Migraine types and the Menstrual Migraine
Migraines can be triggered by dietary and lifestyle factors, including certain foods, alcohol, stress and blood sugar imbalance. Once triggers are identified and modified, many migraines can be significantly improved. However, there is one type of migraine that I have come across frequently in practice that’s much more difficult to get rid of. This is known as a menstrual migraine. It’s a migraine that is typically experienced in the 2-3 days before the menstrual period starts, or during the first few days of bleeding1.
So what causes menstrual migraines?
Menstrual migraines are caused by a change in levels in either of the two main female sex hormones: estrogen and progesterone. In the days before the menstrual period starts, both estrogen and progesterone levels drop. This sudden hormonal plummet can trigger a menstrual migraine. Both estrogen and progesterone can cross the blood-brain barrier and impact the brain’s nervous system and pain processing networks1. Estrogen also has effects on the serotonergic system. In fact, relationships between estrogen and brain neurotransmitters such as norepinephrine, dopamine, and endorphins have been found1. Research suggests that it’s most likely the drop in estrogen that triggers menstrual migraines, based on these interesting associations2.