Cyclical changes, as well as erratic fluctuations in estrogen levels, can precipitate migraines in migraine-prone women.
Estrogen levels fluctuate throughout the menstrual cycle.
Prolonged estrogen changes occur during pregnancy, breastfeeding, perimenopause, and menopause.
Illustration by Cindy Chung, Verywell
Oral contraceptives andhormone replacement therapy (HRT)also influence estrogen levels.
Estrogen has a known impact on the action of serotonin, a neurotransmitter that modulates pain and mood.
It is likely that both of these factors, and possibly others, could mediate the estrogen-migraine connection.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
During this window, estrogen levels drop.
There are several strategies you’ve got the option to use to treat or prevent your menstrual migraines.
Abortive Therapy
Abortive therapy describes medications used to end a migraine attack.
Be sure to discuss this with your healthcare provider first.
Progesterone declines along with estrogen right before your period, but it does not do so mid-cycle.
Hormone Therapy Use
Many people use prescription hormonal therapy for treatment of medical conditions or for contraception.
These medications contain estrogen, and they generally help reduce migraines, but that isn’t always the case.
But for some people, oral contraceptives can actually trigger or worsen migraines.
HRT may help prevent migraines due to the consistent dosing, but this treatment can increase migraines as well.
That said, about 8 percent report a worsening of their migraine attacks.
Most migraine treatments are not recommended during pregnancy.
Compazine (prochlorperazine) and most anti-emetics (anti-nausea medications) are generally considered safe.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Some people find relief of migraines during perimenopause by taking hormone therapies that stabilize estrogen levels.
Menopause
Menopauseis defined as the time when a person stops having menstrual cycles for 12 months.
This happens when the ovaries have stopped producing estrogen.
Migraines often get better after menopause, but in rare cases, they worsen.
Keep in mind that new headaches or migraines after menopause should be medically evaluated.
Summary
Some women experience the effects of the estrogen migraine link on a monthly or bimonthly basis.
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Calhoun AH, Batur P.Combined hormonal contraceptives and migraine: An update on the evidence.Cleve Clin J Med.
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