Why Migraines Develop and How to Overcome the Pain
If you suffer from migraines, you’re probably more aware of your hormonal fluctuations than the average woman. After all, periods of hormonal change can bring on the same pounding, blinding migraine pain that environmental triggers are known to cause, but unlike a stressful situation or smoggy day, you can’t remove yourself from the situation. Instead, you need to find a way to weather the storm until the hormonal turmoil runs its course.
Unfortunately, perimenopause can be a long, hormonally-spiked stretch of mental and physical changes, which could spell trouble for women who suffer from migraines. Recent research supports the suspicion that migraines worsen in menopause and, on the bright side, may provide some insight when it comes to treatment.
The Link Between Migraines and Menopause
There’s a close relationship between female sex hormones and migraine headaches, although some women notice it more than others. About 50% of women report that phases of their menstrual cycle have a direct and significant impact on their migraines: typically, migraines come on a day or two before their period starts. These are known as menstrual migraines.
These migraines can sometimes present as sinus pressure. Women who experience issues with the sinus and menopause may not realize it's actually a migraine, which can cause worry.
Perimenopause sinus pressure is essentially a tension headache, triggered by fluctuating estrogen levels:
- Low estrogen leads to pain. Your estrogen level plays a big role in your pain tolerance and sensitivity. When estrogen is low (for instance, right before menstruation or after menopause), pain-producing neurochemicals increase, and that may explain why migraines typically worsen during these phases.
- Stress feeds migraine symptoms. Studies have found that headaches increase by 50% to 60% once you begin perimenopause (the period leading up to menopause that can last for a decade), when estrogen and progesterone levels dip and rise, which can confuse your body and feed your stress response. The more stress you feel, the greater your risk of experiencing a migraine.
- Increase in headache severity. Once you enter menopause – that is, you haven’t had a period for 12 consecutive months – your estrogen falls permanently, which may explain why 12% of menopausal women report migraines, while only 8% of premenopausal women do. Perhaps more significantly, menopause can make migraines a whole lot worse for up to 45% of women (a lucky 15% will notice an improvement in their migraines).
While estrogen levels almost certainly impact your migraines, there might be other hormonal factors at play, too. Cyclical migraines can continue for up to five years after menopause sets in, since hormones can continue to fluctuate (albeit more mildly) after you’ve stopped menstruating, which may be enough to trigger a migraine.
But remember that your body hosts a very complex system of hormones, and it’s difficult to know which interactions could be feeding your migraine response.
Watching for Triggers
You may not be able to redirect your hormones, but there are other triggers during menopause that could be within your control. For instance, hot flashes and night sweats can disturb sleep, poor sleep encourages your body to produce more of the stress hormone cortisol, and that can have a host of consequences for your brain and nervous system.
