Hormones, Headaches, Migraines and Menopause

By: Red Hot Mamas

Published: May 26, 2010

Headaches can really hit you like a ton of bricks without any warning whatsoever. For as many as 50 million people in North America, severe headaches can be completely debilitating and greatly interferes with their quality of life. Common types of headache includes: tension-type, cluster and migraine. It’s usually the migraine headache, however, that sends women off seeking help from their clinicians.

Tension headaches last typically for a few hours and may cause muscular pain in back of neck. They may cause a pressing sensation felt all over head and tend to get worse as the day progresses. These type headaches usually don’t force you to stop your activities, but if they occur frequently, the can have negative impact on the quality of your daily life.

For many women, headaches can accompany hormonal fluctuations during pregnancy, menstrual periods or perimenopause. Quite often during perimenopause, when estrogen levels start dropping, the prevalence and/or intensity of headaches increases (especially for women with a history of headaches).

By far, the most severe and debilitating type of headache is the migraine. As many as one in five women suffer from them. Migraines are different than regular headaches. Researchers believe the migraine involves brain chemical and nerve pathway disorders. Suffering from migraines can be so painful at times that the smallest amount of light or sound can trigger the greatest head pounding and nausea you’ve ever experienced in your life. You can’t really talk and can barely even function.

Forget about fighting the darn headache, most of the time you become completely laid up in bed, or vomiting until it passes. Migraines can last from a few hours to a few days, occasionally longer. In 15-20% of attacks, neurological symptoms occur in advance of the actual head pain. Sensory symptoms are considered part of the aura phase of the headache. Symptoms can include:

  • Visual disturbances
  • Nausea
  • Vomiting
  • Dizziness
  • Extreme sensitivity to sound, light touch and smell
  • Tingling or numbness in the extremities or face

After crawling out of the migraine miasma, you’re usually left wondering, “why me?” Migraines can be genetic but can also be caused by sinus infections, dental problems, allergies, colds and a whole slew of other contributing factors as well. It’s different for everyone. Weather patterns can even trigger migraines for some people! Learning what foods, habits, environmental factors and even weather patterns can set off your migraines can be an eye opening experience. Some common triggers of migraines include:

  • Changes in weather or air pressure
  • Light
  • Hormone fluctuations and menstrual cycles
  • Certain foods (alcoholic drinks, cured meats, aged cheese, caffeine)
  • Smells, odors or fumes
  • Motion travel
  • Loud or sudden noises
  • Dieting and eating habits
  • Changes in sleeping habits
  • Overuse of headache pain medications
  • Emotional stress*
  • Intense physical exertion

Start a headache diary to find out if you can see any patterns in what may be triggering your migraines. Record everything from the time of day the migraine hits, how long it lasts to where the pain is. Bring your record to your next doctor’s appointment. They may want to do an exam and pry a little more information from you about your personal health history. Once your doctor diagnoses the problem as migraine-related, your doctor can help you find a way to manage and treat them. When discussing treatment options, ask your doctor about any possible side effects.

While over the counter pain relief drugs (i.e., aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs like ibuprofen) are available, quite often this isn’t enough to treat a migraine. Prescription medication is available to treat migraine symptoms when they happen, as well as limiting the amount and severity of them.

Two classes of drugs are commonly used to balance chemicals in the brain.

  1. Triptans include sumatriptan, rizatriptan, zolmitriptan, almotriptan, eletriptan, naratriptan and frovatriptan
  2. Ergot derivatives include ergotamine tartrate and dihydoergotamine

Neither of these types of prescriptions should be used if you have heart disease or high blood pressure. Some people need to use both forms of medication treatments to control their migraines. If you experience extreme migraine pain, a rescue drug may be prescribed so you can carry it with you in case of an attack. Work with your clinician to find which treatment is right for you.

You may not know this, but some everyday medications used to treat other health conditions can help migraines as well. Some antidepressants, anticonvulsants, beta-blockers and calcium channel blockers have been known to prevent attacks.

In some women hormone therapy exacerbates migraines, while in others it seems to helps. Hormone therapy (HT) may help prevent attacks for women whose migraines are linked to hormonal changes and their menstrual cycle. (HT), however, is not government approved to prevent or treat headaches. Discuss with your clinician the use of low-dose estrogen supplement; estrogen progesterone therapy and continuous release transdermal estrogen, along with your individual benefits and risks of such treatment, if you are experiencing migraine headaches. But remember, hormone therapy should not be your first choice for treating migraines.

The key to finding personal treatment solutions can be a lengthy, frustrating experience. It may involve trying something for a month at a time, only to realize it has no affect on you. It may involve cutting out a potential trigger from your life for a month or two, only to realize it didn’t help at all.

The reality of it all is we still don’t know everything to know about migraines. People are different, so are the causes, genetic role, nature of pain and reactions to different medications are different for everyone. A lot of migraine sufferers struggle with finding an effective treatment right away. It can be a very frustrating process for sufferers. Just listen to the patient voices of migraines to hear some of them. Join their conversations, see what has worked and not worked for some people and remember you’re not alone. By all means, if you are worried about recurrent headaches, see your doctor. Your doctor may recommend a thorough neurological checkup and may arrange for further testing.

*Don’t forget that emotional stress can cause migraines and other tension type headaches. Take some time to prevent and reduce every day stress in your everyday life. Eat healthy, get enough sleep, drink plenty of water, stay active, get a massage, biofeedback, acupuncture and other relaxation exercises can all help. If you think your migraines may be connected with depression or anxiety, counseling can also help.

For more information:

Call womenshealth.gov at 1-800-994-9662 or contact the following organizations:

National Institute of Neurological Disorders and Stroke (NINDS), NIH, HHS Phone Number: (800) 352-9424 website

American Council for Headache Education (ACHE) Phone: (856) 423-0258 website

Migraine Awareness Group: A National Understanding For Migraineurs (MAGNUM) Phone Number: (703) 349-1929 website

National Headache Foundation Phone Number: (888) 643-5552 website

National Menstrual Migraine Coalition website


Barrow, Karen. “Patient Voices: Migra
ine.” Health Guide. 15 12 2009. The New York Times, Web. 15 Feb 2010. website.

“Migraines, Headaches, and Hormones.” Migraines & Headaches Guide. WebMD, Web. 15 Feb 2010. website.