If you’ve suffered from a migraine, you know the symptoms: throbbing sensation behind the eyes or temples, light and sound sensitivity, and even dizziness and nausea, to name a few. But sometimes they creep in when your body is already experiencing another type of pain and discomfort. Have you ever noticed that your migraines are more frequent or intense leading up to or during your menstruation cycle? If so, you’re not alone. Unfortunately, migraines affect approximately 1 in 7 people, and women are affected 3 times as much as men. So why do women have it so much worse when it comes to migraines, and what does the menstrual cycle have to do with it?
Hormone levels in women strongly correlate with the frequency of migraines, due to the common fluctuations in estrogen with the menstrual cycle. The variance of hormone levels that come around the time of your period can greatly affect your migraines and worsen existing headaches. The drop in estrogen before menstruation can lead to headaches before and during the time of cycle each month. The migraines can last a few days and up to the entire week of pre-menstruation and during menstruation, depending on your body. During pregnancy, many women may experience a relief from their migraines as estrogen rises and stays high for the duration of the pregnancy.
Around age 40-50, women’s hormones experience another shift as they begin to settle into perimenopause. Naturally as women age, the drop in estrogen causes them to be more susceptible to increased migraines. While women experiencing the hormonal fluctuations of perimenopause and menopause may be inclined to increased and prolonged migraines, they typically improve after menopause. While there is hope to find relief from migraines after menopause, no one wants to wait for their chronic hormonal migraines to just go away with time.
While it’s important for women to take control of their hormonal migraines, anyone suffering with chronic migraines should seek treatment. For anyone experiencing migraines, it’s important to keep a trigger identification journal or diary to track what they are eating, drinking, or doing that may cause a migraine. Exercise is also known to alleviate migraines, so try heading out for a brisk walk or jog to clear up your migraine pain. If you have a job where you are sitting behind a computer screen all day, you may notice that it is a trigger for migraines. Take a break a few times a day to stretch your body and eyes and take note when you feel the most intense migraine pain and when you feel the least. You may also find relief in just sitting back and relaxing. If natural remedies do not work, consult your doctor to discuss any over the counter medicine. Some women may be inclined to try contraceptive prescriptions, which may work to combat your migraines. However, if you are planning on becoming pregnant, tell your doctor and find a plan, as some medications are not safe during pregnancy.
As soon as your migraines become functionally limiting, you should seek treatment. For instance, if you are unable to work, sleep, or live your life normally, then it’s time to seek help. Even if it’s infrequent, a medication to stop the migraines that do happen can be beneficial during the times you are suffering from them. If your migraines are frequent (more than one day per week), then a preventative and an abortive medication is needed. If you suddenly experience the worst headache of your life, seek emergency treatment right away and schedule an appointment with your neurologist.
The good news is that finding relief from your hormonal migraines is possible. There are many preventative therapies you can explore with your doctor, such as antiepileptics (topiramate, zonisamide, valproate), antidepressants (nortriptyline, amitriptyline, duloxetine), antihypertensives (propranolol, verapamil), anti-CGRP (Aimovig, Emgality, Ajovy), and botox injections. If you find that hormones are a major trigger, you may consider hormonal contraceptives after consulting your neurologist. In working with a neurologist you will be able to identify your triggers and find the right solutions.
The advantages to taking control of your migraines are simple: reduced migraine frequency, reduced migraine severity, and an increased ability to function/do day-to-day tasks. Take back your life from chronic hormonal migraines and get back to doing what you love.