The Trouble with Sex When You have MCAS

This post discusses the trouble with sex when you have MCAS. And by sex, I do mean actual sexual activity, but I also include the effect of sex hormones in general on Mast Cell Activation Syndrome or MCAS. Sad but true, sex and orgasm tend to activate mast cells and cause MCAS flare symptoms. Read on for the deets.

What is MCAS?

Mast Cell Activation Syndrome (MCAS) is a chronic condition that affects all organ systems. MCAS is serious and disabling and people with MCAS experience often significant and debilitating symptoms daily, including anaphylaxis, which can be fatal.

MCAS is often found in combination with other chronic conditions such as Ehlers-Danlos Syndrome (EDS) and Postural Orthostatic Tachycardia Syndrome (POTS).

Frequently healthcare providers do not know about MCAS, and the tests for MCAS are problematic because they are not uniformly reliable. MCAS can be difficult to manage. Treatments include blocking mast cell mediators with anti-histamines and mast cell stabilizers, as well as avoiding triggers.

Check out this post on how to manage MCAS.

What is the trouble with sex when you have MCAS?

Mast cells are present in virtually every type of cell that is part of the reproductive system, including the bladder, prostate, penis, vagina, and uterus. – source

In addition, sexual arousal and sexual activity are well-known triggers for MCAS.

As well, mast cells can be activated from kissing, skin irritation from sexual contact, allergic reactions in the vagina and vulva, allergic reactions to semen, post-orgasmic illness syndrome, male pelvic floor dysfunction, female pelvic floor dysfunction, and the emotional aspects of sex, to name a partial list.

Kundalini energy and MCAS

This month I decided to take an online course on raising Kundalini energy. Kundalini is an energetic force in living beings, and it is part of orgasmic energy in humans. Kundalini energy is not just associated with sexual energy but with creative energy as well. Kundalini energy can be activated by chanting, singing, breathing exercises, and repetitive yoga poses, all of which have the potential to cause mast cell activation. But I figured, what the heck, I want to know what it’s like to raise my Kundalini energy.

I discovered after just one week of the class that even gentle Kundalini exercises, like self-breast massage, caused massive MCAS symptoms in my body. And by week two of the class, I was experiencing a huge MCAS symptom flare and had to take a break from the exercises.

MCAS can cause these sex-related symptoms

And according to this source mast cell activation has been implicated in everything from urinary issues to pregnancy:

Urinary tract symptoms

• Frequency of urination
• Difficulty starting urination
• Incomplete bladder emptying
• Painful urination
• Pain from kidney stones
• Blood in the urine (rare)

Vaginal/reproductive tract symptoms

• Inflamed vulva or vagina
• Vaginitis
• Itchy vulva or vagina
• Spotting between periods
• Painful sex
• Endometriosis

Pregnancy symptoms

• Decreased libido
• Infertility
• Early miscarriage
• Severe, excessive or prolonged vomiting
• Pre-eclampsia
• Pre-term labour
• Poor response to anaesthetics

Hormonal symptoms

• Delayed or premature puberty
• Painful periods
• Irregular periods
• Heavy periods
• Estrogen dominance
• Weak bones
• Thyroid abnormalities
• Blood sugar dysregulation, type II diabetes, and hypoglycemia

The trouble with sex hormones and MCAS

Mast cells also have estrogen, gonadotropin, and corticotropin-releasing hormone receptors, meaning that they pick up on and respond to the hormones involved in preparing the female body to release an egg from an ovary, and for pregnancy. – source

And mast cells are found to be more active during PMS, and their activity varies with a woman’s monthly cycle. – source

Mast cells are implicated in making female pelvic floor pain worse. – source

The bucket theory

The bucket theory offers a helpful analogy for understanding symptom reactions with MCAS.

Think of your body as an empty bucket that you want to keep from overflowing. Different foods and activities fill your histamine bucket at different speeds but they combine to form the total level of histamine in your body (how full your bucket is). A fuller bucket means you have more histamine symptoms. When you manage triggers, reduce exposure to known triggers, and take medications and supplements to reduce histamine, you can manage the level of your bucket.

Know your typical symptom progression

Knowing your symptom progression in a symptom flare is the key to developing your own rescue plan. In this post, I discuss how to determine your own symptom progression. Once you know what typically happens in your symptom progression you can design a rescue plan to address those symptoms.

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How to manage sex with MCAS

Sex is an important aspect of being human and a healthy way to express intimacy. It’s a major bummer that sexual activity makes me feel sick. Like every aspect of chronic illness, it adds extra layers of complexity, removes spontaneity, and adds extra stress to having to manage another aspect of your life. But it’s also well worth it to be able to experience sex for relaxation and connection with your partner.

The tools I discuss for managing MCAS in this post and this post are relevant for managing sex when you have MCAS.

I’ve found the following guidelines help me to experience sex successfully with MCAS:

• Reserve sexual activity for earlier in the day, so that you have time to manage your symptoms before going to sleep. Your bucket tends to be less full earlier in the day as well.
• Be aware of the level of your bucket and take extra mast cell stabilizers if you are already experiencing symptoms before having sex.
• Lower your expectations. Sex doesn’t have to be performative. Sex doesn’t have to always be about penetration and orgasm. Sexual pleasure can mean mutual pleasuring, massage, holding, and heart connection.
• Practice self-pleasuring by yourself so that you know what you can handle and what causes symptoms to flare before adding someone else to the equation.
• Communicate openly with your partner about your symptoms, what feels good, what causes symptoms to flare, and what you need.
• If you want to work with Kundalini energy, remember that less is more. As an extremely sensitive person, I found that by doing just a fraction of the Kundalini exercises for a fraction of the time I could experience it and work with it and learn to use it.

What do you think?

Am I bonkers to write about sex and MCAS? I’d love to have your reply below!