Have you ever noticed that your migraine shows up more often around your period or ovulation? You are not alone. Hormonal fluctuations play a big role in migraine, and that is why women experience attacks more often than men. But why is that? Let’s look more closely at the interplay between hormones and migraine, and at how you can respond to it to reduce your attacks.
The influence of oestrogen and progesterone
Oestrogen and progesterone are two important female sex hormones that not only regulate the menstrual cycle, but also have a big influence on your brain and nervous system.
- Oestrogen: this hormone helps regulate serotonin and supports the blood vessels and energy balance in the brain. It also plays an important role in transporting glucose to the brain, which is essential for supplying neurons with energy.
- Progesterone: this hormone has a calming effect on the nervous system and helps keep brain activity in balance.
When these hormones drop or fluctuate sharply, it can set off a chain reaction in the brain that leads to a migraine attack.
Why migraine often strikes around your period and ovulation
The drop in oestrogen before your period
In the days before your period, oestrogen levels drop abruptly. This has several effects:
- Less energy for your brain: oestrogen helps transport glucose to the brain. When oestrogen drops, a temporary energy deficit can develop in the neurons. If your body is not metabolically flexible (so it cannot easily switch to burning fat and depends on carbohydrates), this can send out an alarm signal, putting the brain into a stress response and allowing migraine to develop.
- Disturbed serotonin balance: a drop in oestrogen can lead to a shortage of serotonin, a neurotransmitter involved in pain regulation and mood. This increases sensitivity to migraine.
- Loss of electrolytes: oestrogen makes you retain fluid. The shift in hormones can make you lose more fluid and electrolytes, which can increase your sensitivity to migraine.
- The breakdown of oestrogen often doesn’t run optimally, which produces pro-inflammatory metabolites. These are forms of oestrogen that cause, for example, painful breasts, but just as much migraine.
The drop in progesterone and its effect on brain excitability
Besides the drop in oestrogen, progesterone also drops just before your period. Progesterone normally has a calming effect on the nervous system through its GABA-like action (GABA is a neurotransmitter that inhibits brain activity). When this hormone falls away:
- You experience more stimuli: the dampening of brain activity falls away, making your brain more sensitive to external and internal stimuli (light, sound, stress, emotions).
- You become more anxious and alert: without the calming influence of progesterone, feelings of stress, restlessness and even anxiety can increase. This leads to a hyperactive brain.
- Your brain uses more energy: because your brain becomes more active and filters stimuli less efficiently, it uses more glucose and other fuels. This can deepen the energy deficit in the brain and trigger migraine.
So it is not so surprising that you get angry or emotional more quickly in the days before your period!
The hormonal peak around ovulation
Around ovulation (roughly halfway through the cycle, day 14 in an average 28-day cycle), rapid hormonal changes take place that can trigger migraine.
Oestrogen peak before ovulation
In the days before ovulation, oestrogen rises to a peak. This rise makes you retain fluid and sodium. This process disrupts the sodium/potassium balance: because you retain relatively more sodium than potassium, the electrical signalling in the brain can change, which can be a migraine trigger in sensitive people. The rise in oestrogen can also have a temporary effect on the blood vessels, causing them to dilate, which can provoke a migraine attack in sensitive people.
Rapid oestrogen drop after ovulation
Right after ovulation, oestrogen drops abruptly, leading to a temporary oestrogen dip. Just as in the days before your period, you can be faced with a sudden loss of fluid and sodium, less energy, less serotonin and inflammation.
Conclusion
Hormonal migraine is complex, but by gaining insight into how your hormones affect your migraine, you can take steps to stay ahead of your attacks. Hormones are only one of the building blocks behind migraine: several factors often play a role together.
- The breakdown of oestrogens can be improved and supported with lifestyle and supplements.
- Your metabolic flexibility is entirely in your own hands, and with the right interventions you can bring it back under control.
- Your strong reaction to a disturbed electrolyte balance may have to do with neuroinflammation or a genetic sensitivity, but it can be absorbed by getting the inflammation under control and by managing your electrolyte balance preventively and actively.
- The extra restlessness you feel when progesterone falls away can be cushioned by working on your psyche and supporting it with supplements.
Through nutrition, lifestyle and, where needed, supplements, you can absolutely gain more control over the effect of your hormones on your migraine and help your body stay in balance.
Start with the Building Block Analysis to tackle your hormonal migraine.
