Relieving Hormonal Headaches: What Helps?

Medically reviewed by Kelly Wood, MD

Sex hormones are one of many factors that contribute to headache development. Changes in estrogen and other hormones during menstruation (your period), pregnancy, and menopause can cause hormonal headaches and trigger migraines. About 60% of people with periods who get migraines experience attacks during menstruation.

Hormonal headaches can cause a range of debilitating symptoms. However, there are ways to prevent and treat hormonal headaches. Determining treatment begins with understanding how hormones and headaches are related and what can trigger them.

This article breaks down the causes and symptoms of hormonal headaches, what you can do to manage them, and when to get help.

Hormonal Role of Headaches

Headaches arise due to the activity of the trigeminal nerve. This nerve relays pain and sensation information to the brain's pain center (thalamus) from the blood vessels and tissue surrounding the brain, scalp, face, neck, ears, eyes, and mouth.

Estrogen and progesterone—hormones that regulate reproduction—moderate trigeminal nerve activity, so changes in these hormone levels can trigger headaches.

Estrogen and progesterone levels fluctuate throughout the menstrual cycle. They drop to their lowest levels in the premenstrual stage, which starts about five days before your period.

This hormone shift can cause menstrual migraines, which arise between two days before and three days after menstruation begins.

Estrogen levels rise during pregnancy and fall after giving birth. In some people, the estrogen increase can stop migraines. In others, migraines develop in the first trimester and resolve by the third.

Elevated estrogen levels are associated with migraines with aura, a migraine that also causes visual symptoms. Breastfeeding also contributes to rapid shifts in estrogen levels, which can also bring on headaches.

Perimenopause is the time frame roughly two to eight years leading up to menopause—when the menstrual cycle naturally stops for 12 consecutive months. During this time, estrogen and progesterone decline, potentially worsening existing migraine cases.

Between 8% and 13% of people in perimenopause experience their first migraine attack during this time. However, people with migraine often have fewer symptoms and attacks during menopause.

A range of factors can affect sex hormone levels and contribute to hormonal headaches. These include:

• Hormone therapy: Taking hormone replacement therapy (HRT) or hormone-based birth control causes rapid shifts in hormone levels, leading to hormonal headaches.

• Hysterectomy: A hysterectomy is a procedure to remove the uterus, which causes hormone levels to drop and can lead to headaches.

• Stress: Stress causes a physiological reaction that makes people more susceptible to migraines. Researchers found this to be especially true in the premenstrual time frame, adding to the chance of migraine attacks.

• Sleep disturbances: Disruptions to the sleep-wake cycle—getting too much or too little sleep or having trouble staying asleep—and sleep disorders also contribute to hormonal headaches.

• Dietary factors: Dehydration (not drinking enough water) and skipping meals can also cause headaches. Certain foods may also trigger migraines.

Birth Control and Headache

Estrogen and progesterone are ingredients in a range of hormonal birth control methods, including oral contraceptives (the pill), skin patches, and vaginal rings.

Hormonal birth control contributes to hormone fluctuations, which can lead to hormonal headaches and trigger migraines. That said, some people with menstrual migraines may have less-frequent attacks while on birth control.

Triggers

Various health and lifestyle factors can trigger hormonal headaches. Common triggers include:

• Alcohol, especially red wine

• Aspartame or other artificial sweeteners

• Bright or flickering lights

• Changes in weather patterns

• Dark chocolate

• Drinking too much or too little caffeine

• Foods containing preservatives or, debatably, monosodium glutamate (MSG), such as cured meats, bacon, hard sausage, and processed fish

• Loud sounds

• Not getting enough sleep
  

• Strong odors
  

• Soy products
  

Pinpointing How Hormonal Headaches Feel

Hormonal headache symptoms can vary from person to person and range in severity. Typically, hormonal headaches resemble migraines characterized by throbbing, pulsing, or severe pain, often on one side of the head; some people experience dull pain.

Hormonal headache pain can be severe and move to other parts of the head, such as the jaw.

Along with the headache, hormonal headaches can cause a range of additional symptoms, including the following:

• Blurred or disturbed vision

• Decreased urination

• Dizziness

• Fatigue

• Loss of appetite

• Loss of coordination

• Migraine attacks

• Scalp soreness or tenderness
  

• Sensitivity to light or sound

• Stomach pain, nausea, and vomiting
  

In some cases, people with hormonal headaches have a migraine with aura. Before a headache sets on, auras cause you to see blind spots and wavy lines or experience tingling in the face or hands. Hormonal headaches can last several hours to several days.

Emergency Symptoms

While severe hormonal headaches aren’t usually a sign of a more severe condition, knowing when your symptoms prompt emergency help is essential. Call 911 if you experience any of the following during an attack:

• A headache worse than any you’ve had before

• Problems with moving and motor coordination, loss of balance

• Speech and vision problems, especially if you haven’t experienced these before

• Very sudden onset of headache

Treatment: How to Relieve Hormonal Headaches

As debilitating as hormonal headaches can be, there are many ways to find relief. Since headaches can be complicated and challenging to treat, management strategies typically involve mixing and matching methods to determine what works.

Everything from home management techniques to medications or alternative therapies can play a role in coping with hormonal headaches.

Home Management

Home management techniques that may help with hormonal headaches include:

• Breathing exercises or other relaxation methods, such as massage

• Drinking water and staying hydrated

• Icing or placing a cold cloth on your head
  

• Lying down to rest in a quiet, dark room

• Rubbing and massaging your temples
  

Medications

Several medications are either “rescue” or “abortive” drugs for headaches, meaning they help manage symptoms when a headache starts. Examples of these medications are:

• Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs). such as Advil or Motrin (ibuprofen), Aleve (naproxen), or aspirin for mild cases

• Combinations of caffeine and Tylenol (acetaminophen)

• Triptans like Zomig (zolmitriptan), Maxalt (rizatriptan), and Imitrex (sumatriptan), taken orally or intranasally

• Calcitonin gene-related peptide blockers (CGRPs), such as Nurtec ODT (rimegepant) or Ubrelvy (ubrogepant)

• Antinausea medications like Reglan (metoclopramide) or Zavzpret (zavegepant)

A healthcare provider may prescribe drugs to prevent attacks in severe and recurring cases. These include:

• Anticonvulsants (anti-seizure medications)

• Antidepressants (certain ones)

• High blood pressure (hypertension) medications like beta-blockers or calcium channel blockers

Hormone Therapy and Birth Control

In some cases, hormone therapy aimed at boosting estrogen levels can prevent hormonal headaches. Your healthcare provider may prescribe transdermal patches or oral contraceptives, especially if preventive medications haven’t yielded results.

In addition, they may change the type of birth control you’re on, for instance, switching you to a progesterone-based option.

Complementary Therapies

Alongside medications and other techniques, there are a range of complementary therapies that may also offer relief. These include:

• Supplements: There’s evidence that certain minerals and supplements, such as magnesium, vitamin B2, coenzyme Q10 (CoQ10), and butterbur extract, may help reduce the frequency of migraines.

• Biofeedback: Biofeedback involves paying attention to your body’s signs of stress and learning techniques to head off and cope with symptoms.

• Relaxation training: During relaxation training, you work with a therapist to develop techniques that promote relaxation and ease stress and anxiety that can trigger headaches.

• Acupuncture: A therapy with origins in traditional Chinese medicine, acupuncture involves inserting needles into certain areas of the skin to relieve headache pain. Studies have found this effective in reducing the duration and frequency of headache attacks.

Self-Care in Between Hormonal Headaches

Lifestyle changes, along with other treatments, can be central to hormonal headache management. Adjusting your habits, such as in the following ways, can help prevent attacks and reduce their severity:

• Get enough sleep: Sleep disruptions can contribute to headaches. Aim to get seven or eight hours of uninterrupted sleep at night.

• Exercise regularly: Regular exercise can offer stress relief, improve sleep quality, and manage your obesity risk (obesity is a risk factor for migraines and headaches).

• Eat a nutrient-dense diet: Maintaining a healthy diet improves sleep and manages obesity, reducing the frequency and severity of hormonal headaches.

• Manage stress: Determining healthy ways to manage stress is central to preventing migraines and hormonal headaches.
  

Track Your Headaches

If you have headaches, log your symptoms, medications, and potential triggers. Track when you’re having them and how long attacks last. Note the medicines you take, whether they work, how much sleep you’re getting, and any other triggers.

This information will help you manage your hormonal headaches and help a healthcare provider determine a diagnosis and proper treatment.

When to Talk to a Healthcare Provider

If you experience hormonal headaches, getting a proper diagnosis is a critical step in managing your condition. Call a healthcare provider if you experience:

• Changes in headache activity and patterns

• Frequent headaches that interrupt your daily life

• Headaches that are more severe when lying down

• Increased headaches with birth control or HRT

• New or worsening symptoms
  

• Symptoms that persist or worsen despite treatments

• Uncomfortable or persistent medication side effects
  

Summary

Hormone level changes cause hormonal headaches. These types of headaches can occur with menstruation, hormone therapies, pregnancy, and perimenopause. Hormonal headaches can cause a range of symptoms, and there are various treatment options. It may take time to find what works for you.

Hormonal headaches can severely impact your quality of life and ability to function. However difficult they can be, current treatments and lifestyle strategies can help manage this condition. If you’re having problems with headaches, be proactive and talk to your healthcare provider.

Read the original article on Verywell Health.