How This Helps

Hormonal headaches such as migraines that happen during or before your periods are painful and can cause disruption in your life. Natural treatments can help alleviate your symptoms and also lessen the intensity of these headaches. 

What is a period headache?

Everyone experiences a headache now and then. There are many known causes of headaches, ranging from dietary triggers, genetics, and even seasonal changes. Many women, though, experience chronic headaches during their periods that are caused by the fluctuating hormone levels in the body. These chronic headaches caused due to hormonal fluctuations are also known as period migraine or period headache. It is not necessary that a woman gets a headache during the period only. It is also possible for many women to experience an ovulation headache, which is also caused by varying levels of hormones in the body during ovulation.[1, 2]

It is estimated that over 50 percent of all women suffer from menstrual migraines.[3] This means that these women experience a chronic headache during the period, and at other times of the month, during which there are hormonal fluctuations, such as ovulation. Migraine during a period is usually accompanied by more severe symptoms and is also more challenging to treat. A period migraine is also likely to reoccur despite being on preventive medications for migraines.[4] There are many ways to treat and even prevent period migraine attacks. In order to understand how to prevent these hormonal headaches, it is first necessary to understand the cause behind period migraines. 


See: Ayurveda Treatment for Migraine

Hormonal migraine causes

What are the Causes of Hormonal Migraines?

Hormonal headaches or migraines during periods are closely linked to the hormone estrogen, which is responsible for controlling the chemicals in the brain that determine the sensation of pain. When there is a fall in the levels of estrogen in the body, it can cause a hormonal headache.[5] There are many reasons behind the changes in hormone levels in women. These include:

·        Pregnancy: Estrogen levels increase dramatically during pregnancy. Due to this, many women notice a reduction in hormonal headaches during pregnancy. Some even find that their headaches disappear altogether when they are pregnant. However, some women may experience hormonal migraines in the early weeks of pregnancy and find relief once the first trimester is over. However, after delivery, the levels of estrogen tend to fall rapidly, and you are likely to experience moderate to severe hormonal migraines post-delivery.[6,7]

·        Menstrual cycle: The levels of estrogen and another hormone called progesterone decrease to their lowest levels just before you are about to get your periods, leading to a migraine before the period or migraine during the period.[8,9,10] 

·        Oral Contraceptives or/and Hormone Replacement Therapy: Oral contraceptives such as hormonal birth control pills are known to lead to a fluctuation in hormone levels. Hormone replacement therapy also causes hormone levels in the body to rise and fall dramatically. It has been noticed that women who experience hormonal migraines while taking birth control pills tend to have migraines during the last week of the pill cycle. This is the period when you take the pills that do not contain any hormones, thus leading to a migraine attack.[11,12,13]

·        Menopause: In the years just before your menopause (a period known as perimenopause), many women experience wildly fluctuating levels of hormones. This increases the occurrence of hormonal migraines. As they reach menopause, many women report experiencing an improvement in their symptoms. However, for many, menopause can worsen the symptoms, causing more severe migraines. It has been observed that women who undergo hormone replacement therapies are more likely to experience more migraine attacks after menopause.[14, 15]

See: Yoga asanas for migraine pain relief

Menstrual migraine prevention

How to Prevent Menstrual Migraine?

Hormonal headaches such as migraine that happens during or before your periods or ovulation headaches are painful and can cause disruption in your day to day life. There are many ways in which you can alleviate your symptoms and also lessen the intensity of these headaches. Here are specific helpful tips on how to prevent menstrual migraines.

1. Reduce your stress

Stress has become a part of our daily lives now. With most women juggling a job, family, and many other responsibilities, there is no end of stressful situations in our lives today. Unfortunately for period migraine sufferers, stress is a known migraine trigger.[16]

You should try to actively reduce stress in your life, which may help alleviate your period of headache symptoms. For example, reduce your alcohol intake, quit smoking, follow a regular sleeping schedule, and exercise at least three to four days in a week to experience lower stress levels and fewer migraines.[17]

2. Change your Birth Control

Many women, especially those who have irregular periods, opt for using hormonal birth control pills for regulating their menstrual cycle. However, if you suffer from menstrual migraine, then these hormonal birth control can increase the frequency of your period headache.  Women with menstrual migraines can consider taking continuous birth control options that are also available in the form of birth control pills, the patch, or the ring. These are known to work better for migraine sufferers as these birth control options do not cause any decline in the levels of estrogen, thus reducing the likelihood of getting a menstrual migraine.[18]

Many doctors also prefer prescribing progestogen-only contraception for women with migraines. Progestogen-only contraception has been observed to a better option in women with menstrual migraines since it helps maintain a stable level of estrogen in the body.[19]

3. Avoid known Food Triggers

Regardless of whether you have a period migraine or any other type of migraine, avoiding certain known food triggers can help you prevent a headache during the period. 

These food triggers tend to vary from person to person and usually include foods with monosodium glutamate (MSG), chocolate, dried fruits that contain sulfites, red wine, caffeine, alcohol, aged cheese, and processed meats that have nitrates. 

At the same time, you should also have a regular schedule of having your meals. Skipping breakfast should be avoided at all costs as it is a known trigger for a migraine. Keep track of which foods trigger your headaches and avoid having them, especially in the week before you periods to prevent a menstrual headache.[20]

See: Migraine With Aura Symptoms & Natural Treatments

Summary

Apart from hormonal fluctuations, there are many lifestyles and environmental factors that play a vital role in the onset of a migraine. Identifying the common triggers of your headaches can help you lower the frequency of migraines. Following the tips described above can also help you prevent and manage your menstrual migraines.

See: Migraines vs Headaches treatment

References

1. Sherman, B.M., and Korenman, S.G., 1975. Hormonal characteristics of the human menstrual cycle throughout reproductive life. The Journal of clinical investigation, 55(4), pp.699-706.

2. Scutt, D., and Manning, J.T., 1996. Ovary and ovulation: Symmetry and ovulation in women. Human Reproduction, 11(11), pp.2477-2480.

3. MacGregor, E.A., Brandes, J., Eikermann, A., and Giammarco, R., 2004. Impact of migraine on patients & their families: the Migraine and Zolmitriptan Evaluation (MAZE) survey–Phase III. Current medical research & opinion, 20(7), pp.1143-1150.

4. MacGregor, E.A., 2018. Migraine, menopause, and hormone replacement therapy. Post reproductive health, 24(1), pp.11-18.

5. Newman, L.C., 2007. Understanding the causes & prevention of menstrual migraine: the role of estrogen. Headache: The Journal of Head & Face Pain, 47, pp.S86-S94.

6. Melhado, E., Maciel Jr, J.A. and Guerreiro, C.A., 2005. Headaches during pregnancy in women with a prior history of menstrual headaches. Arquivos de neuro-psiquiatria, 63(4), pp.934-940.

7. Menon, R., and Bushnell, C.D., 2008. Headache and pregnancy. The neurologist, 14(2), pp.108-119.

8. Stewart, W.F., Chee, E., Lipton, R.B., Sawyer, J., and Silberstein, S.D., 2000. Menstrual cycle & headache in a population sample of migraineurs. Neurology, 55(10), pp.1517-1523.

9. Johannes, C.B., Linet, M.S., Stewart, W.F., Lipton, R.B., Szklo, M., and Celentano, D.D., 1995. Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology, 45(6), pp.1076-1082.

10. Silberstein, S.D., and Merriam, G.R., 1991. Estrogens, progestins, and headache. Neurology, 41(6), p.786.

11. Sulak, P., Willis, S., Coffee, A., Kuehl, T., and Clark, J., 2007. Headaches & oral contraceptives: Impact of eliminating the standard 7‐day placebo interval. Headache: The Journal of Head and Face Pain, 47(1), pp.27-37.

12. Ryan Sr, R.E., 1978. A controlled study of the effect of oral contraceptives on migraine. Headache: The Journal of Head &Face Pain, 17(6), pp.250-252.

13. Nappi, R.E., Cagnacci, A., Granella, F., Piccinini, F., Polatti, F., and Facchinetti, F., 2001. Course of primary headaches during hormone replacement therapy. Maturitas, 38(2), pp.157-163.

14. Fettes, I., 1999. Migraine in the menopause. Neurology, 53(4 Suppl 1), pp.S29-33.

15. Hodson, J., Thompson, J., and Al-Azzawi, F., 2000. Headache at menopause & in hormone replacement therapy users. Climacteric, 3(2), pp.119-124.

16. Sauro, K.M., and Becker, W.J., 2009. The stress and migraine interaction. Headache: The journal of head & face pain, 49(9), pp.1378-1386. 

17. Fanciullacci, C., Alessandri, M., and Fanciullacci, M., 1998. The relationship between stress and migraine. Functional neurology.

18. Allais, G., De Lorenzo, C., Mana, O., and Benedetto, C., 2004. Oral contraceptives in women with migraine: balancing risks & benefits. Neurological Sciences, 25(3), pp.s211-s214. 

19. Nappi, R.E., Merki-Feld, G.S., Terreno, E., Pellegrinelli, A., and Viana, M., 2013. Hormonal contraception in women with migraine: is progestogen-only contraception a better choice?. The journal of headache & pain, 14(1), p.66.

20. Finocchi, C., and Sivori, G., 2012. Food as trigger and aggravating factor of migraine. Neurological Sciences, 33(1), pp.77-80.

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