Headaches and Hormones - What You Can Do

HEADACHES CAN BE CAUSED BY HORMONAL CHANGES

Estrogen is the hormone primarily responsible for headaches. About 6% of childbearing-age women suffer from what appear to be hormone-related migraines. Low estrogen levels ultimately decrease serotonin, which, in turn, causes vasodilation and pressure on the nerves of the brain. Estrogen also decreases prostaglandins, which causes an increase in pain sensitivity. Although some of these are not caused by menstruation, they are also called "menstrual migraines" or "PMS headaches."

Estrogen cycles throughout the month. When estrogen levels decrease just before menstruation, during menstruation, at the beginning of menopause, while giving birth, while taking oral contraceptives, after a hysterectomy/oophorectomy, and during lactation, headaches may occur.

People describe these headaches as similar to migraines with throbbing on one side of the head, sometimes with nausea, vomiting, sensitivity to light, sometimes "auras", and other disturbing symptoms (see "migraines"). The symptoms typically last for about a day.

A Terrible Hormonal Headache

Treating Hormone Related Headaches

Over-the-Counter Treatment

• Anti-inflammatories: Begin an NSAID (common: ibuprofen, naproxen) and take it for three days before a period begins. Do not take aspirin; it thins the blood and causes more bleeding.

• Acetaminophen: Tylenol is a pain killer but does not decrease inflammation - an alternative if you cannot take NSAIDs.

• Midol (name brand), which consists of acetaminophen, caffeine, and Pyrilamine maleate (an antihistamine; it decreases inflammation and causes some vasoconstriction (helps headaches)

• Multivitamins (especially containing vitamin E and magnesium).

Considered Natural Remedies 

• ​Chamomile

• Valerian

• Primrose

• Feverfew

• Bromelain

• Soy isoflavones

• Omega 3

• CoQ10

• Black Cohosh

Prescription Medication

Given the relationship between low estrogen and the increased incidence of migraines, it makes sense to use estrogen supplementation during certain times in a woman’s life. 

There are several OCs (oral contraceptives) used to control estrogen-related headaches. These are prescribed on a case-by-case basis, depending on individual risk factors and tolerance.

Delivery methods of these hormones vary and include implants, IUDs, vaginal rings, injections, and patches.

There are three main types of birth control pills, which contain different amounts of estrogen and progestin. Monophasic pills contain the same amount of estrogen in every pill. Biphasic and triphasic birth control pills have different amounts of estrogen and progestin, which change during the month and are formulated to match the phases of a woman’s cycle.

Estrogen can be administered in ways other than oral contraceptives, such as a vaginal gel or patch. Progestin-only pills also help stabilize estrogen, keeping it from dropping very low, thereby preventing headaches. You do not want estrogen to drop too much because it is known to cause estrogen-related headaches.

Both high levels of estrogen and progesterone are reported to have some health benefits. At the same time, they are controversial because both long-term exposure to exogenous estrogens and progesterone are purported to cause or exacerbate estrogen-related breast cancer. Estrogen can also cause blood clots (and related strokes and pulmonary emboli). Estrogen-related clots tend to be more common in women who have migraines with auras and in smokers, so it is typically avoided in these people.

If you believe that your hormones may be responsible for your headaches, speak to a healthcare provider.​