“Last summer I went to the [doctor] because I had hives. They are saying [it could be caused by] stress or hormones,” a ThisIsMenopause member wrote.

Itchy, raised bumps that come and go during perimenopause or menopause may not just be a coincidence. Hives, also called urticaria, can be one of the skin changes caused by hormonal shifts during menopause. Though it’s not the most common or researched symptom, hives in menopause can be a significant concern for some women.

In this article, learn about what may cause hives during menopause, signs and symptoms, and what you can do about it.

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How Menopause May Be Linked to Hives

It’s common for women going through menopause to experience skin changes such as dryness and itchiness due to drier, thinner, and more sensitive skin. Sometimes, hormone-induced changes can lead to the development of hives.

“There is no data regarding women in menopause specifically, but among women between the ages of 40 and 59, 0.3 percent will experience chronic urticaria or hives,” Dr. Gillian Goddard, M.D., author of “The Hormone Loop” and endocrinologist at Park Avenue Endocrinology in New York City, told ThisIsMenopause.

Chronic hives affect more women than men: “Women experience chronic urticaria at about twice the rate of men, and the incidence does seem to peak in midlife,” Dr. Goddard added.

During perimenopause and menopause, female hormone levels decrease, which can affect the immune system and change the skin barrier.

“Dropping estrogen levels in perimenopause and menopause lead to significant changes in the immune system that can allow the immune system to react to things it shouldn’t. As a result, new allergies, hives, and autoimmune diseases like thyroid disease are more common during this time,” explained Dr. Goddard.

Mast cells are a type of immune cell in the body that releases histamine, a chemical involved in hives. These cells are sensitive to estrogen and progesterone levels. Hormone fluctuations may affect mast cells, which could potentially contribute to hives in some people.

In addition, hormones can make women more sensitive to the triggers of hives. Heat sensitivity and hot flashes, which involve changes to blood vessel reactivity at the surface of the skin, can make someone more likely to develop hives.

Other Possible Causes of Hives

New hives may not be related to hormonal changes. Some common nonhormonal triggers include:

• Foods
• Medications
• Contact with chemical irritants or allergens (e.g., cleaning products or pollen)
• Physical triggers (e.g., trauma or cold, heat, or sun exposure)

It can be helpful to work with your healthcare provider to track and monitor your triggers so you can avoid them, but sometimes a clear trigger can’t be identified.

Chronic spontaneous urticaria is chronic urticaria with no identifiable cause, and the condition may resolve by itself in a few years.

Hives can also be caused by factors that cause immune dysfunction, such as bacterial or viral infections like strep throat, mononucleosis (mono), and hepatitis. They can also occur with certain autoimmune conditions including systemic lupus erythematosus, celiac disease, type 1 diabetes, and autoimmune thyroid disease.