11 Causes of Migraine Headache in Perimenopause
Do you get migraine headaches in perimenopause or menopause?
Hormonal headaches, or menstrual migraines, are common in women in their fertile years, and with perimenopause. These can also increase while going through the menopause transition.
According to the Cleveland Clinic, 60 % of women experience hormonal headaches.
If you are post menopause, you may not get migraine headaches any more.
Many women get menstrual migraines (MM), or hormonal headaches right through perimenopause.
However menopause symptoms include headaches. Headaches and hot flashes can go hand in hand. This may be due to blood vessel instability (1).
Menstrual Migraines are more painful and harder to get rid of than a Non Menstrual Migraine (NMM) (2).
That’s one part of perimenopause I DON’T miss. These menstrual headaches. Some days it was worse than the period.
Here are 11 root causes of migraine headaches:
Stress.
When you are stressed you are in constant fight or flight mode - this impacts blood sugar, muscles, and inflammation, as a start.Food triggers.
Many foods can trigger a headache, including the beloved coffee and that pesky wine we think relaxes us, but messes our circadian rhythm and sleep. This is where learning to tune in to your body is a great skill to practice!Dehydration.
Maybe from the coffee and wine 😂.Muscle tension.
Do you carry stress around the head and neck? Are you sitting all day, with your head bent. As a dental hygienist my job required prolonged sitting/standing and I developed a head forward posture.Degenerative Disc Disease.
This can cause frequent headaches. Arthritis can also contribute to this too.Eye strain.
Eye exams are an important part of health. Eye strain can cause headaches.The weather.
An increase in barometric pressure can cause headaches.Bruxism.
Otherwise known as teeth grinding can cause headaches (3). The clenching and grinding of your teeth increase muscle tension in the head and neck.HORMONES.
The shift of sex hormones, like estrogen and progesterone, can cause headaches.Skipping meals.
We deny our hunger, and cause a cascade of symptoms in the body.Low serotonin.
This is a neurotransmitter that also affects mood, can also cause headaches (4).
Wherever that migraine comes from, when you have it, you want to get RID of it. It’s also nice to figure out WHY they are there, and what you can do to alleviate them
Tune in to Potential Food Triggers.
Many foods can trigger a migraine, including the very things we crave while experiencing PMS. Chocolate is a common crave food and a trigger in perimenopause.
Other foods include cheese, beer, and alcohol. The theory behind the trigger is that these foods contain more histamine and other chemicals that make the blood vessels relax and dilate. This relaxation of the blood vessels can bring on a migraine.
Diamine Oxidase is an enzyme that works in our gut to break down histamine. When we ingest food histamine, this enzyme works to break that histamine down. If we are low, or deficient, the histamine doesn’t break down. A headache may occur.
Keeping food diaries can bring on dieting behaviour, or trigger disordered eating thoughts. If you logging your food to see the link between food and headaches, perhaps use a paper journal. Apps that track food also count calories. This may trigger dieting behaviour and excess worry about your food and body.
Tracking your cycle can also show you when these headaches occur, hormonally.
Using the mindful check in on a regular basis trains you to tune in to the happenings of your body.
Keep reading to hone in on certain food triggers.
Ditch the alcohol
Alcohol in general is dehydrating, depletes nutrients, and can cause a headache. The ethanol in alcohol can trigger a headache. Alcohol is a diuretic, like coffee, and this is where the dehydration headache comes into play. Drinking also relaxes the blood vessels of the body, and this increases blood flow, and possible headache.
Coffee withdrawal
Coffee withdrawal causes headache, and if you have ever quit coffee, you KNOW what I mean. This may be due to changes in blood flow and brain rhythm without the caffeine.
Cheese
Cheese, specifically aged cheese, has more tyramine in it. If you’re looking for a food specific list of triggers you can click here. It’s a document from the University of Wisconsin, School of Public Health. It’s an elimination list, where the guide I provide is more of a supportive list. Both could be useful in sorting these pains in the head out for you!
Support your Hormones.
Many women suffer from headaches just before their period when levels of estrogen and progesterone are dropping. Headaches are sometime classified as a hormonal headache or migraine headache. The estrogen drop may be the culprit. With a hormonal headache you may also notice acne, and increased tiredness with your headache.
If you suffered through menstrual migraines while younger, you may be in for some more of them while you go through the peri to menopause transition.
When the post menopause period settles in, the incidences of migraine may drop down to 14% (2). Sometimes they don’t go away but they can diminish.
Women who suffer with migraines in menopause may:
Have a history of daily tobacco use.
Have a history of daily alcohol use.
Have a history or oral contraceptive use or hormone therapy.
May have started menopause younger.
Have had surgical menopause.
Hormone fluctuations come from natural body processes, like the shutting down of ovaries, or oral contraceptives, and hormone replacement therapy.
Hormone replacement therapy concerns should always be discussed with a licensed care practitioner. This is a blog post, and should never be considered as medical advice
Taking Action
Tune in to food connections and ADD in foods.
While elimination diets are regularly recommended, there can be a down side. When restricting food groups, you are also diminishing the gut bacteria that helps with digestion. Instead ADD IN.
If you are in menopause, there are foods that carry phytoestrogens.
These are plant compounds that act like estrogen. These include flax seed, yams, and pomegranates.
Some research may say that you have to eat a lot to reap the benefits but consider this: Plants contain soluble and insoluble fibre.
This fibre is important in feeding good gut bacteria, and relieving constipation. The digestive tract is where your hormones go to be eliminated. You need to be pooping regularly.
Magnesium
This is a commonly deficient mineral in many women. Magnesium citrate is used to help with bowel movements, and relaxation of muscles. This relaxation can help with period cramps and tension headaches. Magnesium also calms our nervous system. It may block certain substances that can cause migraines. Magnesium glycinate is the one to look for.
Stop Skipping Meals.
Not eating breakfast, practicing fasting and restricting meals may cause headaches in some of us.
Many women in the perimenopause to menopause transition worry about their weight. You’ve been through many diet crazes, and this desire to diet comes back in midlife, when fat can accumulate around the middle. This desire to be thin can deplete your body of nutrients, including magnesium.
With the popularity of Intermittent Fasting as a way to weight loss, headaches can occur.
This can happen due to:
Dehydration
While the practice of fasting encourages calorie free liquid, many DO NOT take in adequate liquid and dehydration can trigger headaches.
We need water for our body processes, and we get that from sources like fruits and vegetables, which also give us micronutrients and fibre to keep that elimination pathway of digestion moving.
Blood sugar dysregulation.
Without going into the popular topic of keto eating and talking about fat adapting, our brains do use glucose for energy. The brain is the first organ to be affected if we have our glucose levels drop.
Headache can be one symptom of having a drop in blood glucose, and this can happen easily if you are counting calories, skipping meals, and ignoring your hunger.
We can get so hungry that we have an overriding drive to just eat, and we go for quick acting carbohydrates. This is your biology working.
This is just one of the reasons you may want to rethink your idea about calories, meal skipping, and start practicing an intuitive or mindful approach to eating.
Nutrient deficiencies.
Skipping meals can impact energy, muscle mass, and bone health.
This may also cause headaches.Why?
We need adequate energy and nutrients for our nervous system to function. We need B vitamins for our nervous system, and B2 (Riboflavin), is helpful for migraine headaches. If you’re taking or thinking of takin supplemental B2 speak to a professional to make sure your B’s are balanced out.
Support serotonin.
Serotonin has an impact on our emotions, but did you know that it impacts our whole body?
Low serotonin is implicated in our digestive system, our cardiovascular system, our nervous system (headaches), with cravings, sleep disturbances, and painful chronic illness, like fibromyalgia.
90 percent of serotonin is made in our gut.
When it comes to moods, fear and anger are what author Julia Ross, of The Mood Cure, calls “low-serotonin-style negative moods” (3). Feeding your emotional centers with foods that promote serotonin help physical and mental health.
Migraine has also been called, “a complex neurovascular disorder involving local vasodilation of intracranial, extracerebral blood vessels and simultaneous stimulation of surrounding trigeminal sensory nervous pain pathway that results in headache.”
Simple terms: blood vessels dilate, and a certain nerve, the trigeminal nerve that runs along the side of our faces, gets triggered.
Interestingly though, serotonin causes nerve endings and blood vessels to constrict (5). There are theories that low serotonin levels initiate a migraine headache, because the lack of it causes dilation of blood vessels (4).
Ever have a migraine and throw up? People who vomit when they have a migraine often report the headache lifting. The process of vomiting seems to stimulate your blood level of serotonin, and with that, increased intestinal motility (5). And, serotonin is made in your digestive system!
Support your gut.
The gut brain axis is a two way communication street. There is some evidence that those with gastric health issues have a higher incidence of migraine and vice versa. In fact, one study connected migraine and IBS as the most common condition (6).
Why would that be? When the GI tract is inflamed, the membrane becomes semi-permeable. That is, by products of gut bacteria, called lipopolysaccharides enter the bloodstream and one of the responses could be migraine (6). Our gut bugs have a huge impact on serotonin, which as we see above may be one of the triggers of migraine.
Tune in to your headaches and mealtimes. When do they happen? Are they coinciding with hunger?
Take note if you're also feeling nauseous, dizzy, sweaty with your headache. Are you just plain hungry?
Our body leaves wonderful clues to what we need, if we can slow down and pay attention.
We may not always have the answers, but slowing down is definitely important to our longevity, and quality of life.
Thanks for reading,
Tanya
Resources
Murray, M., The Encyclopedia of Natural Medicine, 3rd ed., Simon and Shuster 2012.
Allais, Gianni, et al. “Menstrual migraine: clinical and therapeutical aspects." Expert Review of Neurotherapeutics, vol. 7, no. 9, 2007, p. 1105+. Gale Academic OneFile, Accessed 13 Feb. 2020.
Kalidas, Kavita. "Migraines in women: fluctuating hormones play a role in migraines, making it important to consider hormonal milestones and factors when formulating a treatment plan." Contemporary OB/GYN, Aug. 2017, p. 12+. Gale Academic OneFile, Accessed 13 Feb. 2020.
Ross, J., The Mood Cure, The 4-Step Program to Take Charge of Your Emotions--Today
Aggarwal, Milan et al. “Serotonin and CGRP in migraine.” Annals of neurosciences vol. 19,2 (2012): 88-94. doi:10.5214/ans.0972.7531.12190210
Xie, et al. “Effects of Diet Based on IgG Elimination Combined with Probiotics on Migraine Plus Irritable Bowel Syndrome." Pain Research and Management, 2019, p. NA. Gale Academic OneFile, Accessed 13 Feb. 2020.