The Link Between Migraines & Oestrogen

Anyone who has experienced migraines will state they differ greatly from a headache and can come with a host of other symptoms.

Migraine, which is the seventh most prevalent medical disease and the second most disabling neurological condition in the world, is often characterised by intense, throbbing, and pulsatile headache attacks in one side of the head.

It often lasts for 4–72 hours and is frequently accompanied by nausea, vomiting, photophobia (light sensitivity), and/or phonophobia (sound sensitivity). There are several types of migraine, including:

• migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights.
• migraine without aura – the most common type, where the migraine happens without specific warning signs.
• migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop.
• Some people have migraines frequently, up to several times a week. Other people only have a migraine occasionally. Yet one thing for certain is that they are debilitating when they do occur.

There are a number of theories as to what triggers migraines, including:

• Food allergy or intolerance
• Food components including histamine and tyramine
• Alcohol and caffeine
• Food additives include MSG, nitrates and aspartame
• Blood sugar imbalance
• Helicobacter pylori
• Gut dysbiosis
• Toxin overload or suboptimal detoxification
• Stress
• Genetics

Another theory which has started to receive more attention recently is the influence of sex hormones on migraines, primarily oestrogen. The prevalence of migraine in women is up to three times higher than in men, with 1 in 5 women affected and 1 in 15 men. Although a peak of incidence appears in individuals in the age range of 25–55 years in both genders, this remains higher in women. It has also been reported that women experience more frequent, longer-lasting, and more intense attacks than men. This could be due to the differences in sex hormones with oestrogen being the primary sex hormone of interest.

Could oestrogen be the cause?

Naturally, oestrogen and progesterone fluctuate throughout the menstrual cycle and this seems related to changes in migraine frequency and/or intensity. Menstrual-related migraine has been reported in more than 50% of women with migraine. It is reported that there is an increased risk in women to suffer a migraine episode between 2 days before and 3 days after menstruation, which could be related to the lowest concentration of oestrogen and progesterone. More specifically peri-menstrual oestrogen withdrawal seems to be a trigger for migraine without aura. A drop in oestrogen may cause increased sensitivity to prostaglandins. Prostaglandins are hormone-like substances that involved the dilation and constriction of blood vessels, and the modulation of inflammation.

Interestingly, during pregnancy, when oestrogen and progesterone are 10 times higher than in non-pregnant states, an improvement in migraine is reported, especially in women suffering from menstrual-related migraine. This certainly highlights the involvement of oestrogens in women with migraines.

Is there a connection between the gut and migraines?

A new study found an association between altered gut microbiota and migraine headaches. Emerging evidence reveals a close association between gut microbiota and human neurological disorders. Could supporting gut health be an important factor to consider for people suffering from migraines? 

More research is needed in this area but what we do know is, a healthy gut is linked to better outcomes in all areas of our health, so it’s a good place to start.