16/12/13 Headaches and hormones: What's the connection? - MayoClinic.com

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Home Diseases and Conditions Chronic daily headaches In-Depth Headaches and hormones: What's the connection?

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Headaches and hormones: What's theconnection?

Being female has some real health advantages, but notwhen it comes to headaches — particularly migraines.Fortunately, there's help.

By Mayo Clinic staff

Many factors contribute to headaches for both men and women, including

family history and age. Women, however, often notice a relationship between

headaches and hormonal changes.

The hormones estrogen (ES-truh-jen) and progesterone (pro-JES-tuh-rohn) —

which play key roles in regulating the menstrual cycle and pregnancy — may

affect headache-related chemicals in the brain. Steady estrogen levels may

improve headaches, while estrogen levels that lower or change can make

headaches worse.

Though fluctuating hormone levels can influence headache patterns, you're

not completely at the mercy of your hormones. Your doctor can help you

treat — or prevent — headaches.

During menstruation

The drop in estrogen just before your period may contribute to headaches.

Many women with migraines report headaches before or during menstruation.

Your menstrual-related migraines may be treated in several ways, including:

Apply ice. Hold a cold cloth or an ice pack to the painful area on your

head or neck. Wrap the ice pack in a towel to protect your skin.

Relaxation exercises. Try relaxation exercises to lower stress.

Biofeedback. Biofeedback may improve your headaches by helping

you to monitor how your body responds to stress.

Acupuncture. Acupuncture may improve your headaches and help

you relax.

Take over-the-counter pain relievers. Your doctor may recommend

you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as

naproxen (Aleve) or ibuprofen (Advil, Motrin IB, others). These

medications may relieve your pain soon after your headache begins.

Take triptans. Your doctor may prescribe triptans, medications that

block pain signals in your brain. Triptans often may relieve pain from

your headache within two hours and help to control vomiting.

Take pain relievers and triptans. Some women may take a

combination of NSAIDs and triptans to relieve pain from menstrual

migraines.

Take other prescription pain medications. Sometimes your doctor

may suggest other prescription pain medications, such as

dihydroergotamine (Dihydroergotamine Mesylate).

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Preventive treatment

If you have several debilitating headaches a month, your doctor may

recommend preventive treatment with NSAIDs or triptans.

If your menstrual cycle is regular, it's often most effective to take preventive

headache medication starting a few days before your period and continuing

through up to two weeks after the start of your period.

If you have migraines throughout your menstrual cycle or you have irregular

periods, your doctor may recommend that you take preventive medications

every day.

Daily medications may include beta blockers, anticonvulsants, calcium

channel blockers, antidepressants or magnesium. Doctors will review any

other medical conditions you may have to determine which medications may

be most appropriate for you.

Making lifestyle changes, such as reducing stress and exercising regularly,

also may help reduce the frequency, length and severity of migraines.

Using birth control pills

Some women first experience migraines while taking birth control pills.

Hormonal birth control may change existing headache patterns —

sometimes for the better, sometimes for the worse or sometimes not at all.

If you experience migraines while taking birth control pills, consult your

doctor. It may help to:

Use a monthly pill pack with fewer inactive (placebo) days.

Eliminate the placebo days completely from most months by taking

extended-cycle estrogen-progestin birth control pills (Seasonale,

Seasonique, others).

Use birth control pills that have a lower dose of estrogen to reduce the

drop in estrogen during the placebo days.

Take NSAIDs and triptans during the placebo days.

Take a low dose of estrogen pills or wear an estrogen patch during the

placebo days.

Use an estrogen-containing skin patch for one day, once a week,

during the placebo days if you're using a birth control patch.

Take a progestin-only birth control pill (Micronor, others) as an

alternative to oral estrogen-progestin birth control pills, if you're not

able to take estrogen-progestin birth control pills due to other

conditions.

Birth control pills may help reduce the frequency and severity of menstrual-

related migraines. Using birth control pills to prevent menstrual-related

migraines may be appropriate for some women who haven't been helped by

other methods.

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See Also

Nighttime headaches: How can I get relief?

Convergence insufficiency

Cluster headache

Migraine

Migraines: Are they triggered by weather changes?

Tension headache

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