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Headaches & Hormones

Are hormones to blame for your headaches? Here's how to handle the pain.



When you think of hormone-related ailments, headaches may not be the first thing that pops to mind. Yet headaches linked to fluctuating hormones are indeed a widespread issue for women, who suffer a reported three times as many headaches as men do.

Hormone-related headaches are related to the withdrawal of estrogen levels. They can kick in as early as the onset of puberty and return monthly, specifically when estrogen drops at the beginning of the menstrual cycle, says Holly Langmuir, MD, an OB-GYN with the Crozer-Keystone Health System in Pennsylvania and Delaware.

Is It a Migraine?
Typically, a migraine is a thick, one-sided headache characterized by throbbing, moderate to severe
intensity and aggravated by movement or sensitivity to light and sound. Only two of these symptoms are needed to define a headache as a migraine, and they’re more common than you might think.

“Eighteen percent of women have had a migraine attack in the past year, and over a lifetime, the rate is
double that,” says Dr. Silberstein. When a migraine strikes, he says, “The most important thing to do is get out of a noisy, smelly, loud and bright environment. Take a painkiller, such as aspirin with caffeine, as quickly as possible, and remove yourself from the situation until it starts to work.”

Lifestyle changes can help alter migraine frequency. “If you can, get to bed at a regular time every night,” advises Dr. Silberstein. Routine exercise and relaxation techniques reduce stress — think yoga and meditation. Avoid excessive amounts of caffeine, alcohol and monosodium glutamate (MSG), a food enhancer often
found in Chinese cuisine and other prepared or processed foods.

“Many women have the worst headaches with their period,” agrees Stephen Silberstein, MD, director of the Jefferson Headache Center at Thomas Jefferson University, one of just a few academic headache centers in the country. During pregnancy, estrogen and progesterone are elevated, a defense against headaches. But after delivery, hormone levels drop off, causing many women to experience headaches postpartum. 

Headache treatment

Over-the-counter remedies, such as Naproxen or Ibuprofen, should be the first line of defense to alleviate the problem, but persistent or severe headaches require attention from your healthcare provider. Triptans, a family of drugs that are generally efficient and well tolerated, are effective as treatment and prevention against intense headaches.

Because birth control pills regulate women’s hormones, they are frequently used to ease the headache cycle. Dr. Silberstein sometimes prescribes birth control pills as headache treatment, advising patients to throw away the week’s worth of placebo pills andimmediately move on to a new pack; this tactic eliminates estrogen withdrawal. Extended-cycle birth control pills that give women four periods a year, such as Seasonale and Seasonique, are two options to consider in this vein.

For women who prefer a more holistic approach, acupuncture is known to reduce tension headaches, while myofascial release, or tissue massage, can be effective for neck or body pain. There’s also good emerging evidence about herbs and natural substances, including Butterbur, Riboflavin and Coenzyme Q10, says Dr. Silberstein.

While there’s no one-size-fits-all headache cure, common sense goes a long way. So does a lifestyle punctuated by regular doses of exercise, downtime and solid sleep. Says Dr. Silberstein, “Women need to make time for themselves, away from everything.”

Erin Kane is a local freelance writer.

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