How Estrogen Levels Impact Migraines
Migraine affects over 39 million Americans, and women are affected more than men. This gender discrepancy in migraine prevalence is largely attributed to the natural fluctuation of the hormone estrogen. Cyclical changes, as well as erratic fluctuations in estrogen levels, can precipitate migraines in migraine-prone women.
Estrogen Levels and Migraines
Estrogen levels fluctuate throughout the menstrual cycle. Prolonged estrogen changes occur during pregnancy, breastfeeding, perimenopause, and menopause. Oral contraceptives and hormone replacement therapy (HRT) also influence estrogen levels.
Menstrual Migraines
Of the women who have migraine, between 20 to 60 percent report that they have them during menstruation. A menstrual migraine is defined as a migraine that occurs during the perimenstrual stage, which begins two days prior to the start of menstrual flow and ends around day three of a person’s period. During this window, estrogen levels drop.
Lifestyle Management
When you know that you are due for a menstrual migraine, be sure to get enough rest, don’t skip meals, and maintain moderate caffeine intake. Avoid any of your migraine triggers and be prepared with an ice pack, tea, or whatever normally makes you feel better.
Medical Prevention
You may opt to work on preventing your menstrual migraines by taking medication a few days before you expect a migraine to begin. Taking an NSAID or the long-acting triptan Frova (frovatriptan) a couple days prior to your period may prevent a migraine from occurring in the first place, but be aware that this strategy doesn’t always work. It might decrease the severity or delay your migraine episode.
Abortive Therapy
Abortive therapy describes medications used to end a migraine attack. Over-the-counter medications like acetaminophen or ibuprofen are often effective, but some migraineurs need stronger prescription medications, with triptans being among the most commonly prescribed for menstrual migraines.
Complementary and Alternative Therapy (CAM)
Magnesium supplements, taken at a dose of 400 to 500 mg per day may be helpful in preventing menstrual migraines. If you want to try this strategy, you should start taking daily magnesium about two weeks prior to the start of your period. Be sure to discuss this with your healthcare provider first.
Perimenopause
Perimenopause is the period of time just prior to menopause when the ovaries begin to slow down their estrogen production. Estrogen levels decline, but not in a gradual manner. Instead, estrogen fluctuates sporadically, sometimes triggering clusters of migraines that can occur almost daily for weeks and are often interspersed with months of no headaches at all.
Menopause
Menopause is defined as the time when a person stops having menstrual cycles for 12 months. This happens when the ovaries have stopped producing estrogen. Migraines often get better after menopause, but in rare cases, they worsen.
Summary
Some women experience the effects of the estrogen migraine link on a monthly or bimonthly basis. Major life stages that involve estrogen changes, such as breastfeeding and menopause, can also alter migraine frequency and severity.
FAQs
- Q: Can I prevent menstrual migraines?
A: Yes, by taking medication a few days before your period or using lifestyle management techniques. - Q: Will my migraines get better after menopause?
A: Migraines often get better after menopause, but in rare cases, they worsen. - Q: What can I do to manage my migraines during perimenopause?
A: Consider taking hormone therapies that stabilize estrogen levels or using complementary and alternative therapies like magnesium supplements.
