Hormonal Migraines: Why They Happen and How to Manage Them.

If you experience migraines that seem to coincide with your menstrual cycle, you’re not alone. Many women find that their migraines flare up just before or during their period, while others may notice them around ovulation. These headaches—known as hormonal migraines—are not just random; they are directly linked to shifts in hormone levels.

In this blog, we’ll explore why hormonal migraines happen, what factors make them worse, and practical strategies for managing them.

What Are Hormonal Migraines?

Hormonal migraines are headaches triggered by changes in hormone levels, particularly oestrogen and progesterone. These migraines often occur just before menstruation, during ovulation, or at other times when hormone levels fluctuate significantly.

They differ from typical tension or cluster headaches because they are closely linked to the menstrual cycle and are often accompanied by other symptoms like nausea, sensitivity to light, or throbbing pain on one side of the head.

Why Do Hormonal Migraines Happen?

Hormonal migraines are primarily influenced by fluctuations in oestrogen and progesterone and the way they interact with other tissues and biochemical processes. Let’s break down how these hormonal shifts trigger migraines.

1. The Oestrogen Drop

One of the most common triggers for hormonal migraines is a sudden drop in oestrogen levels. Just before your period, oestrogen levels decline rapidly. This affects brain chemistry and can make you more prone to migraines. Migraines triggered by this drop usually occur one to two days before menstruation or at the start of your period.

Oestrogen plays a role in regulating serotonin, a neurotransmitter involved in mood and pain perception. When oestrogen levels fall, serotonin levels can also drop, increasing pain sensitivity and making migraines more likely.

2. Progesterone Fluctuations

Progesterone also influences migraine patterns. In the late luteal phase (just before menstruation), progesterone levels drop, increasing histamine release which can exacerbate migraine symptoms. Progesterone generally has a calming effect on the nervous system, so when levels fall, this can lead to increased tension and pain.

3. Prostaglandins and Inflammation

At the onset of menstruation, the uterine lining breaks down, releasing compounds called prostaglandins. These inflammatory molecules can increase pain sensitivity and inflammation in the body, potentially triggering migraines, particularly during the first few days of bleeding.

4. Low Magnesium Levels

Many women have low magnesium levels, especially around their period. Magnesium helps relax blood vessels and supports proper neurotransmitter function. Low levels can cause vasoconstriction, which is when blood vessels tighten or spasm, leading to the onset of a migraine.

5. Histamine Sensitivity

Oestrogen stimulates histamine release and decreases the activity of diamine oxidase (DAO), the enzyme responsible for breaking down histamine. High histamine levels can sensitise nerves and trigger headaches. Migraines often coincide with high-oestrogen phases, like just before ovulation or menstruation.

6. Stress and Cortisol

Stress can significantly increase the likelihood of migraines. Elevated cortisol levels from chronic stress can disrupt hormone balance, especially progesterone and make the nervous system more reactive. Additionally, stress lowers magnesium levels, making the brain more susceptible to migraines.

Why Are Migraines Worse Premenstrually?

The premenstrual period can be particularly challenging for those prone to hormonal migraines. This is due to a combination of:

• Progesterone Drop: Reduced calming effects on the nervous system, leading to increased tension.

• Oestrogen Rebound: A small surge just before menstruation can still trigger histamine release.

• Increased Inflammation: Higher levels of prostaglandins can increase pain sensitivity.

• Stress and Sleep Disruption: Many women experience increased stress or disrupted sleep in the days leading up to their period, further increasing the risk.

Effective Strategies for Managing Hormonal Migraines

Managing hormonal migraines requires a multi-faceted approach, focusing on lifestyle changes, dietary adjustments, and, when necessary, supplements.

Dietary Strategies:

• Balance Blood Sugar: Fluctuations in blood sugar can make migraines worse. Aim to include protein, healthy fats, and fibre at every meal to maintain stable blood sugar levels.

• Anti-Inflammatory Foods: Incorporate foods that lower inflammation, such as leafy greens, fatty fish, berries, and turmeric.

• Hydration: Dehydration can worsen migraines, so aim to drink plenty of water throughout the day.

• Avoid Histamine Triggers: Limit foods that are high in histamine or promote its release, such as aged cheeses, fermented foods, alcohol, and processed meats.

Lifestyle Approaches:

• Stress Management: Incorporate techniques like yoga, meditation, or breathwork to help reduce cortisol levels and promote relaxation.

• Sleep Hygiene: Aim for consistent sleep patterns, aiming for 7-9 hours per night. Quality sleep helps regulate hormone levels and reduce migraine risk.

• Gentle Exercise: Activities like walking, swimming, or stretching can support blood flow and lower stress without overloading your system.

Supplement Support:

• Magnesium (300mg daily): Supports blood vessel relaxation and reduces the frequency of migraines.

• Ginger: Acts as a natural anti-inflammatory and can help reduce migraine severity.

• Vitamin B6 and Zinc: These nutrients support hormone balance and reduce histamine-related symptoms.

• Quercetin: A natural antihistamine that can help stabilise mast cells, but should be used short-term to avoid gut irritation.

When to Seek Professional Help

If your migraines are severe, frequent, or resistant to lifestyle changes, it may be time to seek professional guidance. Hormonal migraines can sometimes indicate deeper issues, such as oestrogen dominance, histamine intolerance, or gut dysbiosis.

As a naturopath specialising in hormone health, I can help by:

• Conducting hormone testing to identify imbalances.

• Recommending targeted therapies based on your specific needs.

• Guiding you on safe and effective supplementation.

Balance is Key

Hormonal migraines can be debilitating, but understanding the root causes makes it possible to manage them more effectively. By balancing hormones, stabilising blood sugar, reducing stress, and supporting nutrient levels, many women find relief.

If you’re struggling to manage hormonal migraines or feel unsure where to start, I’m here to help. Book a 1:1 consultation for a personalised plan that addresses the root causes of your symptoms.

Your journey to a migraine-free cycle starts here—let’s work together to find the balance your body needs.