Migraines and hormones

The National Institute of Neurological Disorders and Stroke reports that migraine is about three times more common in women than men. In part, the gap may reflect differences in sex hormones.

Fluctuations in estrogen specifically appear to raise the risk of migraine symptoms in many women.

If you’re female, changes in your estrogen levels might lead to you experiencing more frequent or more severe migraine symptoms before or during your period, after childbirth, or in the years leading up to menopause.

Read on to learn about the role that hormones might play in your migraine symptoms, as well as some of the treatments that are available.

Experts are still studying the role that hormones play in migraine.

But according to a 2018 study, changes in estrogen levels might sensitize certain cells in your body to migraine triggers. This might increase your chances of experiencing migraine symptoms.

The study relied on in vitro and animal models, rather than human research. More research in humans is needed to learn how estrogen and other hormones affect migraine.

Most women of reproductive age go through menstrual cycles. During those cycles, the estrogen levels in your body fluctuate. These changes in estrogen may contribute to the development of migraine symptoms at certain points in your life.

Menstrual migraine

According to the American Migraine Foundation, more than two-thirds of women with migraine develop symptoms before or during their periods. This might be linked to the drop in estrogen levels that occurs before menstruation starts.

A 2016 study found that estrogen levels may drop more quickly before menstruation in women who have a history of migraine compared to those who don’t.

Postpartum migraine

Hormonal changes during pregnancy can also affect migraine symptoms.

If you become pregnant, the level of estrogen in your body will rise and remain high throughout your second and third trimesters of pregnancy. This may reduce the frequency of migraine symptoms that you experience while pregnant.

After childbirth, your estrogen levels will drop, and you might develop postpartum migraine.

Migraine during perimenopause

Hormone levels also fluctuate in the years leading up to menopause, which are known as perimenopause.

During perimenopause, you might experience more frequent or more severe migraine symptoms than usual. After menopause, the symptoms of migraine often become less frequent and severe.

If you have a history of migraine, talk to your doctor about the potential effects that hormonal birth control might have on your symptoms.

Many types of hormonal birth control, including combination birth control pills, contain estrogen.

Some women start to experience symptoms of migraine after they begin using hormonal birth control. Others experience less frequent or milder symptoms while taking hormonal birth control.

If you take combination birth control pills, it might help to follow an extended- or continuous-cycle regimen. Most packages of combination pills contain 21 active pills and 7 placebo pills.

In an extended- or continuous-cycle regimen, you skip the placebo pills and take the active pills without a break. This will help limit drops in your estrogen levels and may prevent migraine symptoms.

According to the Mayo Clinic, it might also help to:

  • shorten your placebo interval
  • wear an estrogen skin patch during the placebo interval
  • choose birth control pills that contain lower doses of estrogen
  • take a “minipill” that contains progestin alone

Your doctor can help you understand the potential benefits and risks of each approach.

If you develop migraine symptoms during perimenopause, your doctor might recommend hormone replacement therapy (HRT).

During HRT, your doctor will prescribe oral medications, skin patches, or gels that contain a form of estrogen known as estradiol.

This treatment can help stabilize your estrogen levels, which might relieve migraine symptoms. However, HRT can also cause potential side effects.

Talk to your doctor to learn more about the potential benefits and side effects of HRT.

To help treat migraine at any point, your doctor might prescribe one or more anti-migraine medications. Many different medications are available to prevent and relieve symptoms of migraine.

If you experience menstrual migraine, your doctor might encourage you to track your menstrual cycle and take anti-migraine medications before the start of each period.

In some cases, they might advise you to take anti-migraine medications during each period and for a few days afterward, too. Some people may benefit from taking these medications every day.

Your doctor might also recommend lifestyle changes, cognitive behavioral therapy, or other treatments to prevent or relieve migraine symptoms.

If you suspect changes in your hormone levels might be contributing to migraine symptoms, talk to your doctor.

They can help you learn about the potential role that hormones might be playing in your symptoms. They can also help you understand your treatment options.