Hormonal headaches, research states, are experienced by at least 5 million women in the UK each month. According to a new study (published Jan 2016) from researchers at the University of Cincinnati (UC), Montefiore Headache Center, Albert Einstein College of Medicine and Vedanta Research, migraine headaches heat up as women approach menopause.
Women in the perimenopausal stage – the transitional period that leads to actual menopause, experience fluctuating hormone levels that can trigger an increase in migraine attacks.
Although it remains inconclusive about exactly why hormonal fluctuations cause headaches it is now known that hormones, particularly, estrogen, play a role in the development of headaches and in particular, migraines. Doctors believe that the female hormones estrogen and progesterone may affect certain chemicals in the brain that are related to headaches and the effects they have on the brain and its blood vessels.
Estrogen causes blood vessels to dilate
Progesterone causes blood vessels to constrict
As the hormones fluctuate – blood vessels are forced to expand and contract
Result – intense pain in the head
• Migraine attacks tend to happen in the middle of a menstrual cycle when a woman is ovulating.
• Women who have never suffered from headaches may begin to see them as they enter perimenopause (the transitional stage that leads to actual menopause).
• For some women, migraines improve once their menstrual periods cease but tension headaches often get worse.
• Women who have a history of headaches around their menstrual periods or while taking oral contraceptives are more likely to experience menopause headaches.
Hormonal Headaches and HRT
HRT may improve, worsen or cause no change in some women, so it’s not for everyone. If you are taking HRT, your healthcare professional may recommend an estrogen skin patch. The patch promotes a slow, steady supply of estrogen, which is least likely to aggravate headaches.
Women who are a good candidate for hormonal therapy include those without a history of breast cancer, blood clots or other health problems. It is best to use patches or gel as these types of HRT keep hormone levels more stable than tablets and are less likely to trigger migraines. If HRT worsens your headaches, your healthcare professional may decide to lower the dose of estrogen, change to a different form of estrogen or discontinue HRT. IN this case, natural menopause relief may be an option for you to try.
Women can suffer from 2 types of hormonal headaches
Hormonal headaches caused by declining estrogen hormones
Hormonal headaches caused by elevated estrogen levels
Dramatically fluctuating oestrogen levels just before menopause can cause both types of headache
Severity of migraines typically decrease with age and the good news is that as hormones stabilise and remain low, pain should, too. For many women, menopause/postmenopause can:-
• Bring relief from migraine headaches
• Headaches can become less severe
• Common migraine headaches such as vomiting and nausea may also improve
Types of Headache Most Frequently Experienced By Menopausal Women
Migraines with aura – usually about 30 minutes before any head pain commences, a neurological phenomenon (aura) is experienced. Most auras are experienced visually by bright, shimmering lights around objects or at the edges of your field of vision.
Migraines without aura – the most common type of migraine. It can occur on one side or both sides of the head. In some cases, mood swings or fatigue may occur 24 hours before the headache. Nausea, vomiting, and sensitivity to light often accompany migraines without aura.
Tension headaches – mild to moderate pain throughout the head, likened to a tight band around the head. Tension headaches may also cause pain in the back of your neck at the base of your skull. They affect more women than men.
Sinus headaches – normally referred to as a congestion headache caused by Inflammation and blockage of the sinus cavities.
Less Common Types of Headache
Carotidyma – facial migraine. Dull, aching deep pain in the jaw or neck.
Headache free migraine – categorized by the presence of aura without headache. Occurs in people with a history of migraines with aura.
Ophthalmoplogic migraine – pain in the eye and vomiting.
Cluster headaches – relatively rare and occur in a cluster over a series of weeks or months. Short intense headaches that can occur several times a day. More common in men than women. The exact cause remains unknown.
Medication induced headache – headaches occur due to the taking of medication for an unrelated health issue.
Icecream headache – need I say more!
Treatment of Hormonal Headaches
There are two approaches to the treatment of menopause headaches
1) Treat headaches before they occur
2) Treat headache symptoms when they happen
If migraine attacks develop just before your periods and continue after menopause, women can use the same treatments they used to manage them before menopause.
Over the counter or prescription medication.
Relaxation techniques such as meditation, yoga.
Avoiding triggers such as:-
Stress and anxiety. Develop ways to deal with stress – take regular exercise and use relaxation techniques.
Too much or too little sleep. Try to get into a regular sleep pattern.
Bright lights, loud noises, strong odors.
Weather changes (difficult to avoid )
Alcohol and caffeine consumption (too much or withdrawal).
Skipping meals or fasting. Eat small frequent snacks to keep your blood sugar up. Always eat breakfast and have a small snack before going to bed.
Aspartame (common in sugar free sweeteners)
Foods that contain:-
Nitrates (cured meats, bacon, hotdogs, salami, cured ham)
Monosodium glutamate (MSG) found in fast food, chinese food, seasonings-soy sauce, fish sauce, gravy and dipping sauces, flavoured potato chips)
Tyramine found in aged cheese, aged or cured meats (eg dried sausage) marmite, soy products, fava beans, any spoiled meat (meat, poultry or fish)
Common Symptoms of Headaches
• Throbbing, pulsating pain on one side of the head.
• Intensification of pain by routine physical activity.
• Pain can last up to 24 hours plus.
• Sensitivity to light, sound and odors.
• Preceded by visual disturbances, or auras, flashing lights or sometimes a temporary loss of vision.
• Sweaty hands and feet.
Other Causes of Headache
Some women may find that chronic stress or a thyroid imbalance can be involved.
Headaches and adrenal imbalance – headaches may arise with the onset of stress. They may also arise after the “low” that often follows a caffeine or sugar “high.” It’s very common for women with adrenal imbalance to get in the habit of using sugar and caffeine to “kick start” the energy they need to get through the day. This can leave the body feeling run down and cause headaches. Adrenal headaches may also come with other symptoms like light-headedness, fatigue, or salt cravings.
Headaches and thyroid imbalance – headaches or migraines may be related to a thyroid imbalance. Unrelenting headaches related to thyroid tend to cause pain in both sides of the head and have a pressing or tightening sensation. Although generally they are not made worse by physical activity, they can be aggravated by intense light or sound. You may find that your thyroid-related headaches are combined with cold-intolerance, loss if energy, skin issues, fluid retention, and/or constipation.
A Few Points to Remember
There are many causes for headache and finding the definitive source can be difficult, Taking steps to balance your hormones makes all the difference when it comes to avoiding hormonal headaches. The problem can be treated directly at the hormonal source by using natural and alternative medicines to address the hormonal imbalance.
There is a possibility that a premenstrual migraine is coincidental, rather than a hormonal headache.
Hormones can aggravate an existing migraine attack.
Overuse of pain relieving medications for aching joints and back ache in menopause may result in an increase in headaches.
Hormonal headaches usually stop after menopause, when hormone levels are consistently low.
Menopause, Midlife and Migraine. Migraine Fact Sheets. Retrieved from http://www.migrainetrust.org/factsheet-menopause-midlife-and-migraine-10906
Hormone Headaches. Retrieved on 4 June 2015. Retrieved from http://www.nhs.uk/Livewell/headaches/Pages/Hormonalheadaches.aspx
My-Oh-Migraine: Hormonal Headaches & Menopause. Retrieved from http://www.menopause.org/for-women/menopauseflashes/women’s-health-and-menopause/my-oh-migraine-hormonal-headaches-menopause
Chronic daily headaches during perimenopause and menopause. (Nov 2012) Retrieved from http://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729?pg=2
MacGregor, E. A. (Jan 2009) Headache and hormone replacement therapy in postmenopausal women. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19094831
Migraines worsen as women approach menopause. (Jan 2016) Retrieved from http://www.eurekalert.org/pub_releases/2016-01/uoca-mwa012016.php
Martin, V. T. et al (Jan 2016) Perimenopause and Menopause Are Associated With High Frequency Headache in Women with Migrane: Restulst of the American Migrane Prevalence and Prevention Study. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/head.12763/abstract