Migraines affect nearly 30 million people in the United States; three out of four are women. There’s still much we don’t understand about migraines, but the enormous gender disparity has led researchers to the link between migraines and hormones.

Here at Spinal Diagnostics, our team includes headache specialists who work with patients to help them find relief from debilitating and life-altering head pain.

One of the keys to combating migraines is understanding what may be fueling the headaches in the first place. In the following, we discuss the role that hormone shifts can play.

Since women are far more likely to have migraines than men, it should be no surprise that the hormone in question is estrogen. The presence of estrogen isn’t what leads to a higher risk of migraines, but the fluctuations in these reproductive hormones and women experience plenty.

After a woman goes through puberty, her estrogen levels fluctuate with her menstrual cycles, with pregnancy, after childbirth, and after menopause. Making matters more complicated, many women use hormone therapies for birth control or to relieve certain gynecologic conditions. These therapies can cause hormonal shifts that favor migraines.

In other words, women’s estrogen levels shift quite a bit throughout their lives.

A meta-analysis that reviewed 12 different studies on the connection between estrogen and migraines concluded “It appears that estrogen is very likely to play a key role in migraine pathogenesis, but seems to affect patients in different ways depending on their past medical history, age, and use of hormonal therapy.” 

OK, so we see there’s a connection, but how, exactly, does a drop in estrogen trigger a migraine? Unfortunately, we don't have this answer. There are several theories, starting with estrogen’s influence on certain neurotransmitters in your brain, such as serotonin. Your serotonin hormones influence mood regulation and your perception of pain, and when your estrogen level dips, your serotonin levels may follow suit.

Another possibility is estrogen’s role in your endothelial (the lining of your blood vessels) health. When you go through a period of low estrogen, your blood vessels may constrict or dilate more than usual, and these changes may lead to migraine.

The bottom line is that we know there is a connection, but researchers haven’t identified an exact cause-and-effect mechanism.

If, after your evaluation, we feel that hormones are influencing your migraines, we can discuss your treatment options, which may include Botox® injections to reduce migraine frequency, hormone therapies, and lifestyle modifications.

To determine which treatment approach is best for your migraines, please contact one of our locations in Tualatin and Newberg, Oregon, to set up an appointment.