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Hormones and headaches: know the facts

Do you tend to get headaches right before or during your period? Perhaps you’re in the throes of perimenopause and headaches have become annoyingly familiar. Or worse, do you suffer migraines during certain times of the month? Maybe you’re pregnant, and never really endured regular headaches until now, as you slog through your first trimester.

For women, headaches are commonly related to hormones. Headaches may come and go depending upon the state of your hormonal fluctuations. While they aren’t typically a super serious matter for many, they can be downright debilitating for others. This is what we’re going to explore today — hormonal headaches, and what you can do to decrease their presence in your life!

Most common causes of headaches for women

Ever wondered why your best friend seems to almost never suffer headaches, while you get a migraine every month like clockwork? Our bodies are all different, and some of us are luckier than others. The following are some of the most common reasons you may get headaches, while your best girlfriend remains headache-free:


Some women are plagued with headaches thanks to their genes. Why does one woman deal with migraines in her life, while another has never experienced one at all? The answer typically lies within your genetic makeup. A 2018 study, published in Cell Press, aims to shed light on the link between migraines and family genetics. If you’ve failed to win the genetic lottery when it comes to headaches and migraines, you’re not alone.


Some of us have food allergies and sensitivities. When we eat gluten or dairy products, for example, we become prone to headaches. These dietary triggers need to be removed from the diet to reduce the risk of recurring headaches.

These types of food sensitivities can be difficult to diagnose, as they don’t normally show up on regular allergy tests. An elimination diet can help you find out if certain foods are to blame for your headaches. This involves removing potentially problematic foods from your diet and reintroducing them one at a time to monitor reactions. Common culprits include aged cheese, alcohol, food additives and preservatives such as nitrates and MSG, peanuts, smoked fish, pickled foods, onions, organ meats, and cultured dairy products.

Hormonal changes

We experience hormonal changes all the time. It’s the more drastic ones that cause headaches. These more dramatic fluctuations happen during certain times of the menstrual cycle, during pregnancy, during perimenopause, and during menopause. If you’re using hormone replacement therapy, and/or oral contraceptives, your hormones are most definitely in flux. If you’re one of those women who experience headaches linked to hormonal changes, there’s a good chance these pains will pass, once you reach menopause.

The estrogen connection

Not all women suffer headaches during certain times of their cycle or stages in their hormonal lives. But, for the ones who do, it’s usually related to a decrease in estrogen levels.

Estrogen decreases during PMS

We often get hormonal headaches during times when our estrogen plummets. PMS is a good example of this. The period of time after ovulation and before menstruation is characterized by a dramatic drop in the hormones estrogen and progesterone. In some instances, if you’re taking birth control pills, you could be more headache prone. These oral contraceptives often take your hormones on a roller coaster ride. Other times, they help regulate hormones. If you think your birth control pills may be contributing to headaches, talk to your doctor about switching to a different brand or type of birth control.

Estrogen drops after childbirth

For women familiar with hormonal headaches related to decreased estrogen, pregnancy typically eases this annoyance because estrogen increases when you’re pregnant. However, right after birth, those estrogen levels drop dramatically, giving hormonal headaches the opportunity to return with fervor.

Estrogen decreases during perimenopause

Many women in their perimenopausal years complain of more headaches. This is because estrogen is gradually decreasing during the years leading up to menopause. Hormone replacement therapy, a common treatment during perimenopause, can help alleviate certain troublesome perimenopausal symptoms.

Headache triggers unrelated to hormones

Some of the following headache triggers can impact your hormones, and should be taken into account to prevent headaches and migraines. If you’ve ruled out the above headache triggers, you might find the culprit in the list below.

  • You need to improve your sleep schedule. Headaches are related to too little sleep and/or too much.
  • You live in a region where the weather changes dramatically from one day to the next. The Midwest is a perfect example.
  • You tend to get engrossed in your daily routine and skip meals, causing blood sugar fluctuations.
  • You eat too many foods with a high glycemic index that cause dramatic spikes and drops in blood sugar
  • You’re chronically stressed out and overwhelmed.
  • You eat a lot of processed meats that contain nitrates.
  • You drink too much caffeinated coffee, or you experience withdrawal from caffeine.
  • You consume MSG
  • You eat soy
  • You eat aged cheeses
  • You consume artificial sweeteners like aspartame

Hormonal headaches and their symptoms

Not sure whether your headache is hormone related? If you have a migraine or headache in conjunction with any of these other symptoms, it could indicate a hormonal shift:

  • Your face breaks out in acne
  • You’ve lost your appetite
  • You’re more tired than usual
  • Your joints hurt
  • You’re constipated
  • You’re unusually uncoordinated
  • You feel lost in a brain fog
  • You’re going to the bathroom less than usual
  • You have strong cravings for salt, sugar, or alcohol

Ways to treat hormonal headaches

Natural treatments

If the symptoms above are ringing a bell, you’ll want to take the following steps to help alleviate your hormonal headaches:

  • Drink plenty of water to prevent dehydration
  • Do pranayama (breathing exercises that relax the nervous system)
  • Practice yoga to de-stress
  • Ease your hormonal headache with a cold compress
  • Relax and lie down on your bed, turning off all the lights
  • Give yourself a head and neck massage
  • Inhale headache-relieving essential oils like peppermint and eucalyptus
  • Take a magnesium supplement
  • Treat yourself to a massage

Conventional medications for hormonal headaches

Sometimes, you must resort to drugs. As long as you don’t get carried away, pharmaceuticals can help relieve hormonal headaches and migraines. For regular headaches, NSAIDS work to reduce inflammation. For the more serious migraines, triptans and other drugs can lessen their severity. Many women familiar with PMS-related headaches opt for beta-blockers, calcium channel blockers, anticonvulsants, and even antidepressants.

Birth control pills for headache relief

Some women turn to hormonal birth control for headache relief. The pill contains estrogen, as does the patch. For women with estrogen issues, these are two commonly effective forms of relief. Many women find that once they are on contraceptives, headaches and migraines lose their steam.

When might you experience hormonal headaches?

Hormonal headaches and menstruation

As you know now, estrogen plummets the week before your period. For some women, the low-estrogen stage can be closer to 10 days. We all have different cycles, but generally speaking, the window of time after ovulation and before menstruation can be difficult. There’s a reason PMS gets a bad rap. It can be downright miserable.

If you’re using a birth control pill, and still getting bad hormonal headaches or even migraines, talk to your doctor about changing your medication. You may be able to change the dosage of your contraceptive, or even the type of birth control you use.

If you’re not currently taking some kind of hormonal birth control, now may be the time to do so — especially if your hormonal headaches are severe, last for several days, or otherwise interfere with your daily life. If this is the unfortunate case, tell your doctor. It’s possible you need hormonal help in the form of a birth control pill that balances your fluctuating hormones.

Hormonal headaches during pregnancy

If you’re pregnant, expect your hormonal headaches to be worse during your first trimester. It’s at this time that both your hormone levels increase. Your blood volume also rises. These two bodily changes often trigger headaches or even intense migraines. Pregnant women should focus on eating right and drinking plenty of water. It’s easy to let your posture go when you’re carrying the load of a growing child, but poor posture can cause headaches also. So, do your best to work on keeping your spine and neck in line to prevent headaches during this time.

Hormonal headaches and perimenopause

Perimenopause is a time characterized by plummeting estrogen and progesterone levels. Testosterone decreases, too. All these hormonal changes impact headaches and migraines. If you’re someone who experiences headaches or migraines during PMS, you may be more likely to experience them during perimenopause.

Hormone replacement therapy (HRT) is a route taken by many women during perimenopause. But, it may take some experimentation to get the right dosage. The hormonal headache is mysterious in nature. What works for one woman can make matters worse for another. Be patient with yourself and the treatments you explore during this time.

Hormonal headaches and menopause

Many women experience relief from headaches once they’ve reached menopause. This can occur because your hormones are more stable than they were during childbearing years and perimenopause. Once you’ve stepped off that hormonal roller coaster ride, hormonal headache relief may very well be one of the treasures of menopause.

How to tell the difference between a headache and a migraine

Are your headaches migraines or common headaches? If you’re asking this question, you’re certainly not alone. Some women have no experience with migraines, unless they’re in the throes of severe PMS or perimenopause. If you get migraines, and you’re overweight or obese, it may be time to get serious about losing weight. A meta-analysis published in the journal Neurology provides significant evidence for the link between migraines and obesity.

Unlike headaches, migraines often come with additional symptoms. For example, if you’re having a migraine “with aura,” as they call it, you might experience the following sensations. These signs typically signal the onset of a migraine, as they occur about 30 minutes before a migraine takes over.

  • You’re confused
  • Your sense of smell changes
  • Your vision is blurry or you see weird lines or even flashes of light
  • Your hands or face tingle
  • Your hands or face feel numb
  • Your senses of smell, taste, and touch seem different
  • You’re having a hard time thinking

Other migraine “with aura” symptoms

The National Headache Foundation states that approximately 60% of women who get migraines are also susceptible to menstrual-related migraines. This happens due to those fluctuating hormones. With the onset of a migraine “with aura,” the following symptoms are common:

  • You begin to feel nauseated
  • You become extremely sensitive to both light and noise
  • You feel a pain between one of your ears, and/or eye
  • You feel a pain at your temples
  • You might vomit
  • You may even become vision impaired for a time
  • You see spots or light flashes

Migraine treatment

If you find yourself experiencing hormone-related migraines, a wide range of treatments are available. You may first want to make sure you’re getting enough vitamin D, B2, and magnesium. These are the most common nutrient deficiencies for women with migraines. Coenzyme Q-10 and butterbur supplements have been known to help, too. If these natural remedies fail, you’ll want to go the conventional route.

Over-the-counter migraine medications include Advil, Excedrin, and/or Midol. If these don’t work, stronger prescription medications may be necessary. Your doctor may recommend any of the following:

  • Triptans
  • Beta-blockers
  • Calcium channel blockers
  • Anticonvulsants
  • Ergotamine drugs
  • Botox
  • CGRP antagonists

Diet, exercise, and stress reduction

Hormonal headaches and migraines can sometimes be prevented or at least relieved a bit through a healthy lifestyle. Make sure you’re eating a nutrient-rich, whole-foods diet — free of processed foods and refined sugars. Don’t overindulge in alcohol, which can make hormonal headaches and migraines worse.

Exercising is a key component to balancing hormones. Find methods of movement that you love, and that you’ll be apt to actually do. Exercise and the right diet help relieve stress, but these days, extra stress reduction methods may also necessary. Yoga, meditation, aromatherapy, deep breathing techniques, spending time in nature, doing something creative — these are all wonderful ways to reduce stress. If you’ve never tried to meditate, start slowly. You may find it’s something you love. And it reduces stress in amazing ways.

At OB/GYN Associates of Alabama, we can help you understand menopause, hormone imbalances, and the range of treatment options available, including hormone replacement therapy. Contact us to request an appointment today.

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