacement ovariectomized rats re-established airway inflammation levels’ found in intact females. In humans, a much higher asthma prevalence was found in women at reproductive age as compared to men. Serum levels of estradiol and progesterone have been directly correlated with the clinical and functional features of asthma. Around 30–40% of women who have asthma experienced worsening of their symptoms during the perimenstrual phase, the so-called perimenstrual asthma. Postmenopausal women receiving hormone replacement therapy have an increased risk of new onset of asthma. Beside, estrus cycle dependent changes on female sex hormones are related to changes on MC number in mouse uterine tissue and estradiol and progesterone were shown to induce uterine MC maturation and degranulation.

So it’s pretty obvious that women with mast cell disease are especially affected. There’s even more research showing this:

A number of papers have reported that MCs have estrogen, gonadotropin and corticotropin-releasing hormone (CRH) receptors. Moreover, animal experiments have shown that diencephalic MCs increase in number during courting in doves. We had reported that allergic stimulation of nasal MCs leads to hypothalamic-pituitary adrenal (HPA) activation. Interestingly, anecdotal information indicates that female patients with mastocytosis or mast cell activation syndrome may have increased libido.

Remember I mentioned I have an increased libido*? Well, that explains it then, doesn’t it?

I don’t think I’ll tell the hubby that it’s this guy turning me on and not (just) him and his rugged, handsome self, though:

I mean, you know, men have fragile egos when it comes to this stuff and I certainly don’t want to jeopardize our sex life.

Not now, it’s just finally getting good!

🙂

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