Hormonal Migraine: A Guide to Migraine Attacks for Females

Hormonal Migraine: A Guide to Migraine Attacks for Females

Migraine attacks are not just your average headache. For over 28 million women around the nation, they are a debilitating reality that can significantly impact one’s life. Hormones, particularly estrogen and progesterone, play a pivotal role in triggering and exacerbating migraine attacks in females. Understanding the relationship between hormones and migraine throughout different stages of life can provide insights into managing and reclaiming control of these often incapacitating attacks. So, in this guide to migraine attacks for females, we'll break down the link between estrogen, progesterone, and migraine throughout the various chapters of female life. We hope to end with tips to empower you to take control of your migraines head-on.

1. The Link Between Hormones and Migraine in Females

Migraine is a predominantly female disorder”


While the entire reason as to why the risk of migraine is 3.25 times higher for women (and why females are more susceptible to every pain condition as opposed to men) is unknown, researchers believe fluctuating hormone levels play a large role in various neurologic conditions, especially migraine.

The key players here are estrogen and progesterone. Estrogen, of course, is a hormone that regulates sexual and bodily development in females. Meanwhile, progesterone acts as its sidekick, preparing the endometrium for potential pregnancy by thickening the lining of the uterus wall. 

So why are these two hormones linked to migraine? Well, this research study conducted by the NIH suspect that estrogen and progesterone have an effect on cellular excitability or cerebral vasculature. Estrogen, specifically, impacts neurotransmitters, like serotonin, norepinephrine, dopamine, and endorphins, and blood vessel expansion in the brain, which are central to migraine development. Both estrogen and progesterone can also influence the pain-processing networks and the endothelium tied to migraine. One final interesting association is the relationship between increasing estrogen levels and decreasing blood magnesium levels – also linked with migraine development.

These cerebral relationships set the stage for why researchers suspect that fluctuations in female hormones, especially estrogen, have been linked to the onset of migraine attacks.

2. Menstruation

One of the biggest indications of this is the fact that until puberty, the prevalence of migraine in females and males is equal. Yet once puberty begins in females, hormone levels begin to fluctuate. For more than 17 million females, these hormone fluctuations manifest in migraine.

Known as menstrual migraines, these migraine attacks are most likely to develop either the two days before your period or the first three days during the period. For frequent migraineurs, these attacks are usually more severe than traditional migraine and are more likely to come back the following day. Like other types of migraine, your migraine symptoms may get worse with movement, light, smells, or sound. You can expect them to last anywhere from several hours to days.

The culprit? The drop in estrogen levels. Just before the start of your menstrual flow, levels of estrogen drop. This drop in estrogen is associated with changes in blood vessel constriction and blood flow. As a result, menstrual migraines regularly occur during or after estrogen and progesterone drop to their lowest levels.

3. Pregnancy

Pregnancy is a time of remarkable hormonal changes as a woman's body adapts to nurturing a new life. While some women experience relief from migraines during pregnancy, others may find that their migraines either persist or worsen. The first trimester, marked by rapidly changing hormone levels, can trigger migraines, while the second and third trimesters may offer some relief due to stabilized hormone levels.

One research study reported that out of the participants, 89% of women had either no attacks or fewer attacks during pregnancy. Another study of 49 women reported an 11% reduction in migraine attacks during the first trimester, a 53% reduction in migraine attacks during the second, and a 79% reduction during the third. 

It is especially important to note that for the fraction of pregnant females that suffer from migraine during pregnancy, treatment can look a lot different and typical prescription medication should be altogether avoided. 

4. Menopause

Finally, menopause marks the end of a woman's reproductive years and a significant shift in hormone production. As menopause approaches, your hormone levels can swing up and down, your periods can become irregular, and your ovaries produce less amounts of estrogen. For some women the perimenopause (or pre-menopause) phase can result in irregular, frequent, more intense migraine attacks.

Once the body adjusts and menopause occurs, many women (up to 70% according to Dr. Mays) find that their migraine attacks dramatically reduce in frequency, or may even altogether stop. 

5. Empowering Women with Hormonal Migraine: Living Life to the Fullest

“I saw many doctors who wrote me off as just being ‘overstressed…’ Their advice was to go home, relax and have a glass of wine.”

-Cindy McCain

Females, living with hormonal migraine can be challenging, but it's important to remember that you're not alone. Migraine is a disease, and know you are heard.

Empowerment comes from understanding your triggers, seeking appropriate care, and making positive lifestyle choices. Here are some tips to empower women with hormonal migraine to live life to the fullest:

  1. Knowledge is Key: Educate yourself about your unique triggers and patterns. Keeping a migraine diary can help identify potential triggers and patterns related to hormonal fluctuations.
  2. Lifestyle Management: Maintain a healthy lifestyle by prioritizing regular sleep, staying hydrated, managing stress through relaxation techniques, and adopting a balanced diet rich in whole foods and free of your triggers.
  3. Stress Relief: Practice stress-relief techniques such as meditation, yoga, deep breathing exercises, and mindfulness. Managing stress can work wonders in helping to prevent migraine attacks.
  4. Support Network: Build a support network of friends, family, and fellow migraine sufferers who understand your struggles and can provide emotional support.

In conclusion, the relationship between hormones and migraine in females highlights the need for tailored management strategies throughout different life stages. By understanding the triggers and patterns unique to hormonal migraines and adopting a holistic approach to managing them, women can reclaim their lives from these debilitating attacks. 

Remember, you have power to take charge of your health and live life to the fullest!


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