Are Your Hormones Giving You A Headache?

As I was saying goodbye to friend after lunch the other day she said, “You should write about migraines.” I replied with a question, “Have you always had migraines?” She said no, only in the past few years going through perimenopause.

Turns out migraines are not uncommon during perimenopause. There is a strong link between hormones, particularly declining estrogen levels, and migraines. And if you already suffer from migraines before perimenopause, they may get worse during perimenopause.

I feel fortunate migraines are not something I have had to contend with so far but if you are suffering, I hope this article gives you a starting point for a conversation with your doctor.

What is a Migraine?

According to the Mayo Clinic, “a migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.”

There are different types of migraines which each present in different ways. They can last from a few hours to days and can occur as frequently as every day or only a couple of times a year.

What Causes Migraines

Women are more susceptible than men and having a family history increases your chances of getting migraines. Age is also a factor. Most people experience their first migraine before the age of 40. According to one source, “it does become uncommon for people to have a new onset of headache if they’re 40 or older.” And for both men and women migraines begin to decline after age 45.

Certain foods and situations can trigger migraines. Think spicy foods, caffeine, chocolate, and alcohol. Strong scents or bright lights can also set off a migraine. And stress, dehydration, and lack of sleep are also known culprits.

For women changes in estrogen levels resulting in low levels of estrogen can be a cause. This explains why some women get migraines just before their periods when estrogen levels decline.

How To Treat

If unfortunately, the onset of perimenopause has introduced you to migraines don’t give up hope. It turns out there are many approaches to try for preventing migraines as well as treating them. Just remember, like most things in life everyone responds differently. A treatment which works for one person might make another person’s symptoms worse.

Preventative

Strategies in this category include Hormone Replacement Therapy and according to WebMD “anti-depressants, Botox, anti-seizure and blood pressure medications, and calcitonin gene-related peptide inhibitors” as well.

Exercise, a healthy diet, and maintaining a healthy weight can all help reduce the frequency of migraines. Other lifestyle suggestions include avoiding trigger foods, getting sufficient rest, staying hydrated, and managing stress.

After Onset

If you are trying to deal with the symptoms of a migraine, you can try over-the-counter pain medications like Tylenol or Aleve and categories of medications including triptans, ditans, and calcitonin gene-related peptide (CGRP) inhibitors.

Alternatives

This article from Webmd discusses different types of devices as alternatives to traditional medicines. “Cefaly is a portable headband-like device gives electrical impulses on the skin at the forehead that is used daily for 20 minutes at a time. SpringTM which you hold at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.

There is also gammaCore, a noninvasive vagus nerve stimulator which when placed over the vagus nerve in the neck, releases a mild electrical stimulation to the nerve's fibers to relieve pain. And another option is nerivio, a   wireless remote electrical neuromodulation device which is self-applied to the upper-arm and is used at the onset of migraine headache or aura.”

And this article from Every Day Health says, “There is also evidence that complementary therapies such as relaxation, biofeedback, and cognitive behavioral therapy may help improve migraine, according to the American Headache Society. Research published in the journal Headache in September 2019 found that a mindfulness-based intervention helped reduce disability and the negative impact of migraine.”

Lastly, according to the American Migraine Foundation supplement and herbal remedies shown to provide relief include butterbur and magnesium in addition to acupuncture.

The Good News

For many women, once estrogen levels stop fluctuating and they enter menopause many types of migraines often go away, or the symptoms diminish. One specialist says, “I would say about 70 percent of women see some improvement after the menopause transition.”

Parting Thought

Researching this topic was a reminder (yup, I need a lot of these) how important it is to treat ourselves with kindness as we journey through these midlife years.

The changes we experience because of changes in our hormones are real. We can’t and shouldn’t pretend the impact on our lives isn’t real. Carrying on as “usual” might not be the answer.

See you next week…