The Link Between Fluctuating Hormones and Headaches

Migraine is a neurological disorder, one phase of which is an excruciating, throbbing, one-sided headache that can last up to 72 hours.

Migraine affects more women than men, and there’s a known link between migraine pain and hormonal changes. In fact, more than half of women living with migraine report menstruation as a trigger for their migraine attacks.

At Primecare Family Practice, board-certified family practitioners Maryline Ongangi, APRN, FNP-C, and Lewis Nyantika, APRN, FNP-C, understand the hormonal underpinnings of migraine pain and offer treatments that reduce the incidence and/or severity of it. Why are the two connected? Keep reading to find out.

The hormone-pain link

Estrogen and progesterone are the two primary sex hormones for women, and their levels fluctuate throughout the month. They’re at their highest in the middle of your menstrual cycle and the lowest during your period. The drastic shift in hormone levels makes headaches and migraine more likely because estrogen increases your pain sensitivity.

Estrogen levels drop immediately before the start of your menstrual flow. Menstrual migraine attacks (hormonal migraine attacks) can start up to two days before your period and last for three days during your period.

In addition, women who have heavy and painful periods have higher levels of another hormone — prostaglandin — which has been identified as also playing a role in menstrual migraines.

Contraception as treatment

If you struggle with menstrual migraine and have irregular periods accompanied by migraine attacks, there are a range of hormonal contraceptives that may help with the migraine pain.

The combined pill contains both estrogen and progestin. If you’re using this form of contraception and have migraine attacks during the pill-free week, the doctor may recommend you stay on the pill without a break to help manage the menstrual migraine, as your levels won’t fluctuate and trigger an attack.

Other forms of hormonal contraception include the patch, the ring, the Naplexon® implant, and an intrauterine device (IUD).

If you have migraine with aura (neurological symptoms such as visual disturbances or affected speech), the doctor may recommend progestogen-only contraception options. Estrogen is not recommended for migraine with aura.

Some women find that topping up their estrogen levels both before and during their period can help alleviate menstrual migraine. This is most likely to be effective if you have regular periods and you can top up the estrogen for seven days, starting three days before your period begins and continuing for four days during menstruation.

You shouldn’t use estrogen supplements of any kind if you think you’re pregnant or you’re trying to get pregnant.

If you struggle with menstrual migraine, you’re not alone, and Primecare Family Practice can help. To schedule an evaluation, call our office at 817-873-3710, or book online with us today.