Do you find yourself suffering from a headache every time you turn around, whether it’s right before a child’s baseball game, or on a big day at work where you’re expected to deliver a presentation for your group, or on vacation with your family at the beach?
Many women come to me asking how to manage these debilitating headaches that disrupt their life. There are different types of headaches, but migraines take the cake for shutting a person down from his or her normal functioning.
Migraines can be managed, and the key is to take control of how you manage your body.
Definition and Symptoms
A migraine is a complex disorder characterized by recurrent episodes of headache, most often unilateral and in some cases associated with visual or sensory symptoms, collectively known as an aura, that arise most often before the head pain, but that may also occur during or after. Some typical symptoms include pain in the frontotemporal and ocular area as well as around the head or neck; pain that builds up over a period of 1 – 2 hours and headaches can last 4 – 72 hours; nausea (80%) and vomiting (50%), including anorexia and food intolerance and lightheadedness; and sensitivity to light and sound. Migraine auras usually develop over 5 – 20 minutes and last less than an hour. The most common positive visual phenomenon is the scintillating scotoma, an arc or band of absent vision with a shimmering or glittering zigzag border.
Hormonal Causes of Migraines
There are many causes of migraines, but for women, fluctuating hormones due to menstruation, ovulation, menopause and/or the birth control pill use may play a major role in migraine headaches.
Estrogen and Progesterone
Sudden drops in estrogen levels can trigger migraines especially around ovulation or menstruation. Estrogen drops at the beginning of every new cycle in women who are pre-menopausal. In a normal female hormone cycle, estrogen and progesterone levels are lowest during menstruation. Day 1 is the first day of menstruation. Estrogen peaks during the ovulation phase (mid-cycle, around days 10-14). Estrogen and progesterone plummet towards the end of the luteal phase (latter phase of the menstrual cycle) and this drop in hormones can trigger migraine headaches. The use of oral contraceptives can cause sudden drops in estrogen and lead to migraines. Estrogen levels plummet when the pill is withdrawn during that last week to allow the period to begin.
Estrogen is in charge of serotonin transport in the brain. Serotonin is the feel-good neurotransmitter. When serotonin is low, symptoms of melancholy, anxiety and depression can ensue. Falling estrogen levels in peri-menopause and menopause can lead to migraines in some females because serotonin levels drop. When vasodilation occurs in the absence of serotonin’s vasoconstriction effect, the vascular bundles press on nerves to cause neuralgia (face pain) or migraine headaches. In addition, serotonin is also a precursor to the hormone melatonin, which helps regulate the sleep-wake cycle. A low melatonin level is a potential cause of migraines.
Estrogen dominance, a state in which there is an an abnormally high ratio of estradiol to progesterone in the body, can trigger migraines as well as cause irritability, brain fog, breast tenderness, water retention or bloating, unwanted hair growth, irregular or heavy periods, fibroids, severe PMS, and cancer.
Progesterone is a calming hormone that counteracts the negative effects of estrogen in the brain and body. Women generally first lose progesterone during peri-menopause, causing many unwanted and difficult to manage symptoms including night sweats, hot flashes, restless sleep, and migraines. Without an ample amount of progesterone on board to balance sharp dips in estrogen, migraines can come on suddenly.
Testosterone
Studies show that androgens like testosterone have been effective in the prevention of migraine and other headache disorders. Adequate dosages of estrogen-androgen combinations as well as testosterone alone in peri and postmenopausal women can reduce the severity of migraine headaches. Testosterone is a neuroactive steroid and has been shown to increase serotonin, which may also play a role in the prevention of headaches.
Thyroid
Low thyroid hormone levels can contribute to migraines. Low thyroid hormone production causes sluggish metabolism and stagnant circulation. This may result in bloating or swelling in the hands and feet that occurs right before a headache. Often brain fog sets in and then detoxification pathways become sluggish and toxic waste begin to accumulate. Blood vessels may dilate throughout the body, and blood vessels surrounding the brain may swell, leading to the development of a migraine.
Headaches are a hallmark of high thyroid hormone often due to chronically elevated blood pressure.
Hormonal imbalance is an important, and sometimes overlooked, trigger for migraine headaches. Other factors to consider are genetic makeup, stress, food sensitivities, nutrient deficiencies, chronic infection and/or inflammation, leaky gut, blood sugar dysregulation, and exposure to pesticides or heavy metals.
A Functional Medicine Approach to Managing Migraines
Each person is unique, not only in his or her chemical make-up, age, and walk of life, but also in his or her lifestyle habits, diet, and exercise. The functional approach is a systems-biology-based model that empowers patients and practitioners to work together to achieve the highest expression of health by addressing the underlying causes of disease. Functional Medicine uses a unique operating system and personalized therapeutic interventions to support individuals in achieving optimal wellness. A functional approach involves a conversation with patients to discuss how some or all of these factors contribute to their symptoms and lack of well being. Testing may be involved to figure out the underlying or root cause of symptoms. After careful assessment and evaluation of lab results, and one on one consultation with the patient to discuss medical history, genetic predisposition, medication therapies, and health goals, the board certified health practitioner in functional medicine can put the pieces of the health puzzle together to establish a health plan individualized for each the patient to help him or her achieve optimal health long term.
There are holistic approaches to managing migraines with or without medications. Salivary hormone and adrenal function testing can identify whether hormonal imbalance is the culprit. Non-traditional methods including nutritional support, bio-identical hormone supplementation, and CBD therapies can be very effective in mitigating symptoms. At the TLC Medical Centre pharmacy, we want to support you no matter where you currently are in your health. We want to help you take control of your body to manage symptoms and increase your quality of life. A board certified functional medicine health practitioner can help you unlock your health potential.
TLC Medical Centre pharmacy is a traditional pharmacy offering specialized services such as medical equipment, compression stocking fittings, diabetic shoes fitting with shoe selection on site, vaccinations throughout the year and medical compounding (our compounding lab is located inside TLC called Custom Prescription Compounders, LLC). Our compounding pharmacist Zoom H. Heaton is also board certified in Anti-aging, Metabolic and Functional medicine. She works with patients needing help with various medical needs such as bio-identical hormone management, adrenal and thyroid issues, autoimmune conditions, weight management, pain management compounding, nutritional guidance using specialized testing and much much more. If you feel that your health needs a change for the better, call us at 803.648.7800 extension 200 and make an appointment. The first 15 minutes of your consultation with Zoom is free.