Migraine is among the most debilitating conditions in the world, effecting 38 million people in the United States alone. It also comes as no shock that migraines are 3 times more likely to effect women than men, which means migraine is effecting over 25 million American women! While there is no doubt that hormones play a role in migraines, it is still unclear exactly what role they play. Some women feel better after going on birth control, some women feel worse. Some women find relief after entering menopause, while for some women the worst is yet to come. So what is with the variability? This article is going to dive into migraine during menopause and why women can feel better, worse, or it can just be the beginning.
The Hormone Situation
So what is it with hormones? Well, good news is, sometimes migraines can be caused by too much estrogen, so heading into menopause may be the best thing that ever happened to your migraines. But what if that’s not the case? Menopause means many different changes throughout the entire body, but the big thing that happens is a rapid decrease in hormones. Now it’s not so much the decrease in hormones that can cause the issue, in fact that is what is supposed to happen when a women enters menopause. It’s the RAPID decrease (key word being rapid) that causes our bodies to freak out a little bit. A rapid decrease in hormones causes a surge of inflammatory substances, many of which have a large effect on the brain. These inflammatory substances can make our brain more sensitive to our environment, leading to light and sound sensitivity, nausea, fatigue, brain fog, as well as migraine.
Migraine frequency in menopause tends to decrease, so why are so many menopausal women suffering from migraines? A study done by Delaruelle in 2018 found “migraine prevalence declines after menopause compared to the fertile period. However, the prevalence of migraine after the menopause is still 10 to 29% across studies”. That means up to almost 30% of women are still suffering from migraines after they hit menopause.
The big question is why!
What can be done?!
There are many things that menopausal women should know about migraines. Here are just a few:
Inflammation is a major source of problems for all women during menopause, not only those who have migraines. A woman’s body is supposed to adapt to the rapid drop in hormones during perimenopause, but when it cannot we get a bunch of body-wide inflammation. This is one mechanism that can potentially increase the prevalence of migraine in women in menopause. Addressing this inflammation can not only lessen migraine severity and frequency but can also help with other menopausal symptoms as well! Sometimes inflammation like this can be seen on testing, but sometimes it cannot. However, whenever we have a sudden drop in hormones, inflammation is inevitable and must be addressed promptly.
2. Hormone Imbalance
Hormone imbalances are a problem for women of all ages, but going into menopause with a hormonal imbalance can cause real issues. When we reach perimenopause and our hormones begin to drop, our adrenal glands are supposed to take over and produce the little hormones our body still needs. If our adrenal glands can’t handle the new responsibility (whether that be due to subclinical infection, stress, thyroid issues, etc) we see even more of a hormonal problem. The best and most thorough hormonal panel that can be run is called a Dutch test. Running a Dutch test will give us accurate hormone levels as well as how well hormonal enzymes are functioning. With this information, we can accurately manage hormonal levels and in turn, help decrease migraine.
3. Neurological Changes
One major system hormones and inflammation can effect is the nervous system. Our sex hormones even have neuro-equivalents in our brain! Inflammation can break down the blood brain barrier and let bad things through, leading to more inflammation in the brain. This can cause an increase in migraine severity and frequency because our brain becomes more sensitive (see our blog called “Trigger Happy – Why “Triggers” Are Not Causing Your Migraines“)
At Restorative Health Solutions….
Addressing the underlying cause of migraine is one of the most important thing we do. After that, managing other bodily systems involved is equally as important. Doing a thorough history and neurological examination combined with the proper advanced testing can provide the answers you need to manage your migraines properly.
If you are in menopause and are still suffering from migraine, give us a call for a free 15 minute phone consultation with one of our clinicians. During this phone call, the doctor will talk you through the first appointment as well as talk pricing.
Click on the link blow to read more about migraine headaches from Dr. Ellie and Restorative Health Solutions!