Hormones and women's immune health

How do hormones affect women's immunity from puberty to perimenopause? Discover nutrition and lifestyle tips to support immune resilience at every life stage.

Biological sex shapes how the immune system works. Research shows, women tend to mount stronger immune responses than men, and the female sex hormones oestrogen and progesterone are a large part of the reason why, as described in a review in the journal Immunity.

Hormone levels rise, fall and shift at every stage of life, from a first period through to perimenopause. A woman's immune function is not fixed; it changes alongside them. This article looks at how hormones and immunity are connected, what shifts at each life stage, and the everyday nutrition and habits that help support resilience along the way.

In short: Oestrogen generally heightens immune activity, while progesterone tends to calm it. As these hormones fluctuate across the menstrual cycle and decline through perimenopause, immune responses shift too. This is one reason a woman's susceptibility to infection and inflammation can vary across different stages of life.

How hormones and immunity are connected

Oestrogen, progesterone and testosterone all influence the immune system. Immune cells, including T cells, B cells, natural killer cells and neutrophils, carry receptors for these hormones, so changes in hormone levels can change how the immune system behaves. Oestrogen tends to strengthen immune responses, while testosterone is generally immunosuppressive, a pattern detailed in a 2025 review in Frontiers in Immunology.

This heightened immune activity is one reason women's health experiences can differ from men's in ways that go beyond reproductive health alone. Sex hormones, X chromosome genes and immune cell differences all contribute to how the female immune system develops and responds.

Because oestrogen and progesterone change so much over a lifetime, the immune system is effectively recalibrated at each major hormonal stage. Understanding those stages help explain why what supports women’s health can look different from one decade to the next.

Puberty and immune health changes

Puberty is the first major hormonal shift, and it leaves a clear mark on immunity. The Immunity review notes that large changes in sex steroid levels, such as those that occur after puberty, alter immune responses. Before puberty, immune differences between girls and boys are relatively small. After puberty, the female pattern of stronger immune responses becomes more apparent.

For families, the teenage years are a practical time to build the foundations of lifelong health: a varied diet with plenty of fruit and vegetables, regular movement, and consistent sleep. These habits do more for long term immune resilience than any single nutrient.

The menstrual cycle and immune function

Across a typical menstrual cycle, oestrogen and progesterone rise and fall, and markers of immune function shift alongside them. A systematic review and meta-analysis in Acta Physiologica found that immune and inflammatory markers vary measurably across the phases of the cycle.

In the follicular phase, the first half of the cycle leading up to ovulation, oestrogen levels climb. In the luteal phase, the second half, progesterone rises and the immune system shifts toward a more tolerant state, a change that biologically supports the possibility of pregnancy. Some women notice they feel slightly different at different points in their cycle. This is normal physiology rather than a sign that something is wrong.

Menstruation also involves a regular loss of iron, which is one reason iron needs are higher for women during the reproductive years. Iron contributes to normal immune function, so meeting those needs through diet matters more for women than it does for men of the same age.

Stress, busy lifestyles and women's wellbeing

Stress and immunity are closely linked through the hypothalamic-pituitary-adrenal (HPA) axis and the hormone cortisol. Short-lived stress can briefly mobilise the body's defences. Chronic stress, with persistently raised cortisol, tends to do the opposite. A 2025 review in the journal Biology, describes how sustained HPA activation suppresses both innate and adaptive immune responses.

Modern life can make this hard to escape. In the Jean Hailes National Women's Health Survey, more than 40% of women reported that their physical and mental health had declined in recent years. Protecting sleep, making time for movement and downtime, and staying connected with others are practical ways to keep stress in a healthier range, and they support immune health as a result.

Perimenopause, inflammation and immune changes

Perimenopause, the years leading up to menopause, brings a gradual decline in oestrogen. Because oestrogen helps regulate immune and inflammatory activity, its decline is associated with a rise in pro-inflammatory signals. A study in Biomedicines reports that postmenopausal women tend to have higher levels of pro-inflammatory cytokines such as IL-6 and TNF-alpha.

This overlaps with the natural age-related change in immunity known as immunosenescence. A paper in the Journal of Neuroinflammation described perimenopause as a systemic inflammatory phase. None of this means the immune system stops working well; it is shifting, and the everyday choices that support general health become more valuable during this transition.

Nutrients that support women's immune health

Nutrition underpins immune function at every life stage, and food comes first. A varied diet rich in vegetables, fruit, whole grains, legumes and quality protein supplies most of the nutrients the immune system relies on. A few nutrients are worth knowing about specifically.

Vitamin C

Vitamin C is one of the most studied nutrients for immune health. A review in Nutrients describes how vitamin C supports the skin's barrier against pathogens, accumulates in immune cells such as neutrophils, and contributes to both the innate and adaptive immune system. It is also an antioxidant that helps protect cells from free radical damage.

When it comes to the common cold, evidence is nuanced and worth being honest about. A Cochrane review of vitamin C and the common cold found that regular vitamin C did not stop people catching colds in the general population. It was, however, linked to a modest reduction in how long colds lasted, around 8% shorter in adults and 14% in children, along with a reduction in severity.

In Australia, the recommended dietary intake of vitamin C is 45 mg a day for adults, according to Australia's Nutrient Reference Values. Good food sources include citrus, kiwifruit, capsicum, broccoli, strawberries and tomatoes. Most Australians meet their vitamin C needs through diet however, according to the latest Australian Bureau of Statistics data, around 8% of people aged two and over had an inadequate vitamin C intake in 2023, up from under 5% in 2011-12.

Other nutrients that play a role

• Iron: Higher requirements during the reproductive years, due to monthly blood loss, make iron a nutrient many women need to pay attention to. It contributes to normal immune function.
• Vitamin D: Contributes to the normal function of the immune system. Levels can dip over the cooler months when sun exposure is lower.
• Zinc: Involved in the development and function of immune cells, and found in foods such as lean meat, legumes and seeds.

Supplementation considerations

Supplements are designed to fill genuine gaps, not to replace a balanced diet, and a vitamin C supplement can only assist when dietary intake is inadequate. Some groups may not always meet their needs through food alone. People who smoke have higher vitamin C requirements, and those who eat little fruit and vegetables can fall short, as discussed in an article in the Medical Journal of Australia. If you are weighing up your options, our guide to vitamin C, its food sources and when a supplement may help is a useful starting point.

For those considering a dedicated vitamin C supplement, Blackmores Bio C 1000 contains 1000 mg of vitamin C delivered through three forms (ascorbic acid, calcium ascorbate and sodium ascorbate), together with citrus bioflavonoids, hesperidin, rutin, acerola (Malpighia glabra) and rosehip (Rosa canina). Vitamin C may support immune system health and also supports the absorption of dietary iron, which can be relevant for women during the reproductive years. As with any supplement, it works best alongside, not instead of, a balanced diet.

Everyday habits that support resilience across life stages

Good health is built through small, consistent steps rather than dramatic changes. The same foundations support immune resilience whether you are 18 or 55:

• Eat a varied, plant-rich diet with enough protein and a wide range of colours on the plate.
• Move regularly. A mix of walking, strength work and movement you enjoy is more sustainable than an all or nothing approach.
• Prioritise sleep. Practising good sleep hygiene, such as a consistent bedtime and limiting screens late at night, makes a real difference over time.
• Manage stress in ways that suit you, whether that is time outdoors, connecting with friends, or simply protecting unhurried time in your week.
• Limit alcohol and avoid smoking, both of which place extra demand on the body.

When to speak with a health professional

Most shifts in how you feel across your cycle or through perimenopause are a normal part of changing hormones. Some signs are worth discussing with your GP, including frequent or lingering infections, persistent fatigue, very heavy periods, or perimenopause symptoms that are affecting your daily life. If you have a personal or family history of chronic immune conditions, mention this too. A health professional can look at the full picture and recommend the right support for you.

Frequently asked questions

Does your period affect your immune system?

To a degree, yes. Immune markers shift across the menstrual cycle as oestrogen and progesterone rise and fall. A meta-analysis in Acta Physiologica found measurable changes across the cycle's phases. These are normal fluctuations, not a fault in the system.

Are women's and men's immune systems different?

Yes. Women generally mount stronger immune responses, linked both to oestrogen and to genes on the X chromosome, as covered in a 2025 review by Frontiers in Immunology. This supports faster clearance of some infections, but is also associated with higher rates of chronic immune conditions.

Why do some women feel more run down during hormonal changes?

Hormonal shifts rarely act alone. Changes in oestrogen and progesterone can affect sleep, mood and energy, and they often coincide with busy, higher-stress periods of life. The interplay of disrupted sleep, stress and hormonal change is usually what sits behind that run down feeling. Foundational habits help most, and if it persists, it is worth seeing your GP.

Can vitamin C prevent colds?

Not in the general population. The Cochrane review found regular vitamin C did not reduce how often people caught colds, although it was linked to modestly shorter and less severe colds when taken regularly.

How can I support my immune health during perimenopause?

Focus on the basics that help counter rising inflammation: a varied, plant-rich diet, regular movement, good sleep and stress management. Speak with your GP about managing any perimenopause symptoms that affect your daily life.

Key takeaways

• A woman's immune function changes with her hormones, from puberty through to perimenopause.
• Oestrogen tends to heighten immune activity and progesterone tends to calm it, which is why immune responses shift across the cycle and over a lifetime.
• As oestrogen declines in perimenopause, pro-inflammatory signals tend to rise, making everyday health habits more valuable.
• A varied, plant-rich diet, sleep, movement and stress management are the strongest foundations for immune resilience.
• Vitamin C contributes to normal immune function and may support immune system health; food comes first, with supplements filling genuine gaps.

Always read the label and follow the directions for use.

Disclaimer: This article provides general information only and is not intended to diagnose, treat, cure, or prevent any disease. The information presented is not a substitute for professional medical advice. If you have concerns about your health, please consult your GP or healthcare provider for a personalised assessment and recommendations. Supplements should not replace a balanced diet.