How Hormone Therapy May Help Migraine Headaches
The relationship between hormones, particularly hormonal decline or deficiency, and migraine headaches is a complex and multifaceted area of study within the fields of neurology and endocrinology. Migraines, which are severe headaches often accompanied by other symptoms like nausea and sensitivity to light, affect a substantial portion of the population, and their connection to hormonal fluctuations has been widely investigated.
According to the Migraine Research Foundation, migraine is the 3rd most prevalent and 6th most disabling disease in the world.1 A World Health Organization report in 2018, an estimated 1 billion people worldwide suffer from migraines, making it one of the most common neurological disorders.
And in 2023 the American Migraine Foundation estimated that 39 million people in the United States, or 15.1% of the adult population, experience migraine headaches. Also in 2023, The Migraine Research Foundation emphasized that migraines can significantly impact quality of life, causing missed workdays, reduced productivity, and social limitations.
In this article the hormone replacement experts at SottoPelle Method explore the connections between hormones and migraines.
Who Gets Migraine Headaches
While migraine symptoms can start as early as age 5, they typically present with different triggers compared to adults, according to the American Migraine Foundation. Much more commonly, migraine headaches typically begin in adolescence or early adulthood, with peak prevalence between the ages of 25 and 55, per the National Headache Foundation.
And the prevalence of migraines decreases after 55 years old, but the condition can still persist in older adults. As with any disease or disorder, early diagnosis and treatment are crucial for managing migraines effectively and improving patients’ quality of life.
Migraine headaches are more common in women than men, with a ratio of roughly three to one. In women, fluctuations in estrogen levels, especially during the menstrual cycle, pregnancy, and menopause, are often linked to migraines. For many women, migraines tend to coincide with specific phases of the menstrual cycle, particularly the drop in estrogen levels just before menstruation begins. This has led to the term “menstrual migraines.” Similarly, during perimenopause and menopause, when estrogen levels decline more permanently, some women may experience changes in the frequency and intensity of migraines, as well.
It is commonly accepted that genetics play an important roles in who is predisposed to getting migraines. And environmental influences are also well known to “trigger” migraines. Certain foods, alcohol, perfumes or fragrances, are common migraine triggers – as are stress, lack of sleep, dehydration and other lifestyle issues.
The Hormone / Migraine Connection
However, the precise mechanisms underlying the connection between hormones and migraines are not fully understood. But the fact that there is a correlation between the onset and decline of migraines and hormonal events such as adolescence, menstrual cycles, and menopause, have led researchers to believe that there may be a strong hormonal component involved in migraines.
It is believed that estrogen plays a role in regulating pain perception and modulating neurotransmitters in the brain. So, when estrogen levels fluctuate, it may trigger changes in blood vessels and neurotransmitters, contributing to the onset of migraines.
In men, although the relationship between hormones and migraines is less studied, some evidence suggests that imbalances in testosterone and other hormones could also play a role. Testosterone deficiency, for example, has been implicated in certain types of headaches.
And, various hormonal treatments, including birth control methods as well as hormone replacement therapy (HRT) for women going through menopause, have been shown to affect migraine headache frequency – further indicating that there is a strong hormone / migraine connection.
Treating Migraines with Hormone Therapy
Women have been telling their doctors for many years, that their migraines coincide with their menstrual cycles and that they seem to get worse during perimenopause and menopause. Unfortunately, these concerns often fell on deaf ears because medical research simply wasn’t abundant enough to back them up. The good news is that science is finally catching up.
Hormonal changes in women are a frequent trigger for those susceptible to migraine attacks. This happens when estrogen levels drop during the menstrual cycle and menopause, or when they fluctuate wildly as they do in perimenopause. A review of current literature published in 2014 found that: 1) women were more likely than men to suffer from migraines; 2) that considerable evidence supports an important role for sex hormones, and 3) that women’s migraines tended to be precipitated by drops in estrogen concentrations, and minimizing this decline may prevent these headaches.2 In fact, proper hormone treatment has been found to help reduce the incidence of migraines for women both before and during menopause.3
Another study reported in 2009 showed that maintaining stable estrogen levels in menopausal women with a history of migraines markedly reduced the incidence of these headaches.4 In this and other studies, the use of non-oral, bioidentical forms of estradiol delivery helped achieve maximum results. This was due to the ability of those methods to deliver a steady, consistent dose of hormone.
It’s important to note that these studies also found that synthetic estrogen and oral forms of the hormone can actually worsen migraines. This is because these methods of hormone delivery simply can’t produce stable, dependable hormone levels around the clock, like subdermal BHRT pellets do.
Estradiol Hormone Therapy for Migraines
The best results have been achieved using estradiol under-the-skin (subdermal) pellets,5 which provide steady, 24/7 doses of hormone for months at a time. Early research (1974) by Greenblatt demonstrated that both menstrual and postmenopausal migraine could be controlled with subcutaneous hormone pellets.6 That study concluded that estrogen pellets alleviated all symptoms in the majority of his menopausal patients, and that maintenance of stable estrogen levels would control menopausal migraine.
For years, Dr. Gino Tutera, BHRT pioneer and the founder of SottoPelle® Method, used bioidentical estradiol pellets to treat hormone deficient women of all ages who suffered from migraines. A 90 percent success rate was achieved with this approach. Estrogen levels were restored for these patients within three to seven days and their headaches were either reduced significantly or eliminated.
Migraine Headache Hormone Therapy
Understanding the interplay between hormones and migraines is crucial for developing targeted treatments. Hormone therapies, lifestyle modifications, and other interventions can be combined in a comprehensive treatment plan to manage migraines more effectively, especially in individuals whose headaches are influenced by hormonal fluctuations.
However, due to the complexity of these interactions, personalized approaches by a trained hormone therapy specialist are recommended for a comprehensive assessment and tailored migraine treatment plan.
If you are suffering from migraines and have been unsuccessful in treating them with other methods, the issue may be your hormones. Schedule a consultation with a SottoPelle Method BHRT expert today to see if hormone replacement is the headache solution that is right for you.
RESOURCES:
1 https://migraineresearchfoundation.org/about-migraine/
2 Chai NC, Peterlin BL, Calhoun AH. Migraine and estrogen. Curr Opin Neurol. 2014 Jun;27(3):315-24. http://www.ncbi.nlm.nih.gov/pubmed/24792340
3 https://www.clinicalresearch.com/healthday-news/2014/06/24/migraines-may-worsen-during-menopause#sthash.3RGqmC1a.dpuf
4 MacGregor, EA. Estrogen replacement and migraine. Maturitas. 2009 May: 63 (1); 51–55
5 Lichten, EM. Migraine & Estradiol Pellets. Cepahalgia 1999;19(4):332. http://www.usdoctor.com/article5.htm
6 Greenblatt RB (ed). Menopausal Syndrome. New York: Medcom Press; 1974:102-110
