Image courtesy of Pierre Willemin, Creative Commons.
This post on the role of estrogen in monthly migraines is courtesy of Dr. Miranda Marti.
For many women a monthly migraine is an estrogen-associated migraine. Particularly if the timing of the migraine is predictable, such as around the start of menses.
Estrogen-associated migraines occur because of the effects a sudden withdrawal of high estrogen levels has on serotonin levels and blood vessels. This can be a natural occurrence within a woman’s menstrual cycle, it can be a scheduled withdrawal from estrogen-containing medications (such as the placeholder pills in an package of oral birth control) or it can be accidental from a missed dose of any estrogen-containing medication, including hormone replacement therapy.
Stopping the pain
So, what can be done about monthly migraines? Quite a lot, from symptom relief to cure. Our doctors, including gynecologist Mary O’Connell and our naturopath physicians, all specialize in balancing hormone levels to stop the pain of monthly migraines.
For women using any form of hormonal birth control, one of the first places to start is to ask: does it contain estrogen? Is there a lower dose estrogen or estrogen-free option that could work for me?
There are also many non-drug approaches to managing estrogen-related migraines that can provide pain relief, some as simple as supplemental magnesium taken during specific times of the menstrual cycle.
Curing the pain
To address the root cause of why a woman’s body is responding to estrogen this way, one must look at her body as a whole and evaluate not just how much estrogen is being delivered, but how the estrogen is being processed and eliminated.
This is holistic medicine and it is something that our naturopathic physicians excel at.
For all women with estrogen-associated migraines, the question to ask is: how efficient is my estrogen metabolism? Factors affecting estrogen metabolism and breakdown include the liver detoxification, digestion, and possibly estrogen receptor stimulation via pesticide exposure.
Liver Metabolism
Many women don’t realize that their body has to break down estrogen in the liver the same way it does many other biologically active chemicals, like caffeine and alcohol. Some people have an inherently lower capacity to do this than others because of their genetics, and some people have a lower capacity to do so because their liver has a high burden of exposure to many substances needing detoxification.
Signs that your estrogen metabolism could be improved:
- Sensitivity to or intolerance to: caffeine, alcohol or medications
- Other symptoms of high estrogen levels, particularly PMS: premenstrual weight gain or bloating, mood swings, cramping, breast tenderness
Digestion
After estrogen has been broken down into metabolites in the liver, the body moves these waste products via bile into the intestines so that they can be eliminated from the body in a bowel movement. Constipation or sluggish digestion can interfere with this process significantly because it gives the body time to reabsorb some of the estrogen metabolites back into circulation. Laxatives are not a long-term solution to this problem.
Women with monthly migraines and infrequent bowel movements (fewer than 5 per week) or frequent bouts of constipation could benefit from addressing their digestive concerns. Our approach is to focus on healthy non-laxative stimulation of digestive function, primarily using foods and fiber.
Pesticide exposure
Some pesticides are suspected to have the ability to stimulate our estrogen receptors and disrupt our distort our normal hormonal function, as is discussed in my blog post on organic foods.
Effectively treating and eliminating monthly migraines is about more than hormone and medication management. It is about being able to look at the body as a whole and recognize which systems can bring the body back into a stable and sustainable homornal balance.