Managing hormonal migraine.
What is a “migraine”?
Migraine is actually classified as a neurological disease – one that still isn’t fully understood, even by the medical community. In part, this is because not a lot of attention was put on it until more recent years, despite the fact that migraine is the third most common disease in the world, and that it’s the seventh highest among causes of disability globally.
So there are still really only theories on what’s actually happening in a migraine attack. Several of them relate to the idea that it’s blood vessels in and around the brain being triggered by something that causes them to expand and release chemicals, which then creates the inflammation that irritates nerve endings and causes pain. Some theories say neurotransmitters like serotonin are involved, which makes sense given some of the common symptoms outside of head pain that people experience in an attack, like nausea and diarrhea.[1]
But what any migraineur can attest to, is how migraine affects their life, and what a migraine episode feels like to THEM. Migraine symptoms vary by person, but often includes head pain (usually one-sided), and commonly includes cognitive issues like brain fog and difficulty concentrating; fatigue; sensitivity to smell, sound, and light; nausea and vomiting; dizziness; mood changes; and bowel issues like diarrhea or constipation.
And we know there are phases to a migraine episode: Prodrome, aura (for some/sometimes), attack, and postdrome.
The prodrome phase is the 2-48 hours that lead up to the aura or attack phase, and can include many of the symptoms previously mentioned (but usually not the head pain).
The Aura phase is not a phase that everyone experiences, but it usually comes about one hour before the attack phase, and involves visual disturbances like bright, flickering lights or zig-zagging lines or blind spots.
The Attack phase is where the head pain usually begins, alongside other classic symptoms of migraine as previously mentioned.
The Postdrome phase, otherwise known as the ‘migraine hangover’ is the 24 to 48 hours after the attack phase has ended. In this phase, people often experience fatigue, and some other symptoms previously mentioned.
What is “hormonal migraine”?
When people say they have “hormonal migraines”, they’re most often referring to the migraine episodes they get at specific times in their menstrual cycle. Often it’s midway through the cycle (around the time of ovulation), and/or just before, after, or during menstruation.
These are points in time when levels of the hormones estrogen and progesterone are dropping.
These migraine episodes can be more painful and harder to manage than those that happen at other times of the month.
What causes migraine?
Some people think that because there’s a hereditary or genetic component to migraine, they’ll just always have migraine episodes and there’s nothing that can be done.
But I do not believe that to be true. Yes, you may be predisposed to them – they are your ‘weak link’ – but you don’t have to be sentenced to a life with them.
There is a lot we can do to influence the ‘expression’ of our genes (ie. influence whether they get turned ‘on’ or ‘off’), and this is done through all of the things we DO have control over, like diet, lifestyle, environment (to an extent), and mindset.
What we also know is that the migraine brain likes balance, and that everyone is different as far as why they first started having migraine episodes, and why they continue to have them.
In other words, the root causes – the imbalances and/or deficiencies that are underlying the migraine episodes – vary from person to person.
And when the normal and expected fluctuations in hormones that happen within the menstrual cycle bring on a migraine attack, it’s an indication of other factors playing a part…because the fluctuations should not and normally would not on their own.
If we have a lot of stressors stacking up – like a lack of sleep, poor diet, work stress, AND if our migraine threshold is low, the monthly fluctuations in estrogen and progesterone (which is a type of stressor) may be enough to bring on an attack.
Many things can lower your threshold, but top factors include: Imbalance in any part of the body (including endocrine/hormonal system); inflammation; nutrient deficiencies; and digestive issues.
So hormones can cause these attacks?
Yes, hormonal imbalances can be one of the reasons you’re experiencing migraine episodes related to your cycle, with estrogen dominance being one of the most common types of imbalance. This is where the ratio of estrogen to progesterone is off in the body can be a matter of too much estrogen, or too little progesterone.
If this is the case for you, then you may find yourself also struggling with symptoms like fatigue, breast swelling or tenderness, irregular periods, bloating, weight gain (especially around the middle), uterine fibroids, mood swings, anxiety, depression, insomnia, and night sweats.
What role does digestion play in hormonal imbalance?
Digestive issues impact all other imbalances in the body, whether directly or indirectly and so have to be addressed.
When the balance of good and bad bacteria in the gut is out, the lining of the intestinal walls can get inflamed and become ‘leaky’ and start letting things through that it shouldn’t – like undigested food particles and toxins.
These need to get processed by the liver and if the liver is overburdened it can’t do its other jobs - one of which is processing hormones!
Hormone production also relies on adequate protein, but if protein isn’t being broken down properly in the gut, it can’t be used to make hormones.
If we have constipation, then toxins and excess estrogen sit in the colon for too long, to the point where our body starts to reabsorb them.
Besides contributing to the issue of estrogen dominance, this leads to inflammation in the body, because our immune system is responding to the ‘foreign invaders’. The inflammation affects the glands that produce our hormones, like our liver and our adrenals.
What can we do about hormonal migraine?
Support hormone health in general – and there are many ways to do that, including:
Sleep – when our sleep cycle is off, so many other things get disrupted too.
Reduce exposure to toxins, including xenoestrogens, which are hormone disruptors found in everything from personal care products and cleaning products, to our water.
Address any issues around constipation so your body can eliminate excess estrogen.
Reduce stress and find ways to manage your stress response - because progesterone is used to produce the stress hormones, so it gets depleted when we’re in a constant state of stress.
Keep blood sugar balanced by eating well-balanced, whole food meals at regular intervals throughout the day...and by keeping stress levels down.
Of course address any other root causes underlying your migraine episodes and other health issues!
Start tracking your cycle (you can use an app like “FLO”) and be extra diligent in the week leading up to your period, if that’s when you usually get migraine episodes, to eat clean, get good rest, pay attention to your stress levels, and avoid intense exercise.
Consider taking Vitamin E in the form of tocotrienols or a good quality vitamin E with tocotrienols. Take 400 IU for 3 days before menstruation and 3 days during, for three menstrual cycles.
Check first with your doctor in case there are contraindications with your medications.
What are some natural ways to prevent a migraine attack – or manage an episode in progress?
First off, it’s important to get familiar with and pay attention to symptoms you have in the prodrome phase and bring in attack prevention tactics EARLY to improve their effectiveness. Then, here are 4 things you can try to help avert or manage an attack:
is...Drink water! This one seems simple, but we all have those days where we forget to drink water or aren’t drinking enough for what we need that day, and with dehydration being a major migraine trigger, we have to consider whether it could be the case. If you haven’t had enough fluids then it will increase your chances of getting a migraine.
Note: Hydration isn’t just about drinking enough water, we need electrolytes as well! Certain foods will contain the key minerals we need (like potassium, sodium, magnesium), but consider adding a pinch of finely ground Himalayan salt to your water as well.
Go for a brisk walk outside. This will bring oxygen into the lungs, release stress, and raise endorphins (our natural pain reliever!).
Take 300-500 mg of ginger. Ginger is anti-inflammatory, often known for being helpful with nausea, and a 2014 study found that 250 mg of a ginger powder supplement decreased migraine symptoms about as well as the prescription drug sumatriptan! [2] You can drink ginger tea (which contains about 250mg), take 300mg-500mg in supplement or tincture form, or put a few drops of ginger essential oil in water and drink it (ensuring that it’s therapeutic grade, free from synthetics and impurities).
Note: Ginger is a mild blood thinner, and so check with your doctor before using it, especially if you’re on a blood thinner medication.
Use essential oils. There are several oils and oil blends that are fantastic for all kinds of migraine symptoms, but two of the best for averting or managing the head pain that comes in the attack phase are peppermint and lavender.
About the Author:
Julie Gravel is a Registered Holistic Nutritionist and Functional Nutrition Counselor who specializes in migraine. She’s the founder of a 16-week guided program called The Migraine Resilience Method, where she helps women to reduce the frequency, severity, and duration of their migraine episodes by addressing root causes using natural methods, so they can move away from medication and other bandaid solutions – and ultimately get back to enjoying life again!
References
Steiner, Timothy J., Lars J. Stovner, and Gretchen L. Birbeck. "Migraine: the seventh disabler." cephalalgia 33.5 (2013): 289-290.
Maghbooli, Mehdi, et al. "Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine." Phytotherapy research 28.3 (2014): 412-415.
The content of this website is intended for informational purposes. The information presented does not replace medical advice given to you by your own provider. Information on this site should not be used to diagnose or treat. Before starting any new dietary, exercise or lifestyle regimens you should consult your primary care provider.