Hormones and Headaches

by Connie

Severe Pounding Headache

Severe Pounding Headache

Hi Mary Kay...

When I was in my twenties, I started getting migraine headaches. They weren't very frequent, maybe one every six months or so.

Over time, that progressed. By the time I was in my thirties, the headaches were debilitating and came as frequent as once or twice a month.

I couldn't function when I had one of my migraines, the pain was too severe. I sometimes wished someone would take a sledge hammer to my head because I knew the pain of the hammer would be far less than the pain I was experiencing and would at least put me out of my misery.

Eve the best headache medicine alone never worked. I needed dark, cool, silence. Sometimes for hours.

Then, I got pregnant with my first and only child. My headaches stopped. For nine wonderful months I was headache free.

What a blessing that was! However, in the back of my mind I kept thinking, 'what if the headaches come back after I deliver my baby?' What if it's because my hormones are different being pregnant and it all just goes back after I'm not anymore?'

I delivered a healthy baby boy who has just recently turned seven. I have not, to this day, had a single migraine headache in the last seven years.

Is there a connection between hormones and headaches? Has anyone really researched this to try and find a cure for migraines?

I know it cured me.

Connie from Power-Of-Giving.com


Hi Connie,

Well I am glad you are better now. It is quite common for women with menstrual migraine to have a great improvement or even have their headaches disappear during pregnancy.

About 70% of migraineurs improve during pregnancy, while 30% stay the same or unfortunately get worse. For those with headaches during pregnancy if this is a new onset of headache, it should be evaluated by a physician as rarely blood clots can form during pregnancy and travel to the brain.

The good news for you is your migraines are gone. This does happen with some women, but you should know that you still have the potential to develop migraine later in life..specifically during the peri-menopause to menopause years. It doesn't mean it will happen, just that it might.

Yes, there has been plenty of research done on menstrual migraine as it is now called. It is now an official diagnosis according to the International Headache Society who determines the definitions of headaches.

Take care!
Mary Kay Betz MS RPA-c


You're the Expert!

Wow Mary Kay,

Is there anything you don't know about headaches? ;)

Thank you for your very well thought out and informative answer. I knew there had to be a reason why my headaches stopped when I got pregnant. Now I know.

Thank you.



Hi Connie,

Glad I could help! Yes there is plenty I don't know about headaches..it seems as if headache research find something new every few months.

Take care,
Mary Kay

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Hormone Headache

by Jenn G
(Drayton Valley, Alberta, Canada)

Headache Every Day

Headache Every Day


well i am writing to because like many i'm sure i am at a loss of things to do.

I am 27 years old. For the last 7 months i have been getting headaches more and more frequently, but i could control them with some advil so i never thought much of them, then about three months ago just before my period i got a headache that lasted about 4 days that i couldn't get rid of. it was unlike any other one i had ever had before but once my period came it went away. so i thought it was another joyful part of being a women, and something i could look forward to every month.

when my next menstrual cycle came around the headache came back, but this time it was about 6 days before, and it didn't go away when my period started. so i kept trying to get ride of it with advil but nothing was helping.

finally after 10 days i went to the emergency room, and they gave me some toradal(not sure on spelling) and that did nothing, so then them gave me demerol, and again that did nothing so they sent me home. a few more days went by and i still had no relief, so i made an appointment to see a doctor. when i told him my situation he ordered a CT scan, and gave me tramacet for the pain. the tramacet numbed every other part of my body except my head. i had the CT scan and it came back fine.

after this visit i have gone back to see my family doctor numerous times, he has prescribed me Tylenol #3, which didn't work, naproxen, which didn't work, imitrex, which didn't work, he's taken me off of my birth control thinking maybe it was too high of hormone levels.

i've seen a neurologist, who has now put me on topamex and Maxalt for pain, which i tried today for the first time, it dulled it, but didn't take it away completely. so here i am, two months down the road and still have the same headache. i don't know what to do.. this pain is with me as soon as i open my eyes in the morning and is there when i go to bed at night. i don't seen any aura's i don't get nauseous, and most of the time the pain is in my frontal lobe, but when it's really bad it's in the back of my head as well. i have even tried acupuncture, which has done nothing to relieve me of the pain.

i'm wondering if i should be asking for a MRI, is it possible that a CT scan could miss something that a MRI might see? Please any suggestions on what might be causing this pain, or what i might try for pain relief would be greatly appretiated i am desperate for help!! and sick of my cries for help being ignored!! thank you in advance!

jenn g.


Hi Jenn,

You do not state your age but I can tell you that most of my female patients are in their late 30's-40's and are starting to experience some hormonal fluctuations. Even small changes can affect the brain of a migraineur (yup they sound like menstrual migraine.)

Your neurologist is on the right track. Headache medications like Topamax can help calm things down but need a good 90 days to have the full effect..your doctor also may have to raise the dose to find the correct one for you. An MRI is not out of the question if you are not responding to treatment.

Things you can do: really look at lifestyle and how it affects headache. Consider taking magnesium which has been shown in research to benefit menstrual headaches. Again give this 90 days.

I would hold all use of over the counter medications to treat these headaches as this causes analgesic rebound headache. I suspect the use of Advil started increasing your headache profile, rather than treating it.

Work with the neurologist. Generally the patients who get better the quickest are the ones who do everything all at once..lifestyle, exercise (3 times a week!), supplements, prescription meds. These types of migraines do happen but they can be controlled.

If you are having a constant headache everyday, then you are in status migrainosus. A short course of steroid for a week or two could also break the cycle of pain.

Good luck!
Mary Kay Betz MS RPA-C


My 14 yr old has been having headaches all the time for the past 1 1/2 . She has been to the doctors ,done xrays , mri and also ct scans , and found nothing wrong .She also went to a E.N.T. specialist and she was fine.Now she is being referred to neurologist . Do you think it might be hormone migranes? If so , What can she do or use to get rid of her headaches , at times she not able to go to school but she cant concentrate and it hurts to bad and it hurts right between her eye brows and her forehead .She has tried all different pain meds that they could give a 14 yr old . Nothing reliefs it at all . thank you.

I am assuming you meant the past 1-1/2 years..if the migraines are within a few days before, during or a couple of days after then they are menstrual migraines.

One of the best way to regulate this is to have her see an OB/GYN in addition to the neurologist. The two doctors can work together. A 90 day cycling birth control pill can help get these headaches under control, after all a headache once every 90 days is alot easier to deal with than every month.

She should also be on magnesium..400 to 800mg per day and give it three months. Aside from this, get to the neurologist for proper treatment. We do give adolescents Maxalt or Zomig which come in melt wafers to take at the onset of a migraine.

Good luck
Mary Kay

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hormonal migraines

by Linda S.
(Bow, Washington)

Hello fellow SBIer. Oh my, where to start?

Two problems really:
1. Hormonal headaches since the age of 42. Have tried Imitrex and the triptans which didn't work. Even tried some of the natural products for woman's health, but they give me headaches, not full-blown migraines, just nasty headaches.

2. On top of the hormonal migraines, I have glaucoma, gastritis, CFS or fibro (depends on which doctor I talk to) that was diagnosed over 20 years ago. This is on top of about 7 fender benders in my life (none serious). I have arthritis, chronic sciatica from neural foraminal narrowing in the low back, and chronic muscle spasms in my neck and upper shoulder areas.

I regularly take tramadol to cover the pain from the CFS and to cover the migraines. My PCP just has me up the dose when I've got a migraine. These generally will last anywhere from 3-5 days with the first 2 being the worst. The only other meds I take are OTC calcium with magnesium in it, vitamin D, and Omega-3.

My PCP had me try regular birth control for continuous use to see if that would help the migraines (Sprintec 28 day). Many, many years ago I took birth control pills and never had any reactions to them, but this time, I had nausea, a hung-over kind of feeling, a nasty taste in my mouth, and had pain going down my arm and chest pressure, so I stopped it.

About 4 years ago I started up with the weepy, uncontrollable crying jags, had it for about 5 days and then it stopped. We were living in Nicaragua at the time, and I went to see a doctor there. He told me to try Paxil. Bad idea; I had a severe reaction to it because of the tramadol. Those uncontrollable crying jags have started up again and have given me grief since May.

We currently are living here in the state of Washington, and I am seeing a CRNP who is a specialist in our area for menopause. She has me on Vivelle Dot (0.025 mg of estradiol). I'm going into my second cycle taking this patch. While I'm not getting the crying jags, most days now I've got a low grade headache and do get weepy. She told me I was kind of between a rock and a hard place since I'm still getting my periods regularly and that because of the tramadol, I pretty much can't take any of the SSRIs or other antidepressants.

I was put on the tramadol about 2008 and since then have been able to work part-time and pretty much function. Oh, I should also mention that we don't have health insurance.

Any suggestions?

Linda S.


Hi Linda,

You are not unlike many of my patients. With your complex history, first of all I would definitely recommend that you get to a neurologist preferably a headache specialist.

You live in Washington, there is a headache center in Seattle. It really would be worth the drive to go there, but if finances are really an issue start with a neurologist.

There is one medication group that you would respond to..low dose of a TCA. elavil which is generic as amitriyptiline. This medication treats fibromyalgia, migraines and calms down nerve pain from neuralgia.

You must give it 90 days and take it 2-3 hours before bed. I usually start people at 10mg and work up. Your dose is determined by your pain level.

Next..if you are taking tramadol more that 2-3 times per week for more than 4 months this is fueling your pain...ALL of it. Pain killers start after awhile to cause a analgesic rebound.

This is treated by putting the patient on low dose steroid for a week and generally works well.

Good luck (both with the pain and your site!)

Mary Kay Betz MS RPA-C

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Hormonal Migraines

by Penelope
(South East Wisconsin)

I am 34 years old. Have had migraines since 22. They got really bad around 25. Tried all kinds of daily meds including anti seizure, anti spasmodics, anti depressants, muscle relaxers, beta blockers, etc.

I am currently taking: Wellbutrin, Lyrica, citalopram, amitriptyline, nadolol, tizanadine, estraderm patch, sumatriptan, hydrocodone, oxcabazepine and also probiotics, multivitamine, and magnesium. I have severe endometriosis, and fibromyalgia.

I have a 7 and 5 year old. During both pregnancies my migraines went away completely and didn't return for a few months after delivery. I had a hysterectomy nov. 2010 with the hopes of helping the endo and migraines. The migraines never got better. I have an average of 9 a month with a tendency to get them in bunches. I have seen many neurologists in my area and also a headache specialist in Racine and the Diamond Headache center in Chicago.

I am seeing a pain doctor that is helping control the fibro and is starting to do some work on tight muscles in my neck. I think a lot of my headaches stem from my neck. Could this have been missed by other doctors? Also, my hormone levels read within the normal range. Could they still play a part in this? Thank you!!!!



Hi Penelope,

I am glad that you were seen at a headache clinic, Diamond is a well known one and pretty good at headache.

It sounds like there are two things going on, the hormones and the neck. You mentioned the hysterectomy, which may help the endometriosis, but if you still have the ovaries, then the menstrual migraine is still in play. You are on estraderm, but perhaps it has to be at a higher dose and no cycling. I generally recommend this with a hormone headaches.

As to the neck, headaches and neck pain are related, especially if the pain is at C3 or higher. This feeds back into the "migraine generator" in the brainsterm and triggers migraine. Most often we have found that trigger point injections, done monthly for a few months do help. Ask the doctor about increasing the anti-spasmotics slowly as the response may be dose related.

Finally, spasming is usually related to de-conditioning so exercise is vital. Lifestyle changes really do work! Patients who put these in place have far less headaches.

Good luck!
Mary Kay Betz MS RPA-C

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Migraines and the Menstrual Cycle

by Coree
(Delaware, Ohio)


I am a 21 year old female and have been experiencing increasing occasions of migraines since about the age of 17. First they were every once in a while, then associated during my menstrual cycle, and now they have been moving around. However, they are still closely related to my menstrual cycle. The onset is very sudden, starting with loss of clear vision, then seeing a bright light that followed by severe headache. I've been on different birth controls however, I still experience these headaches. If you could help me out with any suggestion, that would be great!

Thank You!



Hi Coree,

You are having migraine with aura, and these can be both menstrual and non-menstrual in nature.

I don't see anything that you have taken for these so if you have not talked to your doctor you need to be on something like Imitrex to take at the onset of the headache.

If you are having more than one disabling headache per month, or 2-3 per week then you need to ask about prophylactic medications to be on for a short amount of time. Generally, most young women your age do well on a 90 day cycling pill to cut down on the menstrual migraines.

Also I would recommend that you start the migraine vitamin formula known as Migralief. Give this 90 days to get the best effect.

Good luck,
Mary Kay Betz MS RPA-C

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