Can Low Estrogen Cause Migraines

Estrogen Dominance Happens In Men Too

Although estrogen is typically a female hormone, men also have small amounts of estrogen and progesterone. When a man typically reaches his forties, both progesterone and testosterone levels begin to decline. This is when a man can become estrogen dominant. Symptoms of estrogen dominance for men include:

• Weight gain
• Depression
• Anxiety

Estrogen can stimulate cell growth and cause prostate enlargement, prostate cancer and even breast cancer. Excess estrogen in men can also raise the risk of heart disease and osteoporosis.

Why Does Hysterectomy Often Make Migraine Worse

All research points to the fact that hysterectomy worsens migraine. The menstrual cycle is controlled by the brain, which sends messages to the ovaries to stimulate the production of the hormones oestrogen and progesterone. These in turn prepare the lining of the womb for a potential pregnancy. If a woman does not become pregnant, then the lining of the womb is shed at menstruation and the cycle starts over again. If the womb and ovaries are removed, the hormone cycle is disrupted and the brain hormones initially go into over-drive as they are not prepared for this early menopause. Migraine initially worsens but generally settles again over the subsequent couple of years. Replacement oestrogen can help lessen the symptoms following hysterectomy, particularly if the ovaries have been removed. Even when the ovaries are retained, the natural hormone cycle can be disrupted, so additional oestrogen may be helpful.

Can Hrt Help Migraine

HRT should not be used as a treatment for migraine. However, many women notice that migraine is more likely to occur when they have bad hot flushes and night sweats. Since HRT is very effective at controlling these menopause symptoms, it can help reduce the likelihood of migraine. However, some forms of HRT can create more hormone fluctuations, triggering migraine. This is more likely to occur with tablets of HRT. We generally recommend that women with migraine who need HRT should use oestrogen patches or gel, as these maintain stable hormone levels with few fluctuations. The best dose of oestrogen is the lowest dose necessary to control flushes and sweats. This may be as little as 25mcg of oestrogen patches, or 1 pump of oestrogen gel. Try this for 6 weeks, and if flushes persist, increase to 50mcg patches, or 2 pumps of gel. Bear in mind that it can take 3 months before full benefit is achieved, so dont increase the dose too quickly. Some women do need higher doses, up to 100mcg patches or 4 pumps of gel, but this can usually be reduced once the symptoms settle. Unless a woman has had a hysterectomy, she will also need progestogens to protect the lining of the womb from thickening in response to oestrogen. If this goes unchecked, it can lead to potentially cancerous many years later. Women with migraine, best tolerate progestogens when combined with oestrogen in patches, or as the Mirena intrauterine system.

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The Initial Link Between Estrogen And Migraines: Estrogen Withdrawal Hypothesis

Estrogens association to migraines was first demonstrated by Somerville in 1972, providing for the first time an explanation for menstrual migraines . Somerville found that he was able to delay menstrual migraine attacks by up to 9 days by treating participants with supplemental estrogen. He noted that migraines were particularly triggered when estradiol levels fell below 4550 pg/mL during the perimenstrual period. Somerville concluded that estrogen plays a large role in the precipitation of menstrual migraines and that estrogen withdrawal during menses is the primary trigger. Although these claims inspired decades of research on the topic, Somervilles study only consisted of 6 subjects and was prone to confounding bias due to some participants being close to the age of menopause.

Migraine Menopause And Hrt

In medical terms, menopause is defined by a womans last natural period. However, we generally also use menopause to describe the time in life when periods become irregular and hot flushes occur. These symptoms result from changes in the ageing ovaries and can start around ten years before a womans last menstrual period. Headaches are common during this time, affecting over 90% of women.

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What Are Some Causes For Such Extreme Fluctuations Of Estrogen Levels

Well, for one we live in an estrogen dominated world. In fact, we are swimming in a pool every day of xenoestrogens chemical endocrine disruptors that alter the normal function of estrogen. Where do we find xenoestrogens? In our make-up, skin care, lotions, cleaning supplies, plastics, food preservatives and coloring, insecticides and so much more. This is very taxing on our liver, the organ that is responsible for conjugating hormones so we dont reabsorb them in a more toxic form. One of the best ways to make sure you arent exposing yourself to extra estrogens is to eliminate these products from your home. Go green as much as possible and check make-up, lotions, shampoos, conditions and so on for parabens and phthalates.

How we check for hormone levels at Integrative Brain and Body is through a saliva test. This shows the free forms of hormones, which are the active forms. If you suspect or know you have a hormonal issue there are some things you can do to help relieve your symptoms and get you on the right road to balancing your hormones.

The first thing is of course getting rid of as many xenoestrogens as you can.

Your liver, the organ that is responsible conjugation unneeded hormones as well as making the majority of your T3 thyroid hormone, loves cruciferous vegetables. Indole 3 carbinol, found in cruciferous vegetables, is known to help liver detox pathways .

Can You Use The Mirena Coil As Well As Hrt

The Mirena intrauterine system can be used for contraception, to control heavy/painful periods, and to act as the progestogen component of HRT. One advantage is that it acts directly on the womb, with very little hormone reaching the rest of the body. This means that side effects are generally very few. Another advantage is that if a woman has a Mirena, it is easy to adjust the dose of oestrogen to suit her needs. Also, many women find that their periods become very light, or stop completely while they are using a Mirena. If migraine was linked to troublesome periods, this in itself can make migraine less likely to occur.

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How Estrogen Levels Impact Migraines

The explanation for why drops and fluctuations in estrogen cause migraines is not completely clear, but there are several possible mechanisms.

Estrogen has a known impact on the action of serotonin, a neurotransmitter that modulates pain and mood. Estrogen also affects blood vessels and blood pressure, and blood vessel alterations are known to play a role in migraines as well.

It is likely that both of these factors, and possibly others, could mediate the estrogen-migraine connection.

Studies With A Focus On The Effect Of Exogenous Sex Hormones

Exogenous sex hormones can also affect headache. Specifically, estrogen administration in male-to-female transsexuals has been linked to the development and worsening of headache . Further, abrupt drops in estrogen have long been suspected as a migraine trigger . On the basis of the observation of the existence of headache with estrogen withdrawal, two recent studies evaluated the effect of estradiol valerate/dienogest on headache .

In a second prospective clinic-based study, 32 women older than 35 years of age with the diagnosis of MRM were included . The number of migraine attacks, duration as well as severity of the head pain were all significantly reduced at the third and sixth cycles of E2 V/DNG compared with baseline . In addition, and similar to the findings reported by Macias et al. , a significantly lower number of acute abortive analgesics were reported at cycle six .

Overall, these studies demonstrate that sex hormones, both endogenous and exogenous, can cause alterations in headache patterns in participants with migraine . The avoidance of large magnitude drops in estrogen may improve MRM or other estrogen withdrawal migraines.

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Symptoms Of Menopausal Estrogen Deficiency

It is not difficult to distinguish the unique symptoms associated with menopausal estrogen deficiency. Menopausal estrogen deficiency symptoms are actually a combination of physical symptoms, which are extremely obvious, and covert psychological symptoms like depression orextreme mood swings. Every woman, especially women approaching menopause should be aware of the symptoms of menopausal estrogen deficiency. Some common symptoms of menopausal estrogen deficiency have been examined in this article.

1. Fatigue

One of the earliest signs to watch out for is extreme fatigue. Pre-menopausal women may experience debilitating fatigueeven after taking adequate amounts of rest. In fact, many premenopausal women who are experiencing estrogen deficiency may complain of fatiguefirst thing in the morning after a good nights rest. The feeling of tiredness gets increasingly worse as the day progress and reaches a point where the individual is unable to focus on the tasks at hand.

2. Headache

Hormonal imbalance particularly an imbalance in the levels of estrogen is responsible for migraine, sinus and tension headachesduring the peri-menopause phase. Typically, estrogen deficiency headachestarts off as mild pain and progresses to a full blown headache. The duration and the severity of the headachecan vary from woman to woman depending on the extent of estrogen deficiency.

3. Hot Flashes

4. Lower Back Pain

Youre Feeling Down Or Depressed

Estrogen helps your body produce serotonin, which is a neurotransmitter that helps boost your mood. If you have low estrogen, your serotonin is likely lower, too.

“Low estrogen can affect your mood by influencing neurochemical pathways linked to depression” says Dr. Eyvazzadeh. “Animal and human studies have shown how estrogen and progesterone affects brain regions involved in mood. Both estrogen and progesterone influence known regions in the brain.”

Estrogenâs connection to serotonin also explains why you might be experiencing depression. Estrogen boosts serotonin, which helps your body combat depression. So if you have low estrogen, your low serotonin levels canât stave off sad feelings.

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What To Do If You Have Chronic Migraines

First, if you already feel a migraine coming on, try some of these home remedies to see if you can rest and head it off.

As noted above, make sure that you record your migraines for a while so that you have some data on triggers, diet, and lifestyle changes that may be contributing to them. Also, if you suspect AFS, estrogen dominance, or other conditions to be underlying causes, make sure you go to the right kind of doctors to get checked out. Not all mainstream medical doctors are experienced in AFS, the NEM, or hormone issues, so if your tests come back negative, they may not dig any deeper even though you may indeed suffer from these problems.

Once you have a clearer picture, youll have a good idea of your options. With chronic migraines, prevention is always better than medication. And one thing you can do is to ensure your adrenals are strong enough to handle the migraines if they come and healthy enough not to add to your migraine problems.

AFS recovery includes a healthy diet, mild to moderate exercise, enough rest, good quality supplements, and stress management all things that can help with chronic migraines as well.

But please make sure that you are well aware of the effects of the supplements you choose, as some may be helpful for some conditions while aggravating others.

When Are Ocs Appropriate And For Which Patient

While there is not sufficient,;high-quality research to support argument, we understand that a small dose of EE has little risk to women with MRM without aura, Dr. Tietjen said. ;

At 20 ug EE and above, there is increased risk of venous and arterial thrombosis. Migraine aura also raises the risk for these thrombotic events, especially in young women,” she said. In Europe, for example, OCs are not prescribed to anyone who is diagnosed as having migraine with aura because of the addictive risk to these women for ischemic stroke, myocardial infarction, venous thrombosis, and hypercoagulability. ;

Practitioners should be aware of the guidelines issued by American College of Gynecology, WHO, and the International Headache Consortium,14 and patients who have migraines with aura should not be prescribed an OC, except on a case-by-case basis, said Dr. Tietjen.

There is a subset of women with an underlying hypercoagulable condition that may precipitate aura, and who have an increased risk of thrombosis; it is these women who are at heightened risk for stroke and should not receive OC, said Dr. Tietjen.;

Identifying patients who have hypercoagulability as a cause of symptomatic migraine with aura is a goal, as they are re-evaluated for an alternative to an OC, and may benefit from taking an aspirin daily or every other day, Dr. Tietjen told Practical Pain Management.

References:

3. Kelman L.; The triggers or precipitants of the acute migraine attack. Cephalalgia. 27:394-402.

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Survey Studies Investigating Menstrual

Four survey-based studies were included in our review, and all were found to support Somervilles estrogen withdrawal theory. However, these were graded to be low-tier evidence due to possible reporting biases. Mattssons study surveyed 728 women and concluded that 75% of these women reported migraines occurring within 2 to +3 days of menstruation . However, this study surveyed patients ranging in age from 40 to 74, suggesting a significant risk of reporting and recall bias, particularly for postmenopausal women being asked about their prior menstrual symptoms. Similarly, Stewart surveyed 81 menstruating women between ages 1855 that self-recorded their migraines and menstrual cycles over 98 days . Stewart noted an increased incidence of migraine perimenstruallydays 0 and 1 had OR of 2.04 and days 1 and 2 had OR of 1.80 .

Natural Supplements For Regulating Healthy Estrogen Levels

• I3C and/or DIM : DIM is a component of I3C. For people over age 40 years, DIM may actually be a better choice, because in order to convert I3C to DIM, adequate stomach acid is needed and many people over 40 years old have reduced stomach acid. . In any case, DIM is completely natural and it encourages the formation of good estrogen metabolites, while decreasing the bad estrogen metabolites that naturally occur with metabolism. In excess, however, DIM may lower thyroid hormone, so be cautious. DIM and I3C are also known to help calm painful menstrual cycles, and support prostate health.

• Vitex Agnus Castus or Chasteberry: this supplement can help support progesterone production. Additionally, it may help with headaches, acne, breast tenderness, depression, premenstrual syndrome, and help normalize irregular cycles by improving ovulation. In menopausal women, it may ease hot flashes.

• Black Cohosh: this herbal remedy and phytoestrogen used in menopause to control hot flashes, and anecdotally, it may help reduce headache frequency. It is also known as mugwort or Cimicifuga reacemosa. Insects hate black cohosh.

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What Is A Migraine With Aura

Not all migraines are the same, and they largely fall into two main categories:

• Migraine without aura
• Migraine with aura

Menstrual migraines are a subtype that can fall into either category.

According to the American Migraine Foundation, about one-quarter of those who have migraines also experience aura. Aura is a series of visual and sensory changes that may include any and all of the following:

• Inability to speak clearly
• Seeing black dots, zig zags or other unusual visual patterns
• Tingling and numbness on one side of the body

These changes may happen right before or during a migraine attack and may last anywhere from 10 minutes to a half-hour. No matter how long it lasts, aura is an unmistakable warning notice that a migraine is imminent.

The American Migraine Foundation reports that women younger than age 45 who have migraine with aura are already at higher risk for ischemic stroke. These women may be more likely to form blood clots due to inflammation, abnormalities in coagulation and dysfunction of the blood vessels.

For women who suffer from migraines with aura, taking combined oral contraceptives heightens their stroke risk even more. Its specifically the hormone estrogen in the oral contraceptive that can cause a stroke. “Estrogen has properties that can cause your blood to clot easier,” Rao says.

Blood clots have the potential to form in an artery that supplies blood to the brain. When the clot prevents or blocks blood flow to the brain, it can cause a stroke.

Estrogen Excess & The Depletion Of Magnesium

Elevated estrogen levels lead to magnesium deficiencies. It is well-known that a deficiency in magnesium is a risk factor for migraines. Excessive estrogen, however, can also deplete magnesium levels by influencing adrenal function. The excess estrogen places the adrenals into sympathetic mode , leading to severe magnesium wasting .

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Hows A Menstrual Migraine Diagnosed What Tests Are Done

Your healthcare provider will want to establish a history of your migraine-related symptoms, likely asking you to:

• Describe the severity and location of your pain. Is the pain pounding? Pulsing? Throbbing?
• Tell how often you get migraine headaches.
• Remember if anything makes your headache better or worse.
• Discuss what medications you take to relieve the pain and how often you take them.
• Talk about the activities, foods, stressors, or the situations that may have brought on the migraine.
• Remember if anyone in your family gets migraine headaches.
• Tell how you felt before, during and after the headache.

Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An electroencephalogram may be ordered to rule out seizures.

Its helpful to both you and your healthcare provider if you keep a migraine journal. Take note of what symptoms you get, how long your symptoms last, and what makes your menstrual migraine better or worse. You and your healthcare provider may be able to use that information to help you heal, and possibly prevent or anticipate your migraine.