Youre Dealing With Hormonal Issues Like Menstruation
Thanks to the drop in estrogen right before menstruation, many people experience PMS-related headaches. In fact, menstruation is one of the biggest migraine triggers for people who have periods.
But it’s not the only time a change in estrogen levels can cause a headacheboth perimenopause and postpartum periods are marked by a significant drop in estrogen, and as a result, often come with headaches. Pregnancy, too, affects estrogen levels, so you may notice that your headaches worsen during this time, the Mayo Clinic says. “Any time of hormonal change is a vulnerable time for headaches,” Dr. Hutchinson says.
Fix it: If you notice that your headaches appear to be cyclical and coincide with your period, its worth bringing this up with your doctor, who may suggest going on hormonal birth control or switching your current birth control.
As the Mayo Clinic explains, hormonal birth control can have an effect on your headache patterns; and for some people, hormonal contraception may make headaches less frequent and intense because they reduce the drop in estrogen that happens during your menstrual cycle.
For short-term headache relief around your period, typical headache remedies can help, like using ice or a cold compress, practicing relaxation techniques, or taking an over-the-counter pain relief medication.
Causes Of Headache Before Period
Your migraine before period is most likely linked to the hormone estrogen. This female hormone controls the brain chemicals that affect headache-related chemicals in the brain. When youre experiencing a headache, this means that theres a drop or change in estrogen levels.;
Theres a wide range of reasons for the change in hormone levels, including:;
- Menstrual cycle. Prior to your period, estrogen and progesterone fall to their lowest levels.
- Pregnancy. During the first trimester, estrogen levels rise quickly, then level out. Because of this, many women notice that their migraines get better or go away after their third month of pregnancy.;
- Hormone replacement therapy. The hormones that women take during a replacement therapy can also set off headaches.
- Menopause and perimenopause. During the years leading to menopause, women have more headaches due to the fluctuating hormone levels. Many women say that their migraines become less severe as they reach menopause.;
What Are The Causes
Doctors are learning more about what brings on these headaches, which often run in families. Some are the result of changes in your brain chemicals. Abnormal brain activity is also involved.
Every person who has migraines has different triggers, but common ones include a lack of sleep, caffeine, and being under stress.
Most people who get chronic migraines are women. This may be because hormone changes are another well-known cause. These shifts happen around your monthly period, as well as during pregnancy and through menopause. Birth control can also play a role.
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What Tests Are Used To Find Out If I Have Migraine
If you think you get migraine headaches, talk with your doctor. Before your appointment, write down:
Your doctor may also do an exam and ask more questions about your health history. This could include past head injury and sinus or dental problems. Your doctor may be able to diagnose migraine just from the information you provide.
You may get a blood test or other tests, such as CT scan or MRI, if your doctor thinks that something else is causing your headaches. Work with your doctor to decide on the best tests for you.
What Are Period Migraines
First things first: You may get torturous headaches during your period, but that doesnt mean they are migraines. Dr. Holly L. Phillips, an internist who practices in New York City, says that more than 90 percent of headaches fall into the category of tension-type headaches. Far fewer people actually experience true migraines. Statistics published in Cephalalgia state that 11 percent of people worldwide get migraines, while tension-type headaches are far more common. Theres also a socio-economic link to your risk for any type of migraine, with people from lower-income households experiencing migraines at higher rates, likely due to more stressors that can trigger them.
There seems to be some confusion about what migraines really are and it often involves the level of pain. We tend to think of migraine as causing more severe pain than other types of headaches, but thats not always the case, says Phillips.
You can spot the difference between a menstrual migraine and a premenstrual syndrome headache by taking careful note of your symptoms. According to the Mayo Clinic, migraine headaches typically last anywhere from four hours to three days. Migraines are characterized by throbbing pain, usually on one side of your head, in addition to other symptoms. You may also have severe nausea that can cause vomiting.
- Sensitivity to light, sound, and smells
- Disturbances in your field of vision, known as migraine aura
- Dizziness and exhaustion, even after the pain subsides
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Other Causes Of Migraine Attacks
Certain risk factors, such as age and family history, can play a role in whether you get migraine or menstrual migraine. Simply being a woman puts you at increased risk.
Of course, you cant control your sex, age, or family tree, but it may help to keep a migraine diary. This can help you identify and avoid triggers.
Medicines That Prevent Menstrual Migraine
If your periods don’t come on schedule or you also get migraine headaches at other times in your menstrual cycle, you can take preventive medicine every day. Drugs that prevent migraine headaches include:
- Some types ofÂ;antidepressants
- Some types of antiseizure medicines
- Blood pressure medicines such as beta-blockers and calcium channel blockers
- CGRP inhibitors, these are a new class of preventive medicine
Devices which may be used for treatment or prevention include:.
- Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked withÂ;migraines
- Spring TMS or eNeura sTM, a device for people who have an aura before migraine headaches. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.Â;
- Noninvasive vagus nerve stimulator Â;gammaCoreÂ;is a hand-heldÂ;portable deviceÂ;placed over the vagus nerve in the neck. It releases a mild electrical stimulation to the nerve’s fibers to relieve pain.
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Are Migraine Headaches More Common In Women Than Men
Yes. About three out of four people who have migraines are women. Migraines are most common in women between the ages of 20 and 45. At this time of life women often have more job, family, and social duties. Women tend to report more painful and longer lasting headaches and more symptoms, such as nausea and vomiting. All these factors make it hard for a woman to fulfill her roles at work and at home when migraine strikes.
Should I Have A Hysterectomy
Hysterectomy has no place solely in the management of migraine. Studies show that migraine is more likely to deteriorate after surgery. However, if other medical problems require a hysterectomy, which can induce the menopause, the effects on migraine are probably lessened by subsequent oestrogen replacement therapy.
Gonadotrophin-releasing hormones create a medical menopause and have been used to assess the likely outcome of a hysterectomy, although symptoms of oestrogen deficiency such as hot flushes, limit their use. The hormones are also associated with bone thinning and should not usually be used for longer than six months without regular monitoring and scans to test bone density. Add-back continuous combined oestrogen and progestogen can be given to counter these difficulties. Given these limitations, in addition to their high cost, this type of treatment is generally only used in specialist departments.
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Contraceptives As A Treatment For Menstrual Migraine
Hormonal contraceptives are a useful option if menstrual migraine is a problem and you also need contraception. Options may include:
Progestogen-based contraceptives to prevent ovulation .
- These include desogestrel – Cerazette®), the contraceptive implant , or the contraceptive injection.
- Most women with migraine at any age can use progestogen-based contraceptives – even if they have migraine attacks with aura.
- The only time you would not be advised to use progestogen-based contraception is if you started to develop migraine attacks with aura only after starting to take one of these types of contraceptive.
Combined hormonal contraceptives ;also prevent ovulation; however, during the pill-free week some women with menstrual migraine will still experience their headaches. Moreover, not all women with menstrual migraine can take these treatments.
- If you have or develop migraine attacks with aura, you should never use combined hormonal contraception again at all.
- If you have migraine attacks without aura you should not use combined hormonal contraception again if you are aged 35 or older. See the separate leaflet called Migraine,;which deals with migraine with aura.
In some women with migraine who use combined hormonal contraceptives, migraine attacks are also triggered by the drop in the blood level of oestrogen during the pill-free or patch-free interval.
How The Menstrual Cycle Can Cause Migraine
Women who experience menstrual migraine may be sensitive to hormonal fluctuations experienced just prior to the onset of menstruation. Just before menstruation there is a natural drop in progesterone levels.
The two important females hormones involved are progesterone and estrogen.
Progesterone is a natural steroid hormone involved in the female menstrual cycle that stimulates the uterus to prepare for pregnancy. It is a naturally occurring hormone in the female body that helps a healthy female function normally.
Estrogens or oestrogens , are a group of compounds that are important in the menstrual and reproductive cycles. They are also naturally occurring steroid hormones in women that promote the development and maintenance of female features of the body.
It is important to note that estrogens are used as part of some oral contraceptives and in estrogen replacement therapy for some postmenopausal women.
Throughout the natural menstrual cycle the levels of these hormones fluctuate. During the cycle, the levels of progesterone and estrogens also change in relation to each other. See the image below for how these levels change throughout the cycle.
These fluctuations are normal and part of being a healthy and fertile woman.
Several research studies confirm that migraine is significantly more likely to occur in association with falling estrogen in the late luteal/early follicular phase of the menstrual cycle.
Is estrogen withdrawal the sole trigger for menstrual migraine?
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When To See A Doctor
If period headaches interfere with daily life, talk to a doctor.
When PMS is the underlying issue, a range of treatments can help, including hormonal contraception, antidepressant medication, and calcium supplements.
The right course of treatment will depend, in part, on the severity and specific symptoms.
Healthcare professionals can recommend ways to help prevent menstrual migraine headaches. They can also prescribe stronger pain relief medication, when necessary.
In pregnant women, a persistent headache can be a symptom of preeclampsia. Anyone who thinks that they may be experiencing this potentially serious issue should seek medical attention.
What Causes Period Migraines
A quick biology refresher for people with periods: Though most people only bleed for three to five days, your body goes through the menstrual cycle all month long. The levels of both estrogen and progesterone drop off sharply at the end of each monthly cycle, signaling to your body that its time to reset your cycle and begin your period. Dr. Lucky Sekhon, a New York City-based, board-certified OB-GYN and fertility specialist, tells Allure that migraines that show up two or three days before your period can be triggered by this steep hormone drop.
If you switched birth control and began to experience menstrual migraines shortly after, that switch may be the culprit. Its possible that a higher dose of estrogen in your birth control pills can make the hormone drop even steeper. Sometimes, all that is required to improve or prevent migraines is switching to a pill with a lower estrogen content, says Sekhon.
A 2013 literature review published in the Journal of Headache and Pain suggests that people who have migraines might even want to stick to progestin-only pills if they are going to use an oral contraceptive.
And menstrual migraines may be worse for people who are approaching menopause. ;
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Feeling Colder During Migraine
I never thought of hypothermia as a migraine symptom, but I knew several of my attacks came with a sensation of cold. I just could not warm up sometimes. Id be sitting there actually shivering. I didnt have a fever I was just experiencing a cold sensation right to my core. During these attacks, I would switch from ice packs to heat. I would be bundled up with blankets and retreat to my room. This symptom always freaked me out because it was so far from my norm. Needless to say, I was once again relieved to find cases of people suffering from migraine who also were experiencing hypothermia! I immediately felt validated after reading over the cases. I had found that my body temperature issues were not just in my head.
What Are The Symptoms Of A Menstrual Migraine
The symptoms of a menstrual migraine are the same as the symptoms for other types of migraines:
- Headache pain that ranges from dull to a severe throb.
- Feeling very warm or cold .
- Sensitivity to light, noise and smells.
- Tender scalp.
- Nausea and vomiting, stomach upset, abdominal pain.
- Diarrhea or fever .
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Whats A Migraine What Does It Feel Like
A migraine is more than a bad headache. Its a neurologic disease with a series of symptoms that might include debilitating pain on one side of your head that you may describe as pulsing or throbbing. Menstrual migraines, also known as hormone headaches, happen right before or during a womans period and may get worse with movement, light, smells, or sound. Your symptoms may last for a few hours, but theyll likely last days.
Its estimated that 70% of people who experience migraines are women. Of these women, 60% to 70% report a connection between their menstruation and their migraine attacks. Women experience migraine attacks three times more frequently than men.
A menstrual migraine is one of several types of migraine headaches. Examples of other migraines include migraine with aura, migraine without aura and chronic migraine.
What Can My Doctor Do To Help Me
If diary cards confirm that your attacks always occur two or three days around the first day of your period, your doctor might consider ways to prevent migraine. They are less effective in women with additional attacks at other times of the cycle resulting from non-hormonal triggers.
Depending on the regularity of your menstrual cycle, whether or not you have painful or heavy periods, menopausal symptoms, or if you also need contraception, several different options can be tried. Although none of the drugs and hormones recommended below are licensed specifically for management of menstrual migraine, doctors can prescribe them for this condition if they feel that this would be of benefit to you.
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What Are Ocular Migraines
The term ocular migraine is used to describe a migraine that takes place in the eye. These migraines can manifest as a variety of different visual disturbances including:;
- Zigzag lines;
- Bright flashes of light;
- Scotomas or blind spots;;
- Scintillations or sparkling, usually of lights or stars but can also be blind spots;
These are the most common symptoms of an ocular migraine, but;the visual disturbance caused by this type of migraine can manifest as anything from shadows in the vision to a complete but temporary;loss of vision in the eye.;;
What makes an ocular migraine different from an aura is that it typically only occurs in one eye and lasts;only a few minutes to an hour. They are also not followed by an actual migraine headache .
What Are Some Ways I Can Prevent Migraine
The best way to prevent migraine is to find out what triggers your attacks and avoid or limit these triggers. Since migraine headaches are more common during times of stress, finding healthy ways to cut down on and cope with stress might help. Talk with your doctor about starting a fitness program or taking a class to learn relaxation skills.
Talk with your doctor if you need to take your pain-relief medicine more than twice a week. Doing so can lead to rebound headaches. If your doctor has prescribed medicine for you to help prevent migraine, take them exactly as prescribed. Ask what you should do if you miss a dose and how long you should take the medicine. Talk with your doctor if the amount of medicine you are prescribed is not helping your headaches.
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Hormonal Contraception For People With Migraine
People with migraine with aura are not recommended to use combined hormonal contraceptives . Having migraines with aura is a risk factor for experiencing a stroke , plus taking combined hormonal contraceptives up to doubles that risk . The combination of these risk factors is associated with a 3x increased risk of stroke, compared to people with migraine who donât use combined hormonal contraceptives .
The United States Centers for Disease Control and Prevention says people with chronic migraine are safe to use certain forms of contraception:
any form of emergency contraception
Most people who experience migraine without aura can use combined hormonal contraceptives, too, as the risk of increased stroke is outweighed by the benefits that the pill offers ; however, people with other risk factors for stroke, such as older age and cigarette smoking, may be advised not to use combined hormonal birth control .
People with non-migraine headaches do not have any restrictions on hormonal birth control .
Some birth control options may be safer than others, depending on your age and other risk factors . Speak to your healthcare provider to figure out what is the best contraceptive method for you.
to track your headaches and see how they appear in relation to your cycle.
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