Hormonal Headaches: Causes, Symptoms, Diagnosis, and Treatment

Check the complete list of causes, symptoms, diagnosis, and treatment for hormonal headaches here.

There are many factors, be it genetic or dietary, that may lead to headaches. However, in women, one of the major factors of chronic headaches is the fluctuation of levels of hormones, especially during their menstrual cycle. There are many reasons behind the changes in the hormonal levels in women. Some of them may include consuming oral contraceptives, pregnancy, and using hormone replacement therapies. But the most important one is the monthly periods or the menstrual cycle.

Normal headaches can be treated by medications like paracetamol. But hormonal headaches in women usually go away during pregnancy or when they attain menopause.

Hormonal headache in women is also referred to as 'menstrual migraine' because it is commonly experienced by women during their menstrual cycle.

Hormonal Headaches: Causes

According to NHS, the main causes of hormonal headaches include:

Menstrual cycle: According to the National Migraine Centre, more than half of the women who get migraines notice a link with their periods, and that is why they are commonly called 'menstrual migraines'. Menstrual migraines occur either two days before the start of the menstrual cycle or within three days during the periods. The reason is a sharp decline in hormonal levels, especially estrogen.

Combined Oral Contraceptive Pills: Many women have reported improvement in hormone-related headaches while they are on contraceptive pills, while others reported frequent episodes of headaches when they stop consuming the pills. The reason is the change in estrogen levels.

Menopause: A lot of women have complained about frequent and severe headaches as they approach menopause. The reason may be frequent periods or a change in the entire hormonal process.

Pregnancy: In the first few weeks of pregnancy, a sharp fluctuation occurs in the hormonal levels, leading to frequent and worse headaches. However, as the pregnancy reaches the end, the headaches stop completely.

Hormonal Headaches: Signs & Symptoms

According to the Cleveland Clinic, these are the commonly found signs and symptoms of hormonal headaches:

• Headaches range from mild to severe

• Appetite loss

• Excessive sweating

• Cold chills

• Sensitivity to smells

• Fatigue and tiredness

• GIT issues, including nausea, vomiting, upset stomach, and abdominal pain

• Dizziness

• Sensitivity to noise

• Blurred vision

• Fever (rare)

• Tender scalp

• Light sensitivity

• Diarrhea (rare)

• Pale skin

Hormonal Headache: Diagnosis

According to Cleveland Clinic, diagnosis of hormonal headaches or menstrual migraines involves the following:

• Checking the history of migraine-related symptoms

• Common blood tests

• Imaging tests like magnetic resonance imaging (MRI) and CT Scan to make sure there's no other serious cause of the headaches

• If the hormonal headaches are followed by seizures, then the doctor might recommend an EEG (electroencephalography)

Hormonal Headache: Treatment

According to Mayo Clinic, the following is the recommended treatment for hormonal headaches:

Preventive Medication Therapy: This includes taking medication like anticonvulsants, antidepressants, magnesium, calcium channel blockers, and beta blockers to prevent the symptoms. If these medicines do not work, then your doctor might recommend monthly injections of a calcitonin gene-related peptide monoclonal antibody. Besides, the doctor might ask you to make some lifestyle changes, such as daily exercises, stress reduction, and having a proper diet.

Over-the-Counter Pain Relievers: If your headache is not so severe, your doctor might recommend you to take some over-the-counter pain reliever medicines which include, ibuprofen, naproxen sodium, and NSAIDs (nonsteroidal anti-inflammatory drugs).

Hormone Replacement Therapy: The majority of women have complained of severe headaches during the phase before menopause (perimenopause) and after menopause. Some women are recommended hormone replacement therapy during perimenopause and menopause to balance the disrupted hormonal cycle. Hormone replacement therapy has been found to improve headaches in some women and also worsen the symptoms in other women.

Acupuncture: Some women have found acupuncture to be very helpful to get relief from menstrual migraines.

Triptans & Gepants: The medications belonging to these categories have been found to be effective against hormone-related migraine.