PMS symptoms tend to be incredibly painful and debilitating for many people who menstruate. About 60% of people who menstruate will experience menstrual related migraines. 1 Migraines in itself is already a debilitating condition for some and affects one in four households in the United States. Those who menstruate experience migraines twice as often and have a higher related disability and resource utilization than those who don’t!2 Globally, migraines affect 11% of the total adult population.3
Symptoms related to your Period
Those who suffer from period related symptoms can often experience the issues listed below:
- Tender breasts
- Mood swings
- Heavy bleeding
- Hot flashes
- Night sweats
- Vaginal dryness
- Weakness and fatigue
- Loss of scalp hair
- Increased body or facial hair
- Acne
- Decreased sex drive
- Vaginal dryness
- Migraines
- Anxiety
- Depression
- The list goes on!
This is just a glimpse as to some of the symptoms you may be experiencing related to your menstrual cycle if you have any hormone imbalances.
Hormones
Below is a snippet of the most common hormones that influence your menstrual cycle and how you feel.
Estrogen. Produced in the ovaries and regulates your menstrual cycle. In charge of breast development, body fat distribution, joint lubrication, vaginal moistness among other things.
Progesterone. Produced in the adrenal glands and counteracts estrogen. In charge of mood and sleep mainly.
Cortisol. Produced by your adrenals and a stress related hormone. In charge of blood sugar levels, blood pressure, immune function, and fluctuates throughout the day.
Thyroid. Produced by your thyroid gland and is an essential hormone in regulating hormone pathways. In charge of energy, weight, mood, autonomic regulation among other things.
DHEA. Produced by your adrenal gland and can be converted to testosterone and estrogen. In charge of mood and sex drive mainly.
Pregnenolone. Produced by converting cholesterol into pregnenolone which is facilitated by your thyroid. Considered the mother hormone from which many hormones are made from.
Each one of these rely on cholesterol in order to be made. If you do not have enough cholesterol in your body, you’ll notice that you may not experience a period during that time.
Why do I get menstrual migraines?
Estrogen Drop
There is no current consensus on what exactly causes menstrual migraines or menstrual related migraines. However, there may be a strong connection between the steep drop in oestrogen levels and how your brain reacts to it. This drop in estrogen levels can decrease our serotonin levels which can trigger migraines.3 Serotonin is a neurotransmitter that is in charge of mood and low levels have been linked to those suffering from migraines. This is due to serotonin receptors being found on the trigeminal nerve as well as cranial vessels which can be pain generators in migraines.4 Although, this is one of the more popular explanations for menstrual migraines, there can be other types of hormone imbalances that lead to these symptoms. Having too high or too low of progesterone levels can also mimic these symptoms. So, it is essential to know what your hormone levels are.
Adrenal Insufficiency and your Brain Stem
Your adrenal glands play a big role in hormone production as well as stress modulation. Any time you experience stress (physical, psychological, or even positive stimuli) this will stimulate your brain stem which then activates your adrenal glands. This can produce stress hormones listed above in the chart. During menstruation, stress becomes a more powerful trigger for migraines. This could be due to inflammatory cascades as well as genetic predispositions.5
There are a few more other causes that can potentially contribute to migraines during the menstrual cycle related to thyroid as well as chronic inflammation. Which is why it’s usually useful to do a thorough metabolic work up for those suffering from menstrual migraines.
How long do menstrual migraines last?
Menstrual migraines have been noted to last about a few hours up to a few days preceding your menstrual cycle but can happen during as well. Some experience an aura during their migraine but most do not.
How do you get rid of hormonal migraines?
At our clinic we approach menstrual migraines from a functional standpoint. It’s important to first look at the metabolic panels related to your hormones. That includes hormone panels (serum and urine) as well as a comprehensive CBC. This usually gives us an idea of what is going on with your body and gives us a roadmap for what is next. We also check the neurological side of your migraines to make sure there is nothing adding fuel to the fire on that end. We utilize a comprehensive neurological evaluation and proceed with any therapies if needed. Utilizing this approach we’ve been able to help many people suffering from period pains and migraines related to hormone imbalances. We work with elite level athletes to people who are just tired of feeling poorly from their period. Give us a call at our office (619-344-0111) or schedule for a consultation below to learn more about our approach.
We do not recommend you manage your symptoms on your own as you may be missing some key factors that can’t be looked at by yourself. However, we do understand that there are many barriers that can exist to accessing care. There are also some natural supplements you can try at home if you are not able to have a practitioner help you. There are a few online surveys you can do on your own to try and figure out what potential hormone imbalances you have (however it’s best if you can do actual lab testing to make sure). If that doesn’t work for you, then you should look into contacting a practitioner to help you. We are available through telehealth as well as in-person evaluations.
References
Pavlović, Jelena M et al. “Burden of migraine related to menses: results from the AMPP study.” The journal of headache and pain vol. 16 24. 18 Mar. 2015, doi:10.1186/s10194-015-0503-y
Guo, Y., Xu, S., Nie, S. et al. Female versus male migraine: an event-related potential study of visual neurocognitive processing. J Headache Pain 20, 38 (2019). https://doi.org/10.1186/s10194-019-0995-y
MacGregor, E Anne. “Menstrual migraine.” Current opinion in neurology vol. 21,3 (2008): 309-15. doi:10.1097/WCO.0b013e3282fd185e
Aggarwal, Milan et al. “Serotonin and CGRP in migraine.” Annals of neurosciences vol. 19,2 (2012): 88-94. doi:10.5214/ans.0972.7531.12190210
Parashar, Rachna et al. “Migraine: is it related to hormonal disturbances or stress?.” International journal of women’s health vol. 6 921-5. 24 Oct. 2014, doi:10.2147/IJWH.S62922
