HORMONES AND MIGRAINES
Estrogen and progesterone both have preventative or provocative effects for migraines. Migraines are suggested to be influenced by the changes in ovarian hormones that occur throughout the monthly cycle, and also that become disordered in the perimenopause phase. Migraines are worse in those with ovaries, and increase after puberty.
The menstrual phase is divided into follicular and luteal phases.
Follicular - includes all days from the first day of the period to the day before ovulation.
Progesterone levels are lowest during this phase, and estrogen levels peak at the end of this phase.
Luteal - includes all days from the first day of ovulation to the last day before the next period.
Estrogen levels peak at the start of this phase, and progesterone levels peak mid-phase before both hormones drop dramatically at the end.
Menstrual migraines are commonly seen at the end of the luteal phase and beginning of the follicular phase. This is where both estrogen and progesterone levels are lowest.
Hormonal migraine theories
The common theory of menstrual migraines is the "estrogen withdrawal theory" - where there is an abnormal response of the nervous system to low levels of estrogen.
Another theory is the prostaglandin release theory. Prostaglandins are chemicals in the body that induce pain and are released into circulation by the shedding endometrium during the perimenstrual time, influenced by the reduction of progesterone.
Another theory is a simple magnesium deficiency. Magnesium is important for the tone of cerebral arteries and influences blood flow within the brain. It is also an important cofactor for enzymes involved in neurotransmitters that modulate pain, including serotonin, GABA and opioids.
Naturopathic approach to treating hormonal migraines
TEST hormones! There are saliva and urine tests available that can look at your hormone levels throughout your entire cycle. Testing allows you to set a baseline to retest in future
Supplement with herbs and nutrients that support the nervous system to adapt to changes in ovarian hormones. Common supplements may include magnesium, B vitamins and adaptogen nootropic herbs like licorice, st johns wort and passionflower
Support estrogen and progesterone levels using herbs and nutrients that support their production. Examples include nutrients like zinc, inositol, B6, and HPO tonics including chaste tree and black cohosh
References:
doi: 10.1111/j.1526-4610.2006.00370.x