Menstrual Migraines

migraine menstrual headache
Migraine Headache

Menstrual Migraines

Suffering from a migraine every month around the time of your period?  Likely there is a hormone imbalance contributing to these PMS headaches.  I have had women who had suffered with these every month for 16 years, who were amazed to find that their period could come and go without a migraine after naturopathic treatment.

What Causes Migraines?

There are a number of theories as to the origin of migraines:

  1. Serotonin imbalance
  2. Histamine – excess or intolerance
  3. Lack of B vitamins
  4. Lack of magnesium
  5. Muscle tension
  6. Hormone imbalance

What Can I do About Migraines?

The solution to migraines is to address some or all of the factors listed above, all of which can be done through naturopathic medicine.

Serotonin imbalance

Serotonin is a neurotransmitter that is produced in the brain, it is a chemical that the brain produces that influences how the brain works.  It is considered to be the “happy” neurotransmitter and it’s one of the key neurotransmitters addressed in people who suffer with depression.  The brain requires vitamin B6, magnesium and an amino acid called tryptophan to make serotonin.  Supporting these nutrients can sometimes allow the brain to rectify a serotonin imbalance on its own.


Histamine is a substance released by white blood cells called mast cells.  It’s part of how the immune system defends you against viruses and bacteria, but excessive histamine can cause inflammatory conditions like allergies.  People with allergies will take anti-histamines to try to prevent histamine release or histamine binding to receptors.  Vitamins C and B6 are natural anti-histamines.  In the gut, we produce an enzyme that helps to break down histamine, called DAO.  Some people aren’t genetically programmed to produce enough DAO, for those people sometimes supplementing DAO helps.

Lack of B Vitamins

Vitamin B2, B5 and B6 supplementation have all been shown to help migraine sufferers.

Lack of Magnesium

Magnesium serves a dual purpose for those with migraines: it helps muscles to relax and helps calm down the nervous system.  Both B vitamins and magnesium are also essential to help the body cope with stress.

Muscle Tension

Tightness in the neck and shoulder muscles can compress nerves, cause misalignment of the spine (subluxation) and contribute to migraines.  Massage therapy, chiropractic treatment, proper posture, yoga, pilates, a more ergonomic work environment, acupuncture, craniosacral therapy and magnesium may all help with migraines that originate from muscle tension.

Hormone Imbalance

Menstrual migraines are obviously related to fluctuations in hormones or hormone imbalance. What has worked most effectively in my practice for these types of migraines has been enabling efficient phase I and phase II liver detoxification through supportive nutrients like pyridoxal-5-phosphate, 5MTHF, vitamin B12, indole-3-carbinol, calcium-d-glucarate, N Acetyl-cysteine, and magnesium.  Herbs like Vitex agnus-castus combined with vitamin B6 will also sometimes help in the event of insufficient progesterone production.


The Benefits of a Detox for Women

Firstly, what exactly do I mean by a detox?  Detoxification is the process whereby the liver breaks down toxins, chemicals, pollution, your own body waste and excess hormones.  This process has to occur in order to make these garbage compounds into something the body recognizes as garbage so that they can be eliminated.  If waste is not fully broken down, or detoxified, it can linger in your system and accumulate.  The liver has two processes where it breaks these down called phase I and phase II liver detoxification.  Certain vitamins, minerals and other substances from plants help ensure that this process runs smoothly, such as vitamin B6, vitamin B12, active folic acid (5 methyltetrahydrofolate or 5MTHF), indole-3-carbinol, glucarate, sulfur, N acetylcysteine and so on.  If your body doesn’t have enough of these, toxins will get stuck in your system.

Because detoxification is part of the process to break down and excrete excess hormones, doing a detox can help:

  1. Acne
  2. Heavy periods
  3. Painful periods
  4. Infertility
  5. PMS symptoms
  6. Endometriosis
  7. Uterine polyps
  8. Fibroids
  9. Many other hormone related conditions.

Clearing toxins from your system can also reduce risk for hormone sensitive and other cancers.


Signs and Symptoms of Hormone Imbalance

How would you know if you had a hormone imbalance? Most of the women I see already have an inkling that something is out of balance by the symptoms that they are experiencing:

  • Hair loss
  • Acne
  • Irregular periods
  • Night sweats
  • Hot flashes
  • Infertility
  • Heavy periods
  • Painful periods
  • Fibroids
  • Ovarian cysts
  • Uterine polyps
  • Excessive facial or body hair
  • PMS
  • Premenstrual migraines

Most often they have already visited their family doctor who “checked their hormones” and told them “everything is normal” or offered them the birth control pill.

There are three main problems here:

  1. By checked their hormones, most doctors mean they’ve done a very superficial screening of hormones, LH, FSH, maybe estradiol and maybe progesterone, but often not measured on specific dates of the menstrual cycle that make the results clinically meaningful.
  2. When “everything is normal” even though you feel that hormones are imbalanced, it’s because the “normal” ranges for hormones are extremely wide and so even abnormal people fall into the “normal” range.
  3. Birth control pills only mask the existing hormone imbalance, they don’t correct it.

If you feel like you have a hormone imbalance, always ask for a copy of blood work results so that you can see exactly how extensive testing was and exactly where your results fall in the “normal” range (normal is always in quotes because lab ranges rarely refer to what is actually normal, it is more often an average of unhealthy people).  99% of the time you will find that either: a) only a very few hormones have been tested and/or b) one or more of your results were borderline.

Menstrual and Premenstrual Migraines

For clues as to what may be causing premenstrual migraines, we have to look at what is happening hormonally at that time. On Day 21 of your cycle, progesterone is hitting a peak and estrogen levels are starting to rise a little to come to a second peak around day 23-24. By about day 25, assuming you are not pregnant or on the birth control pill, both levels are starting to fall which is the cue to your body to release the uterine lining and have a period. The peak of progesterone around day 21 is thought to be protective against migraines. The drop in estrogen is also thought to be associated with migraines. In the women that I have worked with who had premenstrual migraines, what has worked beautifully is an approach that optimizes progesterone production and balances estrogen.

1. Headache. 2008 Nov-Dec;48 Suppl 3:S124-30. doi: 10.1111/j.1526-4610.2008.01310.x. pidemiology and biology of menstrual migraine. Martin VT1, Lipton RB.
2. Headache. 2006 Mar;46(3):365-86. Ovarian hormones and migraine headache: understanding mechanisms and pathogenesis–part 2. Martin VT1, Behbehani M.