wellness
Gender and Migraine Attacks
It comes down to hormones… but it’s also not that simple.
But first, how do you know if it’s a headache or a migraine? Tension headaches typically feel like pressure, dull ache, or tightness around the head. Migraines in the headache phase usually sit on one side or the other of the head and tend to feel like it’s pulsing. With migraine, this tends to be felt at the temples, behind the head, or in the sinuses. And particularly in migraines triggered by sex hormones, these last longer – 24 to 72 hours, and are often more resistant to standard migraine medication. And since menstrually related migraine occurs regularly in 6-7% of menstruating females, this becomes important to understand [1]
So how does sex & gender affect migraines?
First of all, migraine affects three times more women than males. Migraines are more common in males as children, up until puberty. Then at puberty, migraines tend to increase for many females, resulting in many more female migraine sufferers than males. And even though more females experience migraines, from what I’ve seen, the research and medication available do not reflect this gender divide.
Did you know that much of the pain research on animals is conducted solely on male animals? In 2019, neuroscientist Greg Dussor was studying a specific treatment for Migraine. They were seeking to replicate findings from a previous study. However, Dussor decided to follow up with a duplicate study on female rats as a control… expecting no difference. “Instead, his team observed clear sex-specific differences — CGRP elicited a potent pain response in females at doses that had no effect on males.” Migraine is a condition that greatly affects more females than males. Yet it took until 2019 to have an animal study in this area of Migraine research factor in sex. This only adds to the gap in migraine relief for females. It’s known that many migraine medications don’t work as well in menstrual migraine. And having preliminary medication research not even look at testing females in the animal study stage is a big part of the problem. It’s no wonder we are underserved in our health support by conventional medicine.
“Much of this knowledge gap is attributable to gender bias — a pervasive problem in clinical research.”
“Much of this knowledge gap is attributable to gender bias — a pervasive problem in clinical research. If migraine affected men at the same rate, we would have much better studies,” says Pavlovic. “A lot of the biases and stigma associated with migraine have to do with it being a disorder of women.” [2]
Despite this, there have been some recent discoveries in migraine research and sex hormones. You might have heard the hormone at fault is estrogen. And yes, sensitivity to fluctuations and decreases in estrogen levels are associated with migraines.
But it’s not as straightforward as that.
A major player in setting off a migraine attack is the trigeminal nerve. You might have seen devices marketed to cool or electrically stimulate the trigeminal nerve for migraine relief and provide mixed results from what I’ve heard.
A study from Spain identified that changes in estrogen levels made the trigeminal nerve more sensitive to migraine triggers. [3] So that can explain why if your stress levels are low and you’ve been avoiding trigger foods, you might not get a migraine during your period. But if you have that poorly timed glass of red wine, you get hit with a migraine when your changing hormones have made you more sensitive to migraine triggers.
Unfortunately, there has been limited research on migraine in women, particularly on how medications work for migraine when there is a hormonal component. And even worse, these hormonal migraines tend to be more prolonged and severe, putting women at an even higher disadvantage when seeking migraine relief.
It also becomes more complicated to look at Hormonal Migraines as research has noted the more significant prevalence of hormonal triggered migraine in the window two days before the period to 3 days after the start of the period when both progesterone and estrogen are at their lowest. And in some cases, estrogen supplementation has helped reduce migraines. But then, other studies have identified migraines associated with increases and supplementation of estrogen [3]. So, as for most things in hormonal health, many factors are at play.
So, what can we do to support hormonal migraines?
I always recommend looking at what is referred to as the ‘treatment pie’, or looking at multiple therapies and supports when finding relief for migraine. I’ll list my top 3 holistic therapies or practices below:
- Supporting healthy hormone function through mind-body therapies. As an Advanced Reproductive Reflexologist, I’ve seen how amazing my work can be for hormonal health and related migraines. However, other therapies like guided breathwork, acupuncture and auricular therapy are also very beneficial.
- Supporting the Trigeminal Nerve through the ‘Migraine Point’. This point was introduced to me by my Facial Reflexology instructor Ziggie Bergman. This involves applying pressure to a point beside the ear which happens to be over the trigeminal nerve, and I’ve seen in myself, and my clients can reduce the intensity of migraine pain. CLICK HERE for instructions
- Becoming aware of Migraine Triggers and avoiding them at certain times of your cycle. It’s difficult to support an issue that you’re not aware of. So tracking when in your cycle you tend to get migraines, and also keeping a journal of factors like weather, diet, and activity levels help determine what seems to affect your body and migraines. Interested in a trigger tracking journal specifically for those with hormonal migraines? Purchase a print copy HERE or get your FREE pdf HERE.
I hope you find these insights helpful! Let me know what you think about this topic, and if you have any questions, send them too!
With Kindness and Love,
Christine McInnis RCRT MARR
Willow Therapies is Christine McInnis, RCRT MARR. Advanced Reflexology Therapist, Mind-Body Hormone and Migraine Support, and Zone Face Lift Practitioner. The Willow Therapies Studio is located in South Headingley, 5 minutes from the West Winnipeg perimeter. Information on virtual services can be found at www.online.willowtherapies.ca