It's Worse For Women: 4 Ways Hormones Give Us Headaches
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Do female hormones cause more headaches in women? Unfortunately, it appears so.
“From around the time of puberty through the changes of menopause, women experience significantly more headaches than men, particularly migraines”, explains William Rettig, MD.
According to studies reported by the National Institutes of Health (NIH), women in the U.S. suffer migraines at a rate three times higher than in men. The most likely culprits are hormonal fluctuations that result from important life stages, some medical conditions, and even pharmaceuticals unique to women (like contraceptives), reports the American Headache Society.
Here’s a look at how hormones put women at greater risk of headaches, and especially migraines, during various phases of their lives.
Puberty
Once girls reach puberty, they’re more likely to experience headaches. According to a study in the medical journal Headache, of nearly 900 girls between the ages of 9 and 18, just over half of those who had begun menstruating had headaches during their periods, while 37 percent of all girls reported monthly headaches, whether or not they had started menstruating.
Menstruation
About 50 to 60 percent of women’s migraines are menstrual migraines, according to studies reported by the NIH. These can occur during ovulation, or before, during or immediately after a period.
Serotonin is likely the primary hormonal trigger in headaches for both men and women. “But, for women, how serotonin interacts with uniquely female hormones like estrogen and progesterone may be the trigger for menstrual migraines,” says Dr. Rettig.
Menstrual migraines often begin as a one-sided, throbbing headache accompanied by nausea, vomiting, or sensitivity to bright lights and sounds. Treatment may include:
- Medications to treat migraines as they occur. These include nonsteroidal anti-inflammatory drugs (NSAIDs, like aspirin, ibuprofen and naproxen), dihydroergotamine (DHE), triptans, anti-depressants, or a combination of aspirin, acetaminophen and caffeine (but please talk to your doctor before combining these).
- Hormonal therapy. Your doctor may prescribe supplemental estrogen, or, if you’re already taking estrogen/progesterone birth control pills, you may be advised to take them daily (without a break) for three to six months in order to avoid fluctuations.
- Preventive treatment. Your doctor may have you take migraine medications just before a migraine begins to ward off frequent and severe attacks.
Headache specialist Richard Kim, MD, says that migraine headaches are more common for women than men and that many women who experience migraines say that their first migraine attack occurred around their first menstrual period.
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Some women experience a pre-menstrual (PMS) headache with symptoms that are a bit different from a menstrual headache or migraine. You may have headache pain accompanied by fatigue, acne, joint pain, decreased urination, constipation, and lack of coordination. You may also experience an increase in appetite and a craving for chocolate, salt, or alcohol.
Pregnancy
About 15 to 20 percent of pregnant women have migraines. More than half find that their migraines occur less often as they get closer to giving birth. However, migraines may worsen after delivery, during the postpartum period.
Women in the U.S. suffer migraines at a rate three times higher than in men.
Migraines, while intensely painful for mom, pose no dangers to the developing baby. And, according to Dr. Rettig, “If a woman has a history of migraines, and there are no other health problems, then migraines during pregnancy are usually not something to worry about.”
However, if a first-time migraine-like headache occurs in pregnancy, let your doctor know. It’s important to rule out any other dangerous conditions, including bleeding in the brain, meningitis (infection in the brain tissues), preeclampsia or tumors. You may need further testing.
Keeping in mind your baby’s safety, the following migraine treatments may be recommended:
- Soothing measures, such as cold packs, a dark room and sleep
- Avoiding triggers, such as certain foods and stress
- Medications (but because many drugs pass through the placenta to the baby, these must be considered carefully and only with the advice of your doctor)
Menopause
During menopause, fluctuations in hormones may cause headaches and migraines to increase or decrease in women who use menopausal hormone therapy. Migraines may actually worsen in the years immediately before menopause, called perimenopause.
Depending on how severe and frequent your headaches are, treatment may include continuous menopausal hormone therapy or one of these non-hormonal options:
- Lifestyle changes, alone or combined with a nonprescription treatment such as isoflavones
- Antidepressants such as venlafaxine, fluoxetine, and paroxetine
- Gabapentin (a medication typically used to treat epilepsy, neuropathic pain, and hot flashes)
Hysterectomy and/or removal of the ovaries can actually increase the frequency of migraines and menopause symptoms.
“With all the advancements in understanding how headaches affect women at various phases of their lives, and how to treat those, I think we can help many women cope with the discomfort, or even crippling pain, that headaches and migraines bring,” advises Dr. Rettig. “It’s crucial to work closely with your doctor in addressing these problems.”
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Source: American Headache Society; National Institutes of Health; William Rettig, MD, Lifestages Centers for Women; Richard Kim, MD, Clinical Neuroscience Institute
