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Headaches and hormones: What's the connection?

Being female has some real health advantages, but not when it comes to headaches — particularly migraines. Fortunately, there's help.

By Mayo Clinic staff

Many factors contribute to headaches for both men and women, including family history and age. Women, however, often notice a relationship between headaches and hormonal changes.

The hormones estrogen and progesterone — which play key roles in regulating the menstrual cycle and pregnancy — may affect headache-related chemicals in the brain. Higher estrogen levels may improve headaches, while lower estrogen levels can make headaches worse.

Though fluctuating hormone levels can influence headache patterns, you're not totally at the mercy of your hormones. Your doctor can help you treat — or prevent — headaches.

During menstruation

The drop in estrogen just before your period may contribute to headaches. Headaches are a common symptom of premenstrual syndrome, and many women with migraines report headaches before or during menstruation. You can treat menstrual-related migraines by:

  • Applying ice. Hold a cold cloth or an ice pack to the painful area on your head or neck. Wrap the ice pack in a towel to protect your skin.
  • Massaging the muscles. Massage tight, tender muscles in the back of the head, neck and shoulders.
  • Taking over-the-counter pain relievers, such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve, others) and ibuprofen (Advil, Motrin, others).
  • Taking prescription pain medication can help if over-the-counter medications and lifestyle changes don't.

If you have three or more debilitating headaches a month, your doctor may recommend preventive treatment with either over-the-counter or prescription pain medications. If your menstrual cycle is regular, it's often most effective to take preventive headache medication starting a few days before your period and continuing through the first few days of your period. If you have migraines throughout your menstrual cycle or your periods are irregular, it may be better to take preventive medication every day.

Using birth control pills

Some women experience headaches for the first time after starting birth control pills or other hormonal methods of birth control. For others, hormonal birth control changes existing headache patterns — sometimes for the better, sometimes for the worse.

If your method of birth control seems to trigger headaches or make them worse, consult your doctor. Sometimes it helps to use:

  • A monthly pill pack with fewer inactive (placebo) days or to eliminate the placebo days completely from most cycles
  • An estrogen-containing skin patch during the placebo week of the birth control pill
  • A progestin-only birth control pill or another type of contraception
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References
  1. Lay CL, et al. Migraine in women. Neurologic Clinics. 2009;27:503.
  2. Migraine: Frequently asked questions. U.S. Department of Health and Human Services. http://www.womenshealth.gov/faq/migraine.pdf. Accessed Feb. 16, 2010.
  3. Calhoun AH. Estrogen-associated migraine. http://www.uptodate.com/home/index.html. Accessed Feb. 16, 2010.
  4. Lee M, et al. Headache in pregnancy. http://www.uptodate.com/home/index.html. Accessed Feb. 16, 2010.
HE00003 May 29, 2010

© 1998-2012 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

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