October 15, 2020

Hormonal Changes and Headaches in Females

Hormonal Changes and Headaches in Females

For both men and women, there are many things that contribute to headaches. But for women, there’s a link between hormonal changes and headaches. Fortunately, there are things you can do that’ll help.

How Do Hormones Cause Headaches and Migraines?

The hormones estrogen and progesterone play a key role in regulating the menstrual cycle and pregnancy. They and may also affect headache-related chemicals in the brain. Headaches can be triggered when there’s a fluctuation in your estrogen levels, including when there’s a dip in estrogen levels around the time of your menstrual cycle.

Tension headaches and migraines are the most common headaches experienced by women. A tension headache feels like there’s a band around your head, while a migraine headache is characterized by a throbbing and pounding feeling in your head. 

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Why Do Hormones Cause Headaches and Migraines?

There are many reasons why changing levels of hormones can cause headaches. Here are some of the most common causes:

  • Birth control. For some women, the pill can make migraines worse and for others, it can lessen them. Birth control pills keep your hormone levels steady for three weeks out of every month. When you take placebo pills or no pills at all during the week of your period, your estrogen levels plummet and headaches can occur. 
  • Hormone replacement therapy. This type of medicine, taken by women during menopause to control their hormones, can also cause headaches. Estrogen patches are less likely to cause headaches because they give you a low, consistent dose of the hormone.
  • Menopause. Once you stop having periods, you’ll most likely have fewer migraines. Though some women notice that while their migraines get better, tension headaches get worse.
  • Menstruation. About 60% of women with migraines get a type of headache called menstrual migraines. Just before your period, your estrogen and progesterone levels drop, which can cause throbbing headaches. 
  • Perimenopause. During the years before you actually start menopause, your estrogen levels fluctuate greatly. Many women are more prone to get tension headaches, which are stress-related, and migraines during this time.
  • Pregnancy. During your first trimester, your estrogen levels rise quickly, then level out. Because of this, many women notice that their migraine headaches get better or go away after their third month of pregnancy. If you do still get headaches, it’s important not to take migraine medications because many are harmful to your baby. Check with your doctor about what medications are safe to take.

How to Prevent Hormonal Migraines and Headaches

There are things you can do to help prevent migraines and headaches, so talk with your doctor about which of the following might be best for you:

  • Birth control pills. Birth control pills, estrogen patches, and vaginal rings may help lower the number of menstrual migraines you have, or lessen their severity. Unfortunately, they don’t work for everyone and, in some cases, can even make your headaches worse. If you get migraines with auras, using birth control that contains estrogen and progesterone can be dangerous. There are some other reasons why your doctor may not want you to take birth control for your menstrual migraines, including:
    • A history of smoking
    • High blood pressure
    • Obesity
    • Diabetes
  • Medicines that treat migraines. The drugs typically used to treat menstrual migraines can also be used to prevent them. These medications include:
    • Eletriptan (Relpax)
    • Frovatriptan (Frova)
    • Lasmiditan (Reyvow)
    • Naratriptan (Amerge)
    • Rizatriptan (Maxalt)
    • Sumatriptan (Imitrex, Onzetra Xsail, Sumavel, Zembrace)
    • Zolmitriptan (Zomig)
  • Medicines that prevent Migraines. If you’re not responding to other treatments and have four more days of migraine days a month, your doctor may recommend preventative medications, including:
    • Seizure medications
    • Blood pressure medications (like beta-blockers and calcium channel blockers)
    •  Some antidepressants
    • CGRP inhibitors. 
  • Devices. The following medical devices may bring relief:
    • Cefaly. This small headband device sends electrical pulses through your forehead to stimulate a nerve linked with migraines.
    • SpringTMS or eNeura sTMS. You place this magnet on the back of your head, and a split-second pulse interrupts abnormal electrical activity that could lead to a migraine.
    • gammaCore. This handheld device is held over the vagus nerve in your neck and releases a mild electrical stimulation to the nerve’s fibers to relieve pain.
    • Nerivio. Operated through an app on your smartphone, this device is worn on a band on your upper arm and sends low-frequency electrical pulses for 30-45 minutes to stop the onset of a migraine headache. 

Learn More About Hormonal Changes, Headaches, and Migraines from Baptist Health

If you believe you’re experiencing headaches or migraines due to hormonal changes, contact Baptist Health to learn more about your treatment options.


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