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How are Migraines Different for Women?


Migraines are a battle of the sexes that women would rather not win. However, of the 40 million Americans suffering from migraine, 28 million are women. Great, another one to add to the list.


Migraine is a debilitating, episodic form of headache often associated with nausea, vomiting, and sensitivity to light and sound, which prevents most sufferers from their daily activities. Additionally, migraines are different for each person, whether it be differences in migraine types, migraine triggers, or more, making it challenging to identify whether it’s a migraine or something else. For women, there’s the extra wrinkle of headaches being one of the most common premenstrual symptoms.


Why are Migraines More Common in Women?


Women are believed to experience migraines much more often than men due to the hormonal milestones that may occur in a woman’s lifetime, including menstruation, pregnancy, postpartum, breastfeeding, perimenopause, and menopause. One commonality between the six milestones is the result in an extreme hormonal imbalance, specifically in the female sex hormone, estrogen.


A 2018 study explains this link between estrogen and migraines, suggesting that sex hormones affect the cells around the trigeminal nerve, the nerve responsible for sensation in the face and numerous motor functions, and blood vessels connected to the brain. With estrogen being the lead sex hormone, specifically at its highest function during a woman’s reproductive years, scientists discovered estrogen’s particular importance in triggering a migraine attack.


Hormonal Milestones and More...


Pre-menstruation (PMS)

Women experience migraines three times more often than men, and roughly 60% of women suffer from menstrual migraines. This migraine type may occur before, during, or after the menstrual cycle. Right before your period, estrogen and progesterone, two female sex hormones, experience significant drops, potentially triggering a migraine attack. In a study of women referred to headache specialists, 1 in 10 participants reported their first migraine attack at the time of menarche, the first menstruation cycle. Although not a high proportion, the apparent link between migraines and menstruation is quite clear.


Mayo Clinic suggests the following as ways to treat menstrual-related migraines. These methods may work for some women, and not work for others:

  • Magnesium supplements: around 50% of women who suffer from migraine have magnesium deficiencies. Magnesium helps the blood vessels relax, preventing restriction that may lead to a migraine attack.

  • Birth control: Most commonly used by women who experience irregular periods, birth control, in its various forms, may also be used to regulate estrogen levels, so there is never a drop that results in a migraine attack.

  • Ice: Place a towel-covered ice pack on the area on the head, with the most pain. Ice helps to numb painful areas, which may dull the pain.

  • Relaxation techniques that can be performed during an attack or prior: This may include meditation, yoga, massages, acupressure, music and art therapy, aromatherapy, and breathing techniques. These practices have been proven to significantly reduce stress, one of the main triggers for migraines.

  • Biofeedback: This form of therapy focuses on using visual or auditory feedback to gain control over involuntary bodily functions, including blood flow, heart rate, and more. Biofeedback may help you gain control over how your body reacts to stress, and potentially prevent an attack.

  • Acupuncture: Acupuncture is a form of treatment that involves sticking small needles at certain points on the body, and is known to alleviate pain. Acupuncture may help improve headaches and migraines, including their frequency and severity, and may also help with stress.


Pregnancy

The first trimester of pregnancy, where the zygote turns into the embryo, and the baby begins to develop, is also the trimester where the sex hormones of the body significantly rise, as well as an increase in blood volume. Surprisingly, most mom-to-be’s report a significant decrease in migraine frequency during these 13 weeks. With 15 to 20 percent of pregnant women having a history of migraine, over half report a decrease in frequency and severity during their first trimester. Many doctors believe the significant increase in estrogen causes the decrease in migraines, so much so that hormone replacement therapy, a form of migraine treatment, that mimics the body’s reaction during pregnancy, is now increasingly used in migraine patients to alleviate pain.


Additionally, estrogen levels begin to settle down during the second and third trimesters, meaning they are no longer increasing or decreasing, and become leveled. Women may begin to experience migraines, but more often than not during these two trimesters, any sign of head pain is affiliated with high blood pressure, poor posture, and tension from carrying around extra weight.


Postpartum

The term postpartum refers to the period of time immediately following childbirth. After carrying a baby for nine months and giving birth, the body undergoes significant changes to compensate for the sudden loss of the baby in the body. While the body begins to restore its balance, the external challenges begin. The first month with a newborn is full of change, stress, and happiness. During this time, mothers face significant stress, and also begin their menstrual cycle. Migraines occurring during the postpartum phase as a result of stress and hormones are known as postpartum migraines.


Postpartum migraines may be triggered by, but are not limited to:

  • Sleep deprivation: The most common trigger in new mothers is caused by waking up in the middle of the night, early mornings, or being up all night caring for their baby. The best way to prevent sleep deprivation is to try to take naps with your baby while they nap.

  • Stress: Try the relaxation techniques above. Additionally, having someone to help care for the baby will significantly reduce stress, this could include a significant other, other children in the house, mother or mother-in-law, your siblings, or close friends. Do not be afraid to ask for help, your body will thank you later.

  • Dehydration: It’s easy to get lost in the chaos of life and forget to drink enough water. Keep a water bottle close to you wherever you go. When you think you’ve had enough water, you haven’t. Stay hydrated!

  • Irregular meals: Eat well and avoid migraine triggering foods.


Breastfeeding

Though breastfeeding is not directly correlated to migraines, many mothers are afraid to breastfeed their babies due to the migraine medication they may take. For specific migraine medications, contact your doctor, or speak to us at buoyant, where we will help you find an alternative.


Over-the-counter medications that are breastfeeding safe and that may help alleviate some migraine pain include, but are not limited to: acetaminophen (Tylenol), anti-inflammatory medications (Motrin and Aleve), and sumatriptan (Imitrex).


Perimenopause and Menopause

Perimenopause is known as the phase in mid-adulthood where a woman’s periods become irregular until they stop. Starting at around 40 years old, or later, the ovaries begin to gradually stop producing eggs every month. Essentially, the ovaries have run out of eggs and begin to “fall asleep,” but the brain will not let our bodies rest. The body undergoes many changes while trying to adapt, potentially triggering migraines:

  • Fluctuations in hormones: Again, fluctuating estrogen levels are extremely normal and healthy. But, they may cause neural activity that potentially will trigger migraines

  • Hot flashes, night sweats, and irregular sleep patterns: Keeping a consistent sleep pattern is essential in preventing migraines in general, but perimenopause may create conditions where sleep is difficult for many. Have a direct source of cold air closeby during the night, this may potentially lessen hot flashes and night sweats.

  • Mood swings: Emotions and chemical imbalances may add to your stress level, potentially triggering a migraine. Again, try the relaxation tips listed above to reduce your stress levels.


This phase is complete when periods come to a halt completely, and women transition to menopause at around age 50 or later, after not having a period for over a year. Migraine attacks are often linked to the perimenopause stage, when the ovaries produce less estrogen. So, during pregnancy where there is an increase in estrogen and most women report a significant decrease in migraines, the opposite is seen during perimenopause. With this drop in estrogen, the severity and frequency of migraines may increase for many women.


In a study conducted in 2016, scientists dispersed a survey where they found that migraines increased by 76 percent during menopause, but they believe that this sudden increase in migraines is not just due to hormonal changes, but to the increase in medications taken during this time. “As women get older,” Vincent Martin, MD, says, “[they] develop lots of aches and pains, joints and back pain and it is possible their overuse of pain medications for headache and other conditions might actually drive an increase in headaches for the menopause group.” In order to prevent this increase, speak to your doctor about alternatives and lifestyle changes that will help avoid an increase in migraines.



No matter what stage of life you are currently in, we are always here to help. Just as our bodies change over the course of our lifetimes, so do our migraines. It is important to learn and understand your migraine in the context of your stage of life in order to find the right treatment. Find the right doctors, seek out a migraine community, and don’t hesitate to ask for help!

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