The Horror of Hormonal Migraines
It’s a few days before your period and you’re feeling anxious. You know what’s coming (besides your flow), and you aren’t sure what to do about it other than pop a pain reliever, prep your cold pack, and hope you feel well enough to handle life for the next few days. The source of your dread: a monthly migraine.
Migraine headaches affect an estimated 12 percent of adults in the United States. Both men and women suffer from migraines, but 1 in 5 women deal with these debilitating headaches, thanks to key female hormones. Kids get them too; migraines occur in both girls and boys equally during childhood, but once puberty hits girls take the lead.
What causes hormonal migraines?
The ovaries release two hormones that play an important role in menstruation and pregnancy: estrogen and progesterone. These major players work together to prepare for the menstrual cycle, fluctuating throughout each month. If fertilization doesn’t occur, both hormone levels drop sharply about a week before menses begin.
It’s estrogen that typically causes migraines, although the connection between hormones and headaches isn’t entirely clear.
One theory is that estrogen controls serotonin (a chemical in the brain that senses pain) as well as dilates blood vessels (which triggers pain). When estrogen levels drop before your period, they cause headaches in some women. Hormonal migraine sufferers typically feel pain about two days before their cycle begins and up to three days after bleeding starts.
Know the symptoms.
If you’re new to headaches that may have a hormonal trigger, it’s a good idea to begin writing down your symptoms. A few common ones are:
Fatigue, food cravings, or mood changes
Some women experience these warning signs before the onset of a headache. Feeling suddenly tired or irritable, or craving certain foods (often sweets) may indicate pain is on the way.
Vision disturbances
These alterations in vision, called aura, affects about 25% of women. Disturbances may include blurred vision, blind spots, or flashing lights or wavy lines.
Sensitivity to light & sound
Bright lights may irritate eyes more than usual, and normal sound volumes may seem exaggerated to your ears.
Find relief.
There is no cure for migraines, but there are ways to manage them. Some find relief in over-the-counter NSAIDs (ibuprofen, acetaminophen) or naporxens (Aleve, Midol), especially if they’re taken at the first signs of a headache. Taking NSAIDs twice daily, 5–7 days before your period begins may also help decrease your chance of getting a migraine.
Hormonal birth control methods can sometimes make migraines worse. Synthetic hormones in these methods result in a larger estrogen drop, which may trigger pain. There are a few ways to combat this dramatic shift, but talk to your doctor first to see if they make sense for you.
- Switch to a progesterone-only pill (often called the mini-pill).
- Take the pill continuously, skipping the placebo week. Some women do this for 3 cycles, then take the next month to work through the entire pack. Week 5 marks the return to 3 weeks of pills while skipping the placebo once again. (It’s worth noting that breakthrough bleeding may occur with this method, so be prepared!)
- Switch to an extended estrogen-progestin pill type.
- Apply an estrogen patch on placebo days.
Note that women who sufferer from migraine with aura should not take combined pills, especially if they smoke or have high blood pressure, as these situations elevate stoke risk.
Other migraine management options include prescription medications, such as beta-blockers, triptans, and combination triptans/NSAIDs. Some women have also have luck with magnesium supplements to ward off potential migraines. Excess magnesium can make certain health conditions worse, though, so again talk with your doctor before beginning this regimen.
What’s next for migraine treatment?
Doctors and medical researchers continue to search for better migraine relief solutions. The Migraine Research Foundation works to fund research for discovering causes, improve treatments, and find a cure for migraines.
And in 2018 three new medications (Aimovig, Ajovy, and Emgality) were approved by the FDA to fight serious headache pain. Hopefully, one day soon migraine headaches will be treated quickly and easily.
Do you suffer from hormonal migraines? Please share your coping methods — they just may help someone else!
Cassie Hart has written for publications, businesses, and organizations for 15+ years. Her special interests include women’s health and wellness, family, dogs, and coffee. She has yet to write a piece that includes all of these topics, but will certainly do so when inspiration strikes. Learn more at www.cassiehartwriter.com
