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Estrogen Associated Headaches

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Headaches have multiple causes and one of them could be the hormone estrogen. Read about estrogen-related headaches, their prevention, and how to manage them.

Written by

Dr. Swathi. R

Medically reviewed by

Dr. Nitin Joshi

Published At November 6, 2023
Reviewed AtNovember 6, 2023

Introduction:

Migraines and headaches are multifactorial and could be multi-origin. Multiple factors like family history, hormonal changes, and age-related problems could cause headaches. They can also be triggered by hormonal fluctuations and diet.

How Do Female Hormones Contribute to Migraines?

Men and women both may suffer from hormonal migraines. They are characterized based on their sex differences, most obviously marked based on differences in the sex hormones (in males - testosterone, and in females - estrogen and progesterone). Studies show a higher migraine prevalence among women of reproductive age and lower migraine prevalence before puberty and post-menopause. This indicates as estrogen is low before puberty and post-menopause, women are less likely to get headaches during that time.

What Is the Connection Between Estrogen and Headaches?

Stable estrogen levels may improve headaches. Estrogen fluctuations in the body could either cause a headache or make the existing headache worse. Although changing hormone levels may influence headache patterns, one is not completely off their hormones. A doctor may help in treating or preventing hormone-related headaches. Studies show female hormone, estrogen plays a key role in regulating the menstrual cycle and pregnancy which may also trigger a headache by releasing certain chemicals in the brain. Estrogen fluctuations during different phases (menstruation, menopause, and pregnancy) may also be a reason for headaches. Oral contraceptives and hormone replacement therapies also cause disruption in the hormonal cycle which could cause headaches. Women who experience hormonal headaches often find relief during pregnancy or after menopause. A variety of medications and other treatment options are used to relieve such kinds of estrogen-associated headaches.

What Is the Connection Between Estrogen and the Central Nervous System?

In nonpregnant women, estrogen is produced primarily by the ovaries, and smaller quantities of the adipocytes, the liver, the breasts, and adrenal glands. In men, estrogen is synthesized from androstenedione and testosterone by aromatization (converting into one or more aromatic compounds). Estrogen quantities are lower in men than in young women. In nonpregnant women, three major estrogens are estradiol, estriol, and estrone. The most potent form of estrogen is estradiol. Estrogen effects on the brain can occur via three distinct pathways.

Why Do Headaches Occur During Menstruation?

The drop in estrogen just before one's period might contribute to headaches during or before menstruation. One's menstrual-related migraines may be treated in many ways. There are proven treatments for estrogen-related headaches or migraines (menstrual migraine) that are often effective. They may include the following:

  • Ice Packs - Hold a cold or an ice pack with a painful area on one's head or neck. Pack it with a towel to protect the skin.

  • Relaxation Exercises - One can try relaxation exercises to lower stress.

  • Acupuncture Therapy - Acupuncture can improve estrogen-related headaches and helps the body to relax and reduce stress levels too.

  • Over-the-Counter Pain Relievers - Doctors may prescribe medications for menstrual pain which also help in reducing estrogen-related headaches.

Hormonal contraceptive methods such as birth control pills, patches, or vaginal rings might change one's headache patterns by improving or worsening them. Some hormonal contraceptive pills can help reduce the severity and frequency of menstrual-related migraines by minimizing the estrogen drop associated with menstrual cycles. One should consult a doctor about contraceptive options if one has migraines. Oral hormonal contraceptives can change the pattern of headaches. Hormonal contraceptives may include birth control pills, vaginal rings, or patches. Birth control pills minimize, and relieve headache pain and the drop in estrogen level which happens during periods.

What Is the Relation Between Estrogen and Pregnancy Headaches?

Estrogen levels are elevated during pregnancy and remain elevated throughout the phase. Migraines often improve, or even they may disappear during the pregnancy due to increased levels of estrogen. Tension headaches usually do not improve as they are not affected by stress hormones such as cortisol. Chronic headaches before pregnancy need attention and one should seek the right treatment, therapies, and medications since most medications have harmful or unknown effects on developing babies. After delivery, a decrease in estrogen levels, stress, irregular eating habits, and lack of sleep may trigger headaches again due to increased blood pressure in the arteries from lying down may increase the pain. One should be careful with headache medicine while breastfeeding. Doctors can prescribe the medications one can take while breastfeeding.

Why Do Headaches Occur During Perimenopause and Menopause?

Most women experience frequent and more severe hormone-related headaches and migraines during the perimenopause phase due to a drop in hormone levels. In some women, migraine increases due to a drop in levels of estrogen and progesterone hormones, occurring when the menstruation stops. Headaches associated with tension and stress often show worsening of symptoms and are not hormonal-related or estrogen-related. If the headaches persist even after menopause, there might be other hidden causes. In such cases, it is best to consult a doctor and opt for treatments based on the cause. Hormone replacement therapy (medication contains female hormones estrogen and progesterone) is sometimes used to treat or relieve perimenopause and also in menopause worsens headaches in some women. At times doctors may prescribe estrogen patches to provide a steady supply of estrogen to the body to avoid estrogen fluctuations that might trigger headaches.

Persistent estrogen headaches extending to more than a month might be alarming and may need medical treatments. Doctors prescribe medications like NSAIDs (non-steroidal anti-inflammatory drugs) or triptans (medication used to treat migraine headaches). Headaches persist throughout the phase of menstruation and can be treated with preventive medications. These medications may include,

  • Beta-blockers.

  • Anticonvulsants.

  • Calcium channel blockers.

  • Magnesium.

  • Antidepressants.

Lifestyle changes such as reducing stress, avoiding skipping meals, and regularly exercising might also help in reducing the frequency, severity, and duration of hormonal or estrogen-related migraines and headaches.

Conclusion:

Women are more sensitive to the effects of hormones. Estrogen helps to control the chemicals in the brain which affect the sensation of pain. A drop in estrogen levels can trigger headaches. Hormone replacement therapy worsens headaches. If the headaches disturb one's daily activities, work, or personal life, one can consult for help from a doctor. Doctors may lower the estrogen doses that change to different forms of estrogen or stop the hormone replacement therapy.

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Dr. Nitin Joshi
Dr. Nitin Joshi

Pain Medicine

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