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Migraines and Hormones

© Barbara J. Mitchell

It's a fact of life. More women have migraines and that's because there is a connection with the level of estrogen in the body. Men also have some estrogen in their bodies, just as women have some testosterone, but they don't have the monthly fluctuation in estrogen level that women do. It's a sort of withdrawal effect, which you'll understand if you've ever tried to cut out caffeine and suffered awful headaches for a few days.

Hence, menstrual migraines. A menstrual migraine is defined as one that occurs within the time frame of 2 days before the onset of menses and 4 days after onset. Not all migraines are caused by estrogen withdrawal, of course, but 60% of women say their migraines are associated with their menstrual cycle, and many women report that their migraines greatly decrease or go away altogether with menopause.

Just to make things confusing, you may also get migraines with an increase in estrogen, for instance when you first begin taking birth control pills.

Some doctors are prescribing medications such as Amerge to take for a few days beginning 2 or 3 days prior to the anticipated start of menstrual flow. There has been quite an impressive success rate with this drug. A recent report indicated that Rizatriptan taken soon after onset of menstrual migraine is also highly effective.

But let's say you don't want to take drugs because you would like to become pregnant or think you may actually be pregnant. Or you might be as averse to taking drugs as the reader who wrote on our discussion page recently, "Is anyone as tired as I am with drugs as the panacea for migraine?"

There are other methods of fighting migraines, perimenstrual or not. That reader has had some success with vitamins she doesn't specify. A recent study says a low-fat vegetarian diet may reduce PMS symptoms (which would include migraine) as well as menstrual pain.

You're a dedicated carnivore? Then I would suggest taking a good look at your overall health and lifestyle, something you need to do anyway if you want to have a baby. Keep a headache diary to see if you can discern a pattern and therefore figure out your individual migraine triggers. Or follow the advice of Dr. David Buchholz - see my 4/4/00 article, "Headache Expert Claims 'The Book on Headaches is Wrong'." This will take discipline and sacrifice, but we're talking about the quality of your life after all.

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