Women and migraines: the hormone connection

July 10, 2020

Providence Women's Health Team

Why are women more likely than men to suffer from migraines?
Estrogen may play a part in why women get migraines.
Is there a link between estrogen and protection from COVID-19?

[3 MIN READ]

The piercing head pain often starts in the morning and may last a few hours or even up to two days. You may also have nausea, vision changes, extreme exhaustion and sensitivity to light and sounds. When you finally come out of your migraine stupor, you may find yourself raiding your pantry because you are starving from the hard work your body has been doing to deal with the pain. Some people have this happen once or twice a week at varying degrees. Others feel lucky if it only happens once or twice a year. Sure, it’s not a threat to life and limb, but when it happens, it hampers the day’s routine in a major way. It’s not just annoying; it’s draining.

If any of that sounds like your experience, it most likely means you suffer from migraines.

People of all ages and backgrounds get migraines. But according to the American Migraine Foundation, three times more women than men suffer from this condition. Why? Research shows that hormones and migraines are related when it comes to gender differences.

What causes migraines — and why they’re beyond the common headache

At this time, researchers don’t fully understand what causes migraines. Most studies suggest that they could be related to abnormal substances that are produced in the brain. When those substance levels rise, they cause inflammation. The inflammation leads to swollen blood vessels in the brain that press on nearby nerves. The result? Intense head pain.

Abnormal genes may also have a link to migraines. These genes may control the way certain brain cells function and can lead to migraines.

But what about the link between hormones and migraines in women? For many women, migraines take place around the time they have their monthly period. These menstrual-related migraines happen within a two- or three-day window before they start their period. Unfortunately, these migraine attacks may be more disabling than the non-menstrual kind.

The hormone connection

The hormone estrogen is believed to be related to migraines. Studies connect hormones to migraines, but not all migraines are because of hormones. Research has found that when estrogen levels quickly drop just before their periods, women have a greater chance of developing migraine headaches.

For instance, during pregnancy, when estrogen levels rise and stay up through the pregnancy, women have fewer migraine headaches. And for some pregnant women, migraines disappear completely. After pregnancy, however, the abrupt drop in estrogen levels may trigger headaches again.

During perimenopause, which is when women begin to transition to menopause, migraines may happen more often and be more severe. That’s because of the sharp rise and fall of hormone levels during this time. But once women reach menopause, many see an improvement in their migraine headaches.

Migraine triggers

Along with hormone changes during the menstrual cycle, experts have found other kinds of factors and events that affect people who get migraines. These are called triggers. Everyone reacts differently to triggers and they don’t always cause migraines. Usually, a mix of triggers and not just one thing or event is more likely to cause a migraine attack.

According to the Office on Women’s Health, women who get migraines tend to have attacks triggered by:

Lack of sleep or too much sleep
Skipped meals
Bright lights, loud noises or strong odors
Stress and anxiety, or relaxation after stress
Weather changes
Alcohol (often red wine)
Caffeine (too much or withdrawal from it)
Foods that contain nitrates, such as hot dogs and lunch meats
Foods that contain MSG (monosodium glutamate), which is a flavor enhancer found in fast foods, broths, seasonings and spices
Foods that contain tyramine, such as aged cheeses, soy products, fava beans, hard sausages, smoked fish and Chianti wine
Aspartame, which is found in sweeteners like Equal^®

Learn what prompts your migraine attacks so you can avoid or limit them. Migraines are more common during times of stress. Now with the COVID-19 pandemic affecting day-to-day life, it’s important to find healthy ways to cope with stress. Ask your doctor if a fitness program would be helpful or try an online relaxation class.

COVID-19 and migraines

While more research is needed, data suggests that estrogen may provide some protection for women exposed to COVID-19. It seems to do this by building their immune systems.

Still, there hasn’t been enough solid research on migraine and COVID-19 at this time to be sure estrogen protects against the virus. It’s important to note that most doctors believe that women who are otherwise in good health don’t seem to be at higher risk of getting the virus.

While the guidelines to help limit the risk of getting COVID-19 still apply to everyone, there are a few things to keep in mind when it comes to migraines. These tips may help lower your chances of having migraine attacks during the pandemic.

Stay on top of your medicine supply. If you suffer from migraines, the last thing you want is to run out of medicine when you’re trying to limit outings and stay socially distant. That’s why you’ll want to make sure you have any rescue medicines or preventive medicines on hand.
Stay on track with your schedule. While you can’t completely control all disruptions to your schedule, try to address what you can. That means sticking with a routine when it comes to staying hydrated, eating well (avoid those food triggers!) and getting enough sleep.
Stay calm and avoid stress. As mentioned, stress and anxiety can trigger migraines. To help manage stress, reach out for support and learn ways to practice self-care.
Stay in touch with your doctor. As hospitals and doctors’ offices reopen, keep in mind that they’re very careful to make each location safe for patients. Your health is too important — reach out to your doctor for help when you need it. If you’re more comfortable with virtual visits for now, see if your doctor and health plan provide telemedicine resources.

Make a connection to get migraine help

Migraine is a disease that affects 39 million Americans. The Migraine Research Foundation says that in the US,18% of women suffer compared to 6% of men. Despite those overwhelming numbers, you may feel alone in your pain. But you don’t have to be. That’s why it’s important to connect with your doctor and get the help you need, even during the pandemic. Providence has committed to 7 safety steps that can help give our patients confidence when they need to visit our facilities.

If you need care, get care. Don’t delay.

Find a doctor

Providence doctors can help you find help to take control of your migraine pain and its triggers. Search in our provider directory for a primary care doctor.

Do you suffer with migraines? Share your experiences and solutions with others @Providence. #migraine

Related resources

Botox may offer relief for chronic migraine sufferers

American Migraine Foundation

Migraine information page

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Headaches in menopause: Are you at risk?