Will balanced hormones stop the monthly torture? Is this your cure for migraine headache?
My functional medical doctor says "yes" and attempts to balance my estrogen dominance with progesterone cream and DHEA supplements... slowly adding others... for over ten years!
FYI, it's not just one hormone you'll need to balance.
After years of research and experimentation, let me tell you where the hype is and where you can have hope.
Fluctuations in estrogen levels are believed to be one of the most common triggers of migraine headaches in women.
If you've landed on this page, I'm guessing you're also plagued each month by the condition called menstrual migraine.
The treatment is the same as other migraines: non-steroidal anti-inflammatories (NSAID) like Naproxen, the long acting triptans Frova® and Amerge®, sedatives and even magnesium supplements. (Rothner MD, 2011)
Dr. Rothner, Director of the Pediatric/Adolescent Headache Clinic and Chairman Emeritus of Child Neurology at the Cleveland Clinic Foundation says that...
"Migraines that fall around menses are often more severe than those that strike at other times of the month."
And here's the good news:
Because these headaches are predictable, they can be planned for with acute or preventive treatments.
~ Dr. Rothner, Director of the Pediatric/Adolescent Headache Clinic
So, maintaining a healthy lifestyle, getting adequate hydration, and ensuring regular meal and sleep times can help you reduce your susceptibility to migraine triggers.
And balancing your hormones... if none of the above seems to be working.
You have most likely heard of estrogen and progesterone, but have you heard of pregnenolone and DHEA? Did you know that women need testosterone too?
The roles that estrogen and progesterone play in migraine are critical and complex.
Most practitioners will help you balance both of these together because the balance between them is just as important as their individual levels.
It is crucial to get both sides of the equation right for eliminating migraine, and all of the other additional symptoms us women experience during perimenopause and menopause.
I know my migraines are hormonal although no specialist has seen that pattern. I get them the week before, during and after and then have one week off. Thank God for that week off.
Using Bio-Identical hormones in the hope of a cure for migraine headache, if your migraines happen around your menstrual cycle, may just prove to be a solution. So there is hope.
But keep reading to see where I think the hype is. And always remember it's all an experiment, there is currently no cure for migraine headache. But anything you can do to reduce them in any way (frequency of occurrence or intensity) is a victory.
According to Dr. Christiane Northrup it is essential to balance your hormones - specifically estrogen and progesterone. She says that normalizing hormones and neurotransmitters will normalize the excitation in the brain which should reduce or stop migraines.
She recommends 2% natural progesterone cream to her patients to relieve premenstrual or menopausal migraines.
Her dosage instructions are to use: one quarter to one half teaspoon of 2% progesterone cream on your soft skin areas (under arms and inner thighs I was told) 3 – 4 days before your period is due.
For a more acute treatment to prevent an oncoming migraine, you can apply one quarter teaspoon every 15 minutes. This is known to “calm neurons by acting on the GABA receptors in the brain, much like Valium.”
I found using progesterone cream very useful as one of my migraine headache remedies. It calmed me down, but after 4 – 6 hours of migraine symptoms, I was reluctant to continue with applying the cream every 15 minutes. And I found that the migraine would still strike eventually regardless of how much progesterone cream I used. I don't ever want to overdose on anything.
I also experimented with 6% cream for many years, but as I was still getting twenty migraine days each month, she suggested I stop everything and start again from scratch.
Yes... start again... just a kind reminder here to have patience with yourself if your trial takes some time to produce results.
If you are going to experiment with balancing your hormones as a cure for migraine headache and you prefer the bio-identical hormone route, I would suggest finding a doctor to help you along the path and to recheck your hormone levels every two years or so.
There are numerous products that advertise similar effectiveness to properly prescribed and compounded progesterone cream that can be bought over the counter in many countries. But I have found them useless against the strength of my migraine attacks.
Make sure you find a reputable product that your doctor approves of, or stick to their prescription. I trust my local pharmacist who has a great reputation and prescription compounding services.
I tried Triest (tri estrogen) cream prepared by a local compounding pharmacy that contains all three estrogen's: 10% estradiol, 10% estrone and 80% estriol. It came in a tub with a syringe attached on top making it easy to measure the small dose I needed.
There is a lot of controversy in this area. I decided to avoid using Premarin as an estrogen supplement (made from pregnant horse urine). From my research, it is more apt to cause headaches than bioidentical formulations or patches.
Avoid synthetic progestins that cause your blood vessels to constrict.
Also avoiding any synthetic progestin that causes constriction of the blood vessels is important too. The brand names to avoid are: Provera, Prempro, and the combination patches like Ortho Prefest and Activella, just to name a few. I would consider this hype but always check with your doctor first.
Let me tell you about DHEA before we get to the estrogen's as part of your cure for migraine headache.
Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands.
It is a precursor for the estrogens and testosterone production in your body.
Blood levels of DHEA are at their peak during your twenties and then decline as you age. By the age of 70 or 80 they will have decreased significantly to 20-30% of your peak levels.
My DHEA was very low and my doctor monitored it for years, while we played with doses from 5 to 25 mgs. Less was better for me.
Dr. Sergey Dzugan, author of The Migraine Cure, says we must “balance steroid hormones such as pregnenolone, DHEA, estrogen, progesterone, and testosterone; reset the function of the pineal gland using the hormone melatonin and other natural substances; restore gastrointestinal and digestive health using probiotics; and achieve a balance between calcium and magnesium, two minerals that play a crucial role in migraine.” (Dzugan, 2006).
Low levels of DHEA are also linked with a number of health problems including migraine, chronic inflammation, and depression, just to name a few. (ibid.)
Dr. Dzugan says that maintaining an optimal DHEA-to-cortisol ratio is important for achieving hormonal balance and eliminating migraine.
So you can see, the more I write the more I would have to write about the other hormones involved. Hormones are a complicated field. I suggest that you find a specialist if you suspect your migraines are hormone related.
Your general physician can check your DHEA levels, or more specifically DHEA-sulfate (DHEA-S) with a simple blood test.
The range of DHEA in women is: standard reference range is 65-380 µg/dL and the optimal range is 350-430 µg/dL. Dr. Dzugan’s numbers suggest restoring the levels back to the peak range. For men, the optimal range is 500-640 ug/dL; for women, 250-380 ug/dL. The usual daily dose he suggests is 50-100 mg taken as an oral supplement. (ibid.)
In my attempt to get my DHEA levels up to the optimum, I discovered that I could not take the higher dose, it caused anxiety and panic attacks so I had to be happy with a lower reading.
Dr. Dzugan’s treatment gets a bit more complicated by recommending 7-keto DHEA supplementation in addition to regular DHEA, but it is not allowed here in Australia so I can’t comment on the results with that.
DHEA is not publicized as a cure for migraine headache.
Estrogen is a blanket term used for several types of the hormones. There are three main types of estrogen in the human body: estrone, estradiol, and estriol. Men also have these hormones but they are found in lower levels.
Hormones effect every cell in your body and influence your organs. They are chemical messengers that carry instructions to cells throughout the body.
When your estrogens are balanced they work together to support the central nervous system, determine your female physical characteristics, and minimize loss of calcium from your bones. But wait, there’s more, they enhance your skin health, promote blood clotting, sexual function and support ovulation and reproduction.
Hormones regulate your metabolism and the way your body uses food. They even effect your reaction to emergencies and balance your moods.
You can see that the estrogens play critical roles in your body but they also have some risks as well. For example, estradiol and estrone are produced at lower levels naturally by the body as they have cancer causing abilities.
The body naturally makes more of estriol that is believed to have cancer reducing properties. When they are all in balance everything in the body functions better. Hence the potential cure for migraine headache.
The form of bio-identical estrogen that I trialed was called Triest cream.
The compounded formulation normally consists of 90% estriol, 7% estradiol, and 3% estrone. But a compounding pharmacy will prepare this formulation based on your doctor’s prescription for you.
I applied the cream (there are gels now that are more efficient at absorption) every morning after my shower.
It is best to alternate between the soft skin areas:
inner thighs or lower abdomen.
I wish I could say that all this experimenting and all this money was my cure for migraine headache, but it wasn't.
My migraines seem to hit when my estrogen goes up or down. So any movement seems to trigger an attack. This is different for everyone. You might only have a migraine before your period.
I have written more about that in these posts: menstrual headaches and premenstrual headaches.
Here is what Dr. Dzugan says about estrogen and migraine:
Getting the balance between estrogen and progesterone right is critical in the elimination of migraine.
Progesterone levels also naturally rise and fall during your monthly menstrual cycle.
Perimenopause, missing ovulation and menopause causes progesterone fluctuations. Oh dear, it sounds like we are doomed as women!
Missing ovulation in any phase means that your body is producing lower levels of progesterone that contributes to imbalanced estrogens.
Dr. Dzugan says "This imbalance explains why many women begin to experience symptoms of perimenopause in their mid to late thirties and forties, and also why the peak incidence of migraine for women is between the ages of 35 and 45."
Now there is a huge controversy around bioidentical progesterone that chemically matches the natural hormone produced in our bodies and the synthetic progesterone-like substances called progestogens or progestins.
Say that three times fast!
And then there is yam cream you can buy over the counter. Hype! Hype! Hype!
Clients of mine, and friends have had no results with this, helping me to choose prescribed bio-identical hormone cream.
I saw progesterone cream as a cure for migraine headache, and although it helped me feel a lot calmer, it did not affect the frequency, severity or duration of my attacks. Sadly NOT A CURE!
Dr. Dzugan recommends using “micronized progesterone USP. Micronized progesterone is also available as a gel (transdermal form), which is the form I recommend for migraine as well as for other conditions that benefit from hormone balancing.”
He also suggests an over-the-counter micronized cream product called ProFem as another alternative.
If you choose to experiment with balancing your hormones as a cure for migraine headache, then this is not something I would do without professional guidance from your doctor.
I've been on and off testosterone cream for many years. It gives me strength which I absolutely love.
You might think this is just a male hormone but testosterone also helps with: mood, your energy levels, bone marrow production, fertility, and supports a healthy libido.
As a cure for migraine headache, your testosterone levels need to be in balance to eliminate migraines.
“Measurement of testosterone levels is part of the male and female hormone panels that are used to identify the levels of other steroid hormones. The optimal range for men is 650-827 ng/dL; for women, 60-76 ng/dL.” (ibid).
There are many forms of testosterone available: oral supplements, injections, cream, gel and transdermal patch.
A word of caution though... your body can convert DHEA to testosterone when it’s needed. So if you are also restoring your DHEA levels using supplementation already, get your doctor to help you monitor all of that.
And P.S. making changes in your diet can effect hormones.
This has been a general overview, but you can see that there are more hormones to balance than just your estrogens.
Just because this wasn't my cure for migraine headache doesn't mean that it won't be yours. Your cure for migraine headache could be from any one of these things.
You can also practise regular self care with: meditation and do gentle exercise like yoga and tai chi and create health filled routines to manage your migraines.
Come check out my pain management course if you are still getting breakthrough pain and want some help taming any emotional chaos that comes with this pain filled condition.
I also recommend having professional pain counseling for a little extra migraine support each month (or do my course). I think it is crucial to have someone to talk to that you can be real with.
I know you know what I mean.
The largest study ever done on hormone replacement is called the Women’s Health Initiative Hormone Therapy Study. Click on National Institutes of Health if you are considering menopausal hormone therapy and find out about the potential risks and benefits.
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Cure for Migraine Headache References:
1. Northrup, C. M.D. (2012) Migraines [Available Online], Available at: http://www.drnorthrup.com/migraines/ Accessed on Feb 2, 2016.
2. Dzugan, Sergey A. MD, PhD (2006) The Migraine Cure. Cited at http://www.lifeextension.com/magazine/2006/12/cover_migraine/page-02
3. David Rothner MD. (2001) Breaking The Cycle. [Online], Available at: www.joomag.com/magazine/headwise Volume 4 issue 3 pg 22. Accessed Feb. 01, 2016.