That there is a connection between hormones and migraine is well known. That’s why more women than men get migraines and why we women are more prone to them at certain times of the month.
What isn’t as commonly known is why it is the way it is and what we can do about it.
From my reading, I’ve found that there are at least 2 reasons hormonal imbalance causes migraines. One is a relatively direct link, the other has to do with enzymes and food triggers.
The first is that basically estrogen tends to cause a dilation of the arteries and that progesterone has the effect of constricting the arteries. Too much estrogen and our arteries are over dilated which triggers a migraine. This typically happens in the luteal phase (the second half of the menstrual cycle after ovulation has occurred) and can be responsible for migraines at the time of ovulation as well as PMS migraines.
When everything is working as it should, a good strong egg is released at ovulation, a corpus luteum (which is “a yellow glandular mass in the ovary formed by an ovarian follicle that has matured and discharged its ovum”, according to http://www.biology-online.org/) is formed, a good quantity of progesterone is produced, and we go about our merry way.
But, things being out of whack the way they are, some of us produce the estrogen ok, but fail to produce enough progesterone to counterbalance it. This condition is known as estrogen dominance. The other symptoms of estrogen dominance are outlined in the following link:
At other times, it’s possible to suffer a migraine from the sudden drop in estrogen after ovulation and before our period. (See notes below for references).
The good news is that we don’t have to just suffer through those excruciating hormonal headaches anymore. You’ve probably heard of bio-identical hormones for menopause. Well, they can also work for perimenopause (the time leading up to menopause, when our hormonal situation is especially tricky) and for PMS.
There are excellent books on this subject which I’ve read and consulted many times. I really recommend you read them to understand the ins and outs of hormonal balance. If you can, buy them, because you’ll probably end up consulting them more than once (you’ll find links to them in the sidebar). But if money is tight, you can borrow them from the library.
The tricks are 1) Finding a good doctor who’ll prescribe them, 2) Finding a good compounding pharmacist, and 3) Figuring out with him or her, what dosage is right for you.
As far as finding a doctor, the compounding pharmacies can tell you who the doctors are who prescribe bio-identical hormones. The one I’ve seen is Dr Scott Mawdsley, a gynecologist on Baker Drive in Dartmouth, NS.
As for figuring out dosages, in my experience, this takes a bit of tweaking, but here’s where the compounding pharmacist can really help. There are 2 excellent ones in Halifax:
Your Pharmacist, 366 Lacewood Drive, Halifax and
The Quinpool Wellness Centre, Medicine Shoppe, 6407 Quinpool road, Halifax. www.quinpoolwellness.com (they provide hormone saliva testing for a fee)
There’s also one in New Glasgow: The Medicine Shoppe on East River Road, New Glasgow.
I’m hereby launching a challenge to any medical technology guys out there, to develop a home testing gismo such as those used by diabetics for testing their blood sugar. During perimenopause in particular, hormone levels can fluctuate wildly, so in my opinion a one-time test provides only a snapshot in time. It’s like a family photo. The very next minute after you’ve taken the baby’s smiling picture, he can have a screaming fit and still ruin your cheerful disposition!
I go to ‘Your Pharmacist’ on Lacewood Drive in Halifax for my prescriptions. The pharmacist has been SO helpful, going above and beyond the call of duty to help me recognize symptoms and get me on track.
Something to consider if a person does go for bio-identical hormone treatment: If we’re very sensitive to a lot of food triggers, we even have to be careful which ‘carrier cream’ the pharmacist uses to mix with our progesterone. My pharmacist now mixes mine with Aveeno body lotion (which is hypoallergenic) and it’s well tolerated.
With a little progesterone cream in the second half of my cycle (I’m using 20mg at bedtime and another 10 mg in the morning), those hormonal headaches are much reduced.
Just a note about wild yam creams or gels: Unless it has been added to them, they don’t contain any actual progesterone. From what I understand, they contain diosgenin, which apparently acts as an estrogen antagonist. So it might have an effect by displacing excess estrogen and thereby reducing estrogen dominance. Many women have found them helpful. I’ve used them, and they have helped, but I still seem to do better with actual bio-identical progesterone. Everyone’s different.
The second connection between hormones and migraines, is something that I had never heard about, in all my years of reading everything I could about migraines, until very recently. We know that some migraines in some people are triggered by certain foods like chocolate, nuts, wine, cheese, etc. What these foods all have in common is that they contain one of two amino acids: tyramine or PEA (phenlyethylamin). The following link outlines some of the many migraine food triggers: http://superiorsites3.com/NNS02DietMigraineHeadaches.htm)
The reason these foods trigger migraines is that some of us don’t produce the enzymes needed to help in their digestion. These enzymes are called MAO-A and MAO-B. What do these enzymes have to do with hormones?
MAO production is influenced by hormones. Progesterone aids MAO production while estrogen hinders it. Not enough Progesterone = not enough MAO and too much estrogen = not enough MAO.
So it gets us coming and going!
I was astounded when I read that. So there is some hope that, in time, proper hormonal balance could lead to less sensitivity to migraine food triggers.
There is, unfortunately, also a genetic factor to MAO production, but maybe that can be mitigated.
The third factor in MAO production is copper. Not enough copper = not enough MAO. Of course, the best copper-rich foods are nuts, chocolate, beans etc. (http://www.healthaliciousness.com/articles/high-copper-foods.php), which are the very foods that trigger migraines in some people. So, it’s a vicious circle.
Caution: several sources caution that overdosing on copper can be dangerous, so it's best to have our copper levels tested before starting any supplements.
Caution: several sources caution that overdosing on copper can be dangerous, so it's best to have our copper levels tested before starting any supplements.
I’m hoping more research will be done in this field. The initial findings are encouraging.
The bottom line is that we really need to have our hormones in balance to overcome our migraine problems. We need to have sufficient progesterone and not too much estrogen.
Hope this helps!
Notes :
The Hormone Survival Guide for Perimenopause, by Nisha Jackson, pp. 134-136 discusses hormone-related headaches and migraines. She discusses how estrogen and progesterone can induce headaches and the difficulty of discerning whether it’s too little estrogen or too little progesterone that is causing the problem. She advocates having these levels tested 5 to 7 days before your period.
Dr Jackson also gives a list of symptoms to help identify the effects of high and low estrogen (page21) and the effects of high and low progesterone (page24).
Dr John Lee’s Hormone Balance Made Simple, by John R. Lee, M.D. and Virginia Hopkins is another informative book by the pioneer of bio-identicals. As its title implies, it’s an easy-to-use guide. His website is: http://www.johnleemd.com/index.html. You can read the first chapter of his book and download his handy symptom tracker chart.
Ageless, by Suzanne Somers, pp. 35-40 gives lists of symptoms associated with estrogen and progesterone deficiency or dominance. Her book is full of interesting information and interviews with leading edge doctors.
Her main webpage has loads of info: http://www.suzannesomers.com/
You can also check out this page for specific info on the various hormones: http://foreverhealth.com/category/hormones/
Ageless, by Suzanne Somers, pp. 35-40 gives lists of symptoms associated with estrogen and progesterone deficiency or dominance. Her book is full of interesting information and interviews with leading edge doctors.
Her main webpage has loads of info: http://www.suzannesomers.com/
You can also check out this page for specific info on the various hormones: http://foreverhealth.com/category/hormones/
The Quinpool Wellness Centre’s website is: http://www.quinpoolwellness.com/
Your Pharmacist’s yellow pages ad is: http://www.yellowpages.ca/bus/Nova-Scotia/Halifax/Your-Pharmacist/7331614.html
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