Guide to Hormone Headache: Definition, Causes & Treatments

Nearly everyone experiences headaches from time to time, but hormone headaches and migraines are particularly bothersome. These headaches are caused by fluctuating hormone levels, mainly estrogen, commonly affecting women. In fact, migraines are about three times more likely in women than in men and affect over 12% of adults in the United States.

Fortunately, treatments can reduce headache pain and even prevent hormone headaches from occurring in the first place.

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A Rundown of Hormone Headaches

Understanding more about hormone headaches can help you decide if you’re at risk of developing them and if fluctuating hormone levels are causing your symptoms.

What Are Hormones?

Hormones are the human body’s chemical messengers that travel through the bloodstream to organs and tissues. Hormones affect many body functions, including sexual functioning, reproduction, growth, development, mood, and metabolism. 

The endocrine system, including your pancreas and thyroid, thymus, pituitary, pineal, and adrenal glands, make hormones. Testes in men and ovaries in women also produce hormones. 

When not balanced properly, hormones can cause an array of body changes. Hormone lab tests determine if your hormone levels are too low, too high, or just right. These tests measure hormones in the urine, saliva, or blood. For example, home pregnancy tests measure hormone levels in urine.

Fluctuating estrogen levels are common causes of hormone headaches in women, also commonly referred to as menstrual migraines. Estrogen is a hormone that plays a vital role in female reproductive development and sexual functioning. When its levels drop, headaches may appear.

Relationship Between Hormones and Headaches

A review demonstrates a strong link between hormones, especially estrogen, and headaches. The researchers found that natural declines in estrogen levels (below 45–50 pg/mL), particularly before or during menstruation, can cause migraines. 

One reason decreased estrogen levels cause headaches is because estrogen affects neurotransmitter systems, thereby affecting pain pathways.

All You Need to Know About Migraines

A migraine is typically more intense than a headache and may affect one or both sides of your head. It can contribute to visual disturbances (auras), weakness, throbbing pain, nausea or dizziness, light or sound sensitivity, fatigue, and difficulty concentrating. Migraines may last several hours, even days, when not treated. 

Menstrual migraines are intense headaches that appear before or during menstruation in women. 

Migraines can appear for other reasons, too. Examples include food additives, highly processed foods, caffeine, alcohol, stress, sleep changes, intense physical exertion, and even weather changes or medications. Aspartame and a preservative called monosodium glutamate (MSG) may increase your risk of migraines. 

Unlike other types of migraines, menstrual migraines appear because of a drop in estrogen levels. They may develop up to three days before menstruation. Common symptoms of menstrual migraines are the same as other migraines, but you might also experience sweating, chills, a tender scalp, pale skin, or abdominal pain. 

In addition to estrogen drops before menstruation, other causes of hormone headache fluctuations in women include taking birth control pills and undergoing hormone replacement therapy for menopause symptoms. A family history of menstrual migraines also increases your risk of experiencing crippling headaches.

Symptoms and Causes

It’s helpful to know the symptoms and causes of hormone headaches to receive the treatment needed to ease worrisome symptoms.

10 Symptoms of Hormone Headaches 

The common symptoms of hormone headaches include:

• Severe head pain
• Throbbing or pulsing pain
• Zigzag lines, spots, or other visual disturbances
• Pain on one or both sides of your head
• Sound, light, or smell sensitivity 
• Nausea, vomiting, or loss of appetite
• Weakness
• Fatigue
• Worsening pain with exercise
• Pale skin

Hormone headaches might last 4-72 hours when not treated. Some women struggle with menstrual migraines until they reach menopause.

15 Triggers of Hormone Headaches

15 things that can trigger hormone headaches include:

• Menstruation in women
• Drops in estrogen
• Birth control pills
• Hormone replacement therapy
• Some foods and drinks
• Alcohol
• Strong smells or bright lights
• Caffeine
• Too little sleep, too much sleep, or sleep apnea
• Jaw clenching, teeth grinding, or jaw disorders
• Anxiety
• Stress
• Hunger
• Dehydration 
• Weather changes

Sometimes, a combination of factors contributes to hormone headaches or worsening symptoms. 

Diagnosing Hormone Headaches

Diagnosing hormone headaches is the first step in getting the treatment needed to eliminate debilitating pain.

How Are Hormone Headaches Diagnosed?

Diagnosing hormone headaches involves a discussion about your symptoms, lifestyle, medical history, and current medications. Additional diagnostic tools include a physical exam, blood testing, and other tests that determine the cause of migraines and how best to treat them.

Tests for Hormone Headaches

Biannual tests that help diagnose hormone headaches and their underlying cause include:

• Adrenal stress test: an adrenal stress test is a saliva test that evaluates varying cortisol levels, a migraine trigger.
• Food sensitivity panel: food sensitivity testing helps identify foods that may trigger headaches or migraines.
• Neurotransmitter panel: a neurotransmitter panel consists of a urine test that detects neurotransmitter imbalances linked to migraines.
• Female hormone panel: female hormone testing includes blood tests that assess estrogen levels and other hormone levels in women.
• Microbiome analysis: a microbiome analysis is a comprehensive stool test that measures microbiome balance in the gut (GI-MAP and GI Effects are both great options).
• Micronutrient analysis: a micronutrient analysis is a blood test that screens for nutrient deficiencies linked to headaches (i.e. SpectraCell's Micronutrient Test).
• Imaging procedures: CT scans, MRIs, electroencephalogram (EEG), and other imaging procedures can detect brain abnormalities associated with headaches and migraines.

Undergoing multiple diagnostic tests establishes the best way to treat hormone headaches or other types of headaches and migraines.

Managing and Treating Hormone Headaches

The good news is that hormone headaches are treatable, even preventable, with lifestyle changes and medications.

Medicines Used to Manage Hormone Headaches

Medications commonly used to treat hormone headaches (menstrual migraines) include:

Triptans

Triptans are selective serotonin receptor agonists. Examples include:

• Naratriptan (Amerge^®)
• Rizatriptan (Maxalt^®)
• Sumatriptan (Imitrex^®)
• Eletriptan (Relpax^®)
• Frovatriptan (Frova^®)
• Zolmitriptan (Zomig^®)
• Almotriptan (Axert^®)

These medications help stop menstrual migraines after they appear. 

Nonsteroidal anti-inflammatory medications (NSAIDs)

NSAIDs lessen inflammation, contributing to hormone headaches. Examples of NSAIDs commonly used to treat menstrual migraines include:

• Fenoprofen calcium (Nalfon^®)
• Naproxen (Naprosyn^®)
• Ketoprofen (Orudis^®)
• Ibuprofen (Motrin^® and Advil^®)
• Nabumetone (Relafen^®)

Taking these medications several days before menstruation begins can ease symptoms. They’re usually taken for a short time.

Other medications

Other medications that may help reduce hormone headaches include:

• Estrogen gels, patches, pills, or other contraceptives 
• Ergotamine (Bellergal-S^®)
• Methylergonovine maleate (Methergine^®)
• Calcium channel blockers (verapamil)
• Beta-blocker drugs (propranolol)
• Anticonvulsants (topiramate)
• Corticosteroids
• Caffeine
• Analgesics
• Leuprolide (Lupron^®)
• Diuretics 
• Dihydroergotamine (Trudhesa^®, Migranal^®)
• Anti-nausea medications: promethazine (Promethegan^®, Promethazine Plain^®) or prochlorperazine (Procomp^®, Compro^®,)

You might take medications several days before menstruation and continue taking them during your cycle.

Do These Medications Have Side Effects? 

Common side effects associated with medications used to treat hormone headaches include:

• Chest pain
• Chest heaviness or pressure
• Weakness
• Dizziness
• Nausea
• Dry mouth
• Numbness
• Prickling
• Tingling
• Fatigue
• Cold or warm sensations

Side effects vary in type and severity from person to person.

Treatment Options for Menopausal Headaches

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Menopausal migraine treatment options for women may include continued estrogen therapy or supplements. You might take hormones every day to ease bothersome symptoms or prevent hormone headaches from appearing. Hormone therapy may be as simple as applying Estraderm^® or another estrogen patch. 

Treatment Options for Pregnancy Headaches

Medications used for migraine treatments can often harm a baby during pregnancy, so expectant mothers should typically avoid them. However, they might be able to take acetaminophen or another mild pain reducer. 

Migraines may get better or disappear during pregnancy but often return after delivery because of a drop in estrogen that usually happens during that time period.

Self-Help Tips for Hormone Headaches

In addition to or instead of taking medications for hormone headaches, self-help measures you can try include:

• Spend time in a dark, quiet room
• Avoid missing meals; consume small, frequent snacks
• Try relaxation training or biofeedback
• Minimize stress
• Maintain a regular sleeping schedule
• Avoid known headache triggers (stress, alcohol, dehydration, etc.)
• Limit excessive amounts of caffeine
• Consider behavioral therapy 
• Try dietary supplements (magnesium, riboflavin, coenzyme Q10, or butterbur)
• Massage your scalp
• Meditate 
• Try acupuncture 
• Consider Botox^®
• Use a circular motion to apply pressure to your temples 

Avoiding stress buildup and other hormone headache triggers is vital to minimize head pain or prevent it entirely. 

Preventing Hormone Headaches

Hormone headaches are sometimes preventable by taking early action with medications or healthy lifestyle habits. Examples of migraine prevention medications include:

• Naratriptan
• Sumatriptan
• Prophylaxis
• NSAIDs
• Frovatriptan
• Magnesium
• Fluoxetine
• Estrogen therapy
• Methylergonovine
• Dihydroergotamine (DHE)

These medicines are typically taken daily with a higher dosage close to the time of menstruation in women. 

FAQs on Hormone Headaches

#1. How can I relieve the symptoms of a hormone headache?

The best way to relieve frequent hormone headache symptoms is to see a doctor who develops a long-term treatment plan. This may include hormone therapy, lifestyle changes, medications, or combinations of treatments. 

Things you can do at home to reduce debilitating symptoms include relaxing in a quiet, dark room, minimizing stress, avoiding alcohol, drinking more water, using hot or cool packs, taking a nap, and trying over-the-counter pain relievers. Avoid skipping meals and migraine triggers, such as nicotine and overly processed foods.

#2. Can hormone headaches cause brain damage?

Hormone headaches and other types of headaches and migraines DO NOT cause brain damage. However, some underlying causes of headaches, including brain tumors, can affect brain functioning.

#3. When should I seek immediate help or contact my doctor?

Headache symptoms or complications that warrant immediate care from a doctor include:

• New, severe, or sudden headache pain
• Very severe headaches or migraines 
• Headaches with a stiff neck, rash, shortness of breath, or fever
• Speech problems
• Seizures
• Confusion
• Headaches that appear after a head injury 
• Weakness
• Paralysis
• New types of headaches after age 55
• Inappropriate behaviors
• Personality changes

• Blurred vision, blind spots, double vision, or other vision changes
• Dizziness
• Sudden falls
• Loss of balance
• Tingling 
• Numbness

If you’re unsure if you need medical care for a headache or migraine based on your medical history and symptoms, call your doctor’s office for recommendations. 

#4. How can I know whether I need to see a specialist?

Your primary care doctor determines if you should see a specialist for hormone headaches or migraines. 

They discuss your medical history, symptoms, lifestyle, and medications. You might undergo blood testing, a CT scan, or other imaging procedures to detect or rule out underlying concerns. If your doctor isn’t sure of the cause of your headaches or you have signs of a tumor or neurological disorder, they may refer you to another specialist for care.

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Key Takeaways

Hormone headaches are common among women because of hormone fluctuations, particularly drops in estrogen linked to menopause, menstruation, or the post-partum period after pregnancy. Fortunately, many self-care methods, medications, and hormone treatments can reduce the severity of hormone headaches (menstrual migraines) or prevent them altogether.

Effective hormone headache treatment plans often consist of medical supervision, intervention as needed, diagnostic tests to detect or rule out underlying problems and care from a specialist for complex conditions causing extreme migraines.

Adopting healthy lifestyle habits and steering clear of migraine triggers may also provide the relief needed to overcome crippling migraine symptoms.

Don’t live with hormone headaches when highly effective treatments are within reach!