Hormonal headaches are caused by fluctuations in hormone levels. This can happen due to a drop in estrogen levels or during a period. They can occur as a result of menopause, pregnancy, and the use of oral contraceptives.
People may refer to a hormonal headache as a menstrual migraine or premenstrual syndrome (PMS) headache.
This article describes what hormonal headaches are, what causes them, and how to treat them. It also explores how a person can help prevent it from occurring.
A hormonal headache can refer to any headache in which changes in hormone levels cause pain or other symptoms.
According to the National Headache Foundation (NHF), hormones are responsible for triggering the pain response. They can act as part of the body’s defenses, alerting a person to an underlying health condition. As a result, people may have a headache or other pain due to their hormones.
The NHF also states that serotonin acts as the primary hormone trigger for headaches in everyone. However, in women, the way serotonin interacts with estrogen is a major contributor to hormonal migraine headaches.
For example, just before menstruation, the level of estrogen drops, which can trigger headaches.
According to the American Migraine Foundation (AMF), a menstrual migraine is any migraine that starts between 2 days before a period and 3 days after your period starts.
When a hormonal migraine occurs, it typically presents as a migraine with no aura. However, an aura can occur before the migraine begins. The headache pain is often severe, throbbing, and starts on one side or the other.
Other symptoms may accompany the headache, including:
PMS headaches occur before your period and have different symptoms than a menstrual migraine. A PMS headache occurs before your period and accompanies the following symptoms:
- Joint pain
- decreased urination
- Lack of coordination
- Changes in appetite
- Cravings for salt, chocolate, or alcohol
According to the AMF, the main cause of hormonal headaches is changes in estrogen levels.
They also find that the degree of fluctuation, regardless of the amount of estrogen present, is the main factor causing a hormonal headache to appear.
Menstrual migraines can occur 2 days before to 3 days after the start of menstruation. This is likely due to a drop in estrogen that occurs around this time.
PMS headaches occur before your period starts.
According to Pregnancy, Childbirth, and Baby, changes in hormone levels can lead to headaches during pregnancy for many people, especially in the first and third trimesters.
They also suggest that migraine headaches can also get worse in the first few months. This can improve in the later stages of pregnancy when estrogen levels stabilize.
The AMF states that around 50 to 80% of pregnant women with migraines experience relief from their symptoms.
This may be due to the increased levels of estrogen during pregnancy. During pregnancy, a person may have less common and less severe migraine symptoms.
Find out more about headaches during pregnancy here.
According to the North American Menopause Society, pre-menopausal people may experience an increase in the number and severity of their migraine symptoms, which is likely due to hormone fluctuations during that time.
However, after menopause, some people no longer experience migraine symptoms.
The United Kingdom’s National Health Service (NHS) states that those taking the combined oral contraceptive pill may find their headaches improve.
However, others report more frequent headaches, especially during the pill-free week. This is when the level of estrogen goes down.
In a 2017 study, researchers found that low-dose estrogen contraceptives can help prevent migraine symptoms.
A person should speak to a doctor about the safest form of birth control for them.
Other contributing factors
Previous research from 2012 shows that women are three times more likely to experience migraines than men. This rise in levels is due to the way hormones interact in your body.
The study also finds that hormone replacement therapy can trigger migraine headaches.
A person may also find that other things can be triggering their headache. This can be triggers such as food, smells, light or stress.
Learn more about triggers for migraines here.
Treatment plans for hormonal headache often include preventive measures and acute treatments.
They may also include recommendations for self-care and natural remedies, such as: B. the use of magnesium supplements.
Home remedies and self care
A person can take steps at home to manage migraines. This may include lying down in a darkened room or placing a cool, damp towel over your eyes or forehead.
In addition, some people can find migraine relief through yoga. A 2021 study found that yoga therapy can improve quality of life and reduce the frequency of migraine sufferers.
Learn more about the poses that help with migraines here.
The NHS also suggests the following:
- Eat small and frequent snacks to keep blood sugar levels high
- try to maintain a regular sleeping pattern
- Avoid stress if possible
Magnesium is a dietary supplement that a doctor may recommend to a person to help prevent hormonal headaches.
To use magnesium, a person can take it 15 days after the start of the period and continue until the start of the next period. While this may not work for everyone, the AMF generally finds it easy and safe to try.
The AMF notes that other natural remedies can also help treat migraine headaches. However, they emphasize that natural therapy should not replace medical intervention.
Some therapies they consider successful are:
- Mindfulness training
- Food supplements with vitamins and minerals
- essential oils
There are three general types of medication used to treat acute migraine headaches.
- Tablets: They can include nonsteroidal anti-inflammatory drugs (NSAIDs) or fast-acting triptans like zolmitriptan, almotriptan, sumatriptan, eletriptan, or rizatriptan.
- Injections: These work faster and bypass the stomach and may contain sumatriptan or dihydroergotamine.
- Nasal sprays: These are faster than a pill. However, they are not as quick as an injection. Nasal sprays can contain zolmitriptan, dihydroergotamine, and sumatriptan.
A person should speak to a doctor about recommended treatment options if hormonal headaches persist.
The AMF also states that some doctors may recommend additional therapies, including:
- Stress reduction
- Yoga or meditation
- avoid other triggers
Although acetaminophen is often considered safe, pregnant or breastfeeding women should not take any medication until discussed with a doctor.
Treatment during perimenopause and menopause follows a similar approach and includes both acute and preventive treatments.
According to a 2018 study, doctors may need to take some precautions and consider other aspects of their general health when treating people in perimenopause and menopause.
For example, some people are more likely to develop cardiovascular disease, which makes treatment with triptans less safe because of their interaction with the cardiovascular system.
A person should speak to a doctor about the best approach to treatment during menopause.
Prevention may include medications that make migraines less likely to develop and lifestyle changes.
According to the AMF, health professionals can prescribe preventive drugs that are off-label. In other words, they’re not specifically designed to prevent migraines, but they can help.
Common preventive drugs are:
- Hormones: These come in a variety of forms such as oral, gel, or patches to help prevent the drop in hormone levels that lead to menstruation.
- NSAID: A person can take these about twice a day in the week leading up to menstruation.
- Magnesium supplement: A person can start taking on the 15th day of the cycle and continue until the onset of menstruation.
- Triptans: A person can take these twice a day during menstruation. They can help prevent hormonal headaches.
Another option is to have continuous hormone therapy, often in the form of hormonal contraception. This approach can help regulate hormone levels and prevent headaches.
Finally, a person can take steps to avoid other triggers that can contribute to their migraines. This can include:
- Eating healthy and avoiding foods that can trigger a seizure
- regular exercise
- reduce stress
- Avoidance of other external triggers
If symptoms are new or worsen, a person should speak to a doctor to either start treatment or change their treatment plan.
A person should speak to a doctor before making changes to their current treatment.
Hormonal headaches, also known as a menstrual migraine headache or PMS headache, occur due to a drop in estrogen levels.
The symptoms are similar to those of a migraine, with severe, throbbing headaches and frequent nausea or vomiting. Premenstrual headaches can appear alongside symptoms like fatigue, joint pain, acne, and more.
Treatment may include lifestyle changes, preventive medications, and management of acute symptoms. Many people will see symptom relief when they are pregnant or when they reach menopause.