Menstrual Migraines and Hormonal Headaches
“70% of female migraine sufferers report a worsening of migraines just before their periods.”
~ Dr. Lara Briden, The Period Repair Manual
Migraines are a real problem and they can be debilitating for some menstruators. So let’s dig into the why and what you can do about it!
Causes of Menstrual Migraines: The Fluctuation of Estrogen
Estrogen might be a key factor in the menstrual migraine conversation. Our female Body goes through beautiful ebbs and flows through the month with estrogen and progesterone (see image below). During the first part of your cycle, from about day 7 to 14, estrogen is really rising rapidly, preparing the body and uterine lining for the possibility of pregnancy.
Then after ovulation, if conception doesn’t occur, then estrogen drops rapidly, it then has a slight peak and a complete drop when you shed your uterine lining with the start of the bleeding phase of your period. Either of these drops also causes a dip in a brain chemical called, Serotonin, you’ve probably heard of it! Serotonin, is the brain chemical that is responsible for our sense of happiness and wellbeing. With this big dip in estrogen and subsequent drop in serotonin, some women have a migraine. It is believed that both low serotonin and low estrogen could be potential menstrual migraine triggers! A double whammy!
Lower Pain Threshold
To make things even worse for migraine sufferers, with the drop in estrogen and serotonin also comes a drop in our ability to manage pain. Estrogen actually regulates pain through its interaction with endorphins which allows the brain to dull the signal of pain when estrogen is high.
When we have those estrogen dips, however, in the second half of our cycle, we become much more sensitive to pain. I first learned about this from my acupuncturist 5+ years ago because It was always so much more painful to get acupuncture when I was about to get my period!
So on the flip side of too little or the drop in estrogen, we have to consider the opposite – TOO MUCH estrogen and specifically estrogen’s relationship with Histamine. This is something we’ll be posting about in a blog and podcast next month so please subscribe to the SHE Talks Health newsletter or the SHE Talks Health podcast to be the first to know!
Too much estrogen at ovulation can trigger your mast cells to release too much histamine causing a whole host of symptoms including headache. And of course, because this is an article about double whammies the high estrogen also decreases the enzyme DAO which is what actually clears histamine. This is why some women experience menstrual migraines in the middle of the cycle or if you are one of the unlucky ones you might have too much estrogen all month long – cue the month long headaches! Ouch!
Non Hormonal Reasons for Headaches/Migraines
- Genetics – MTHFR
- Nutrient Deficiencies
- Birth Control
MTHFR GENE MUTATION
WHAT IS AN MTHRF!? or as I commonly refer to it the (motherf*ck*r gene mutation!)? It stands for Methylene tetrahydrofolate reductase (MTHFR) and it is responsible among many tasks to help regulate the use of key B vitamins like B9, B12 and B6. About 10-30% of the population has a SNP in the MTHFR gene causing them to have trouble utilizing these B vitamins and this has been associated with migraines. My favorite line of defense is actually Beef Liver Capsules + a diet rich in bio available B vitamins from grass fed red meat and leafy green vegetables. If you are not an animal lover, talk to your doctor about whether taking a B Complex with the bioavailable methyl B vitamins is a good idea. Look for Methyl-Cobalamin (b12), Pyridoxal 5′-Phosphate (vitamin B6) and Folate rather than Folic Acid for B9) *use code SHE10 for 10% off Paleo Valley Beef Liver Capsules.
Magnesium about 50% of migraine sufferers are deficient in magnesium, in fact Dr. Alexander Mauskop from The New York Headache Center recommends that all migraine patients be treated with magnesium. Magnesium is such a super mineral for hormones, it is usually my very first step when supporting someone with migraines but also with any sort of PMS symptoms since it reduces inflammation, calms your nervous system and even helps to balance brain chemicals! Most women need between 300-500mg of magnesium in a day and your needs increase after ovulation. The good news magnesium is plentiful in many foods like: leafy greens, dark chocolate, pumpkin seeds, sunflower seeds, almonds, avocados, bananas. If this isn’t sufficient I’m a big fan of Magnesium Glycinate for a bit of extra support.
B2 (Riboflavin) at doses of 400 mg/daily has been shown to help with migraines at 50% reduction compared to 15% in the placebo! B2 regulates serotonin and helps the energy houses of our cells (called mitochondria) work well. They are also helpful in people with that genetic variant, MTHFR mentioned above. Make sure to consult with your physician before taking any supplements.
Iron deficiency caused by heavy periods can actually cause a headache after your period, from the loss of blood and therefore the anemia. It is critical that if you believe you could be iron deficient that you get a full iron panel including TIBC & Ferritin and discuss with your doctor the best ways to incorporate more iron into your diet, supplements or medications as necessary for you.
Some birth control MAY make migraines worse. In fact, I have a client in EmpowerHER, who came to us on birth control which chronic, daily migraines. We worked to support her liver, gut and adrenals and she was able to successfully transition off the pill with no side effects of post birth control syndrome and EVEN better, no more migraines! To add insult to injury, hormonal birth control carries a higher risk of stroke for people with migraines. The reason some women may experience more migraines while on the pill, is most relevant to the estrogen containing contraception because of the withdrawal from synthetic estrogen during one week of the pill pack (the sugar pill week) That drop is estrogen that I described above is what some migraine sufferers on the pill go through each month when they stop taking the estrogen containing pills.
- red wine
- aged cheese
- nitrites found in hot dogs and deli meats
- food additives like msg
- low blood sugar
- neck and shoulder tension
- certain medications (including some headache medications!)
- perfume and other strong odors,
- bright lights
ACTION STEPS TO REDUCE MENSTRUAL MIGRAINES/HORMONAL HEADACHES
- Keep a headache journal – if you’ve been reading though this and you just don’t know what your triggers are then it might be an idea to track your headaches. Look for clues like – I always get a headache when I get less than 7 hours of sleep, or right before my period, or right at ovulation or right after I eat bread!
- Know your triggers – for example, one study found that avoiding wheat eliminated migraines 89% of the time!
- Lower your stress – we know that stress causes all sorts of hormonal imbalances including excessive estrogen but just the nature of stress itself can make us more prone to tension headaches. Regular massage, meditation, walking, breath work and yoga can all be effective tools to destress.
- Aroma therapy – lavender and peppermint have been extremely effective for in the moment headache support.
- Incorporate an anti-inflammatory eating style full of omega 3 rich foods (think flax and salmon), anti-oxidants (think organic berries) and phytonutrients and fiber (think leafy greens) Reducing inflammation causing foods like soy, wheat, dairy, sugar and transfats can also help.
- Supplements (my Fullscript link is below!)
- Feverfew – is a natural anti-inflammatory that prevents and reduces migraines. However if you are on any blood thinner or are pregnant this one is one to skip. The Dose is 25 mg/daily.
In order to find the best action plan for you, you really do need to get your hormones tested — I highly recommend DUTCH testing which is what I use inside my programs so we can actually get to the true cause of what is causing these horrible symptoms and to give you an exact action plan as to how to attack it.
 S. Menon, R. A. Lea, B. Roy et al., “Genotypes of the MTHFR C677T and MTRR A66G genes act independently to reduce migraine disability in response to vitamin supplementation,” Pharmacogenetics and Genomics, vol. 22, no. 10, pp. 741–749, 2012.
 Role of magnesium in the pathogenesis and treatment of migraines
 Feverfew for preventing migraine
 Low serum diamine oxidase (DAO) activity levels in patients with migraine
Disclaimer: This information is being provided to you for educational and informational purposes only. It is being provided to educate you about options to take care of your body and as a self-help tool for your own use so that you can reach your own health goals. It is not intended to treat or cure any specific illness and is not to replace the guidance provided by your own medical practitioner.
If you are under the care of a health care professional or currently use prescription medications, you should discuss any dietary changes or potential dietary supplements use with your doctor, and should not discontinue any prescription medications without first consulting your doctor.
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