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Published on April 01, 2014

Coping With Hormonal Headaches


SIOUX FALLS (April 1, 2014) – If you get slammed with headaches that only come at “that time of the month” or get worse with monthly cycles, you can rightly blame your hormones.

“There is some hormonal influence in most female migraine sufferers. It is common to have some worsening a day or two before your period,” said Dr. Carol Miles, Neurologist with Neurology Associates, located on the Avera McKennan Hospital & University Health Center campus, and the Headache Center located at 6709 S. Minnesota Ave.

“Menstrual migraine” is the term for headaches that only happen around the time of your period, or at the time of ovulation. Even if period-related headaches are mild, they probably fall into the “migraine” classification. “Other types of headaches aren’t affected by hormones,” Dr. Miles said.

Migraines usually are characterized by throbbing, pounding pain on one side of the head. Headaches are aggravated by routine activities, and often involve nausea. About 20 percent of migraineurs also experience an “aura,” which often includes visual disturbances such as flashes like lightning.

Any hormonal fluctuation can influence migraines. “Some women start getting headaches with the start of their first menstrual period, or after the birth of a child. Or, they may have headaches that get worse with menopause,” Dr. Miles said.

Stabilizing hormones helps. “We often encourage breastfeeding for at least a year after the birth of a child, as that can break a bad headache cycle,” Dr. Miles said.

Some migraine patients need preventive and symptomatic treatment. Preventive treatment includes medication such as high blood pressure drugs, anti-epileptic medications and anti-depressants, which help reduce the frequency and severity of headaches. Hormonal treatments also can help. Medications such as triptans and over-the-counter analgesics are prescribed to treat symptoms at the time of a migraine attack.

Not all treatment comes in the form of a pill. Botox injections at various sites – between the eyebrows, at the temples, on the back of the head, and on the neck and shoulders – decrease the release of neurotransmitters responsible for pain. Similar to injections for cosmetic purposes, the injections don’t impact the look of the face, other than perhaps diminishing wrinkles associated with furrowing the brow. These treatments have little or no side effects, and reduce headache frequency and severity by about 50 percent.

Another non-medication treatment is wearing glasses with therapeutic lenses. Although this approach is intended for chronic daily headache sufferers, some migraine sufferers also experience benefit.

Over-the-counter remedies might work for milder headaches. “If you’re not getting a response, or if you’re taking an over-the-counter medication daily, you should go to your doctor and explore other options,” Dr. Miles said.

There are several non-medication steps that migraine sufferers can take to prevent headaches.

  • Sleep on a regular schedule. “The migraine brain likes routine. Go to bed and get up at the same time,” Dr. Miles said.
  • Eat on a regular schedule, and try to include at least three meals daily. If your schedule prevents you from eating at your normal time, bring along a snack.
  • Avoid foods with preservatives, aspartame (NutraSweet), caffeine and alcohol.
  • Exercise three to four times a week for at least 20 minutes. It does not have to be strenuous, just a walk can be just as beneficial.
  • Minimize stressors in your life.

When headaches do strike, stay hydrated. Minimize stimulation, i.e., light, sounds and smells. Go to a dark, quiet room for 20 minutes if you can.

“Migraines are under diagnosed and under treated. They affect two out of 10 women – and these are only the ones we know about. If headaches impact your life at all, it’s worth going in to see your doctor,” Dr. Miles said. “Some people just accept migraines as their lot in life. Yet even patients who have ‘tried everything’ can often be helped. Sometimes, it takes so little to really improve quality of life.”