Migraines, Headaches, and Hormones
In this article
If you’re a woman who gets migraines, you’ve
probably noticed they’re likely to hit just before your period. These
headaches are called menstrual migraines.
What’s the Link Between Hormones and Headaches?
Headaches in women, particularly migraines, are tied
to shifts in the levels of the female hormone estrogen during your
menstrual cycle. Estrogen levels drop right before the start of your
menstrual flow.
Premenstrual migraines regularly happen during or
after the time when the female hormones, estrogen and progesterone, drop
to their lowest levels.
Migraines often go away during pregnancy, especially
if they’re tied to your period. Or you might get headaches during the
first trimester, only to have them vanish after the third month of
pregnancy.
What Triggers Hormonal Migraines in Women?
Birth control pills as well as hormone replacement therapy during menopause can trigger migraines in some women.
As early as 1966, investigators noted that migraines
may be worse for women taking birth control pills, especially those
with high doses of estrogen. Pills with low doses of estrogen and those
with progesterone cause fewer side effects.
How Do You Treat Menstrual Migraines?
Nonsteroidal anti-inflammatory medications (NSAIDs) are the medications of choice to stop a menstrual migraine.
The NSAIDs most often used for menstrual migraines include:
- ibuprofen (Advil, Motrin), ketoprofen (Orudis)
- fenoprofen calcium (Nalfon), naproxen (Aleve, Naprosyn)
- nabumetone (Relafen)
Your doctor may tell you to begin treatment 1 to 2 days before your period starts and to keep taking it until the period's over.
Other drugs are given by prescription only. They include:
- Small doses of ergotamine drugs (Bellergal-S, Cafergot, Migranal)
- Beta-blocker drugs such as propranolol (Inderal)
- Anticonvulsants such as divalproex sodium (Depakote), valproate (Depacon)
- Calcium channel blockers such as verapamil (Calan, Covera-HS)
Your doctor will likely tell you to start one of
these drugs a couple of days before your period, and take it until the
period ends.
Your doctor may suggest a diuretic during your
period. He may also tell you to limit how much salt you eat before your
period starts.
If you still can’t get relief, your doctor might suggest a drug that affects hormone levels, leuprolide acetate (Lupron).
Migraines, Headaches, and Hormones
(continued)
In this article
Migraines and Birth Control Pills
Because of a greater likelihood of strokes, if you have migraines with aura, you should not take birth control pills.
Even if you don’t have aura, your doctor may not
want to prescribe birth control pills if you’re over 35 and you smoke,
have high blood pressure or cholesterol, are obese or have diabetes.
How Do You Treat Migraines During Pregnancy?
Avoid migraine treatments during pregnancy. Not only can these drugs affect your uterus, they can also affect your baby.
You might try a mild pain reliever, like Tylenol, but discuss the safety of any drug with your doctor before you take it.
What Are Treatments for Menopausal Migraines?
For many women, migraines get better once their periods have finally stopped.
If you're on estrogen replacement therapy and your
migraines get worse, your doctor may lower the dose, prescribe it in a
different form, or have you stop it altogether.
An estrogen patch (like Estraderm) can provide even levels of the hormone and may be less likely to worsen migraines.
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