Headaches and Hormonal Imbalance: Causes, symptoms, Complications, Treatment, Prevention


Headache is the most common thing that we experience in our daily life. It can be caused by many factors, including genetics and dietary triggers.

June 20, 2018

Headache is the most common thing that we experience in our daily life. It can be caused by many factors, including genetics and dietary triggers. Fluctuating hormone levels are a major contributing factor in chronic headaches and menstrual migraines in women.
Hormone fluctuations occur naturally during puberty, menstrual cycle, pregnancy, menopause and perimenopause. Hormone imbalance may also be caused by toxins or an unbalanced lifestyle, oral contraceptives and hormone replacement therapies and many more. Hormonal headaches often disappears during pregnancy or menopause by their own. A variety of medications and other treatments are available to get relief from headaches.

Causes of Hormonal headaches:

The female hormone estrogen is associated with headaches, especially migraine headaches. As estrogen controls chemicals in the brain that affect the sensation of pain, a drop in estrogen levels can trigger a headache.
The reasons for which there is change in estrogen level varies person to person, including:

Menstrual cycle:

Just prior to menstruation, levels of estrogen and progesterone fall to their lowest levels causing headache.

Pregnancy:

Estrogen levels rise in pregnancy. For this reason, hormonal headaches go away during pregnancy for most women. However, some women experience their first migraines during early pregnancy and then find relief after the first trimester. Estrogen levels fall rapidly after giving birth to a baby.

Perimenopause and menopause:

Fluctuating hormone levels in perimenopause can cause more headaches in some cases. However, the symptoms improve after reaching menopause for most of the women. For few of them, migraines actually worsen. This may be due to the use of hormone replacement therapies.

Oral contraceptives and hormone replacement therapy:

Birth control pills and hormone replacement therapy can cause hormone levels fluctuation causing headache. Women whose migraines come as a result of hormonal changes, can have migraine attacks during the last week of the cycle if they are on the pills.

Other contributing factors:

Chronic migraines can be linked with genetics and dietary triggers. A combination of factors that can trigger headache, especially migraines include:

  • skipping meals
  • getting too much or too little sleep
  • stress
  • severe weather changes
  • artificial sweeteners
  • too much caffeine or caffeine withdrawal
  • alcoholic beverages, especially red wine
  • intense lights, sounds, or smells
  • processed meats, hard sausages, and smoked fish
  • monosodium glutamate (MSG), a flavor enhancer
  • aged cheeses
  • soy products

Symptoms of hormonal headaches:

Menstrual or hormonal migraines are similar to a regular migraine. The migraine is a throbbing pain that starts on one side of the head. It may also involve sensitivity to light and nausea or vomiting. The symptoms of hormonal headache are different from normal headache that are due to either skipping meals or lack of sleep. The symptoms include:

  • loss of appetite
  • fatigue
  • acne
  • constipation
  • decreased urination
  • lack of coordination
  • cravings for alcohol, salt, or chocolate
  • joint pain

Complications and emergency symptoms:

Women with frequent hormonal headaches or menstrual migraines are susceptible to complications like depression, sleep disturbances and anxiety.
Oral contraceptives and estrogen are considered as safe for many women. But they are also associated with a slightly higher risk of stroke and blood clots. Women with high blood pressure or family history of stroke are particularly at risk. 

If you experience dizziness, stiff neck, rash, shortness of breath, loss of vision or any other drastic symptoms with a sudden, severe headache, immediately seek emergency medical attention.

Treatment for hormonal headaches:

The treatment option varies from person to person depending on the cause and condition of headache. These include:

Medication:

For acute headache, treatment include medications that can be taken once a headache or migraine attack has started. Examples include:

  • over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen
  • triptans, which are migraine-specific medications that can reduce the intensity of a migraine attack

For frequent hormonal headaches, preventive therapy and medications may be used. These medications may be taken daily or before the time in your cycle when you know you are most likely to get a hormonal headache. These medications include:

  • beta blockers
  • anticonvulsants
  • calcium channel blockers
  • antidepressants

Hormone therapy:

Hormone therapy will be prescribed if preventive medications does not work. You may be given estrogen to take daily. These may be either in the form of a pill or a pitch. Birth control pills are commonly used to balance hormones and reduce hormonal headaches. If you still experience hormonal headaches, even after taking the pills, the dose should be adjusted by your doctor. Your doctor may switch you to a medication with a lower dose of estrogen to reduce your symptoms. However, changing of dose or switching to other medication will totally depend on your overall health condition.
Skipping the hormone-free placebo pills in the last week of the pack or starting the next birth control pack early may be beneficial for some women. But this can only be done three to six months at a time, which can reduce the frequency of attacks.
As some headache medications may harm the development of infant as well as fetus, you should discuss all your medications with your doctor if you are planning on getting pregnant, are pregnant, or are breastfeeding.
If you take hormone replacement therapy medication and experience an increase in headaches during perimenopause or menopause, ask your doctor to adjust your dose. A low, steady dose of estrogen can be given through estrogen patch, which can lessen the frequency and severity of headaches.

Preventing hormonal headaches:

Preventive medication are recommended if you have regular periods. The medication would begin a few days prior to your period and last up to two weeks. Daily medication may be required in some cases. Keep a track of your menstrual cycle, diet, sleep, and exercise habits. This will help identify possible triggers.
Below are some alternative ways to take oral contraceptives. But ask your doctor if you can choose any one of them:

  • switch to a regimen that includes fewer or no placebo days
  • take pills with a lower estrogen dose
  • switch to progestin only birth control pills
  • take low dose estrogen pills in place of the placebo days
  • wear an estrogen patch on placebo days

If you don't currently take birth control pills, consider taking them which might reduce your hormonal headaches. Start taking them only after your doctor permission.