Statistics don’t lie: Seven out of 10 people with migraine head pain are female. But why are women more prone to migraine than men?
The main reason: hormones! A woman’s menstrual cycle can significantly affect why, when, and how she may experience migraines.
From the surge of estrogen when puberty begins, until menopause when estrogen levels decline, women experience fluctuating hormone levels throughout their monthly cycles. And the body’s hormonal and nervous systems are intricately connected. In fact, about 70% of women with migraine confirm that their monthly period affects the frequency and intensity of their migraine days.
Migraine symptoms ─ head pain, nausea, sensitivity to light and sound ─ may occur at several different points throughout this cycle: a few days before menses, during it, right after it, and/or during ovulation. Symptoms don’t typically include migraine aura (temporary visual and sensory disturbances just before migraine pain begins), although some women may experience those as well.
Can a woman avoid or prevent migraine symptoms potentially caused by monthly hormonal swings? Can birth control pills perhaps help? Let’s answer a few questions:
Birth control is hormonal contraception therapy, typically available as pills, patches, rings, shots, implants, and even intrauterine devices. In general, women who are using oral contraception ─ “the pill” ─ temporarily refrain from taking it, or take a “placebo” in its place, for one week out of the month, in order to initiate menstruation.
Estrogen levels fluctuate before and after menstruation, and these fluctuations can cause migraine to occur or migraine symptoms to worsen in some women. So, because the pill works to adjust fluctuating estrogen levels, it can be beneficial for these women to take the pill throughout their entire cycle.
You are unique, and so is your monthly cycle, so hormonal treatment should be individualized to you. A specialist can determine if taking the pill throughout the cycle may help to lower the frequency and intensity of your migraine symptoms.
Dosage, type of contraceptive (typically estrogen or estrogen+progesterone), and duration of treatment should be based on careful examination of your medical history, which may include any family history of migraine headaches, particularly related to the menstrual cycle. Ask your doctor to carefully explain your treatment plan and any possible long-term hormonal effects.
You are unique, and so is your monthly cycle, so hormonal treatment should be individualized to you. A specialist can determine if taking the pill throughout the cycle may help to lower the frequency and intensity of your migraine symptoms.
For women who do experience migraine with aura, studies show they’re 4 times more likely to experience intensified symptoms when they start taking combination oral contraceptives (those containing both estrogen and progesterone), compared to women who get migraine without aura.
In addition, whenever a woman begins a new form of hormonal therapy like oral contraceptives, headache pain (clinically known as “exogenous hormone-induced headache”) may result. Symptoms may disappear as therapy continues and/or if ovulation is completely suppressed.
If migraine symptoms continue, the specialist may recommend switching to a progesterone-only contraceptive pill or trying another form of contraception such as an intrauterine device (IUD).
Evidence shows that women who experience migraine with aura may have a slightly greater risk of stroke than women without aura. Therefore, if you have migraine with aura, your healthcare professional will generally not prescribe hormonal contraceptives that contain estrogen, but will instead prescribe progesterone-only contraception, such as the mini-pill.
Of course, for all women with migraine, additional risk factors for stroke ─ such as smoking or high blood pressure ─ should be considered as well. The healthcare professional may recommend a progesterone-only option or a separate form of contraception.
Migraine is a complicated condition, with many potential triggers and treatment methods. The situation can be even more complex for women, who tend to experience more frequent migraine episodes and more acute symptoms than men.
But every woman is unique, so your triggers may be different from another woman’s. To better understand what’s contributing to your migraines and how to treat them, it can be a good idea to consult a specialist and investigate which migraine medications are more likely to work for you.
Mable’s DNA test can help determine the treatment approach most likely to help you, given your individual genetic makeup. Take our quiz to learn more and start the process.
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