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Headaches and hormones: What's the connection?

During pregnancy

Estrogen levels rise rapidly in early pregnancy and remain high throughout pregnancy. Migraines often improve or even disappear during pregnancy, but tension headaches are less likely to improve. After delivery, an abrupt decrease in estrogen levels — along with stress, irregular eating habits and lack of sleep — may trigger headaches again.

If you have headaches during pregnancy, ask your doctor about treatment options. Many headache medications may have harmful or unknown effects on a developing baby, especially if you take them at the time of conception. Although you'll need to be cautious about headache medications while you're breast-feeding, you'll have more options than you did during pregnancy.

During perimenopause and menopause

For many women, migraines become more frequent and severe during perimenopause — the years leading up to menopause — because hormone levels rise and fall unevenly. This fluctuation can trigger migraines.

For most women, migraines improve once their menstrual periods cease — but tension headaches often get worse. Hormone therapy can affect headaches, too. Menopausal hormone therapy worsens headaches in some women and improves headaches in others.

If your headaches persist after menopause, you can continue to use the same medication and lifestyle measures as always. If you choose to use estrogen to manage the signs and symptoms of menopause, your doctor may recommend an estrogen skin patch. The patch provides a low, steady supply of estrogen, which is least likely to aggravate headaches.

Every woman is unique

Some women are more sensitive to the effects of hormones. If headaches are disrupting your daily activities, work or personal life, ask your doctor for help. Treatment is available.

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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

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