“Have you ever considered whether your migraines might be related to your menstrual cycle? Many women get menstrual or hormonal migraines before or during their period.” I’ve fielded this question many times over the two decades I’ve suffered from headaches and migraines.
Until last year, I would shake my head. “No,” I’d say. “My headaches have many different triggers: lack of sleep, stress, too much sugar, not enough water, too much computer time, and the list goes on. I get several headaches a month, and it’s certainly not always right before my period.”
In a way, I wasn’t wrong—each of the items on my list are common headache triggers. But it wasn’t until I started charting my cycle using a Fertility Awareness Method (FAM) that I realized I was missing the big picture.
Today, I’m sharing my story because charting allowed me to find the right treatment plan for my migraines, and I believe it could do the same for other women. I share it, too, to show why charting using FAM may help provide answers that a “headache diary” alone cannot.
A history of headaches
I’ve suffered from headaches since the first grade, and from migraines since high school. Over the counter (OTC) medications such as ibuprofen provided no relief whatsoever. During my high school years, I saw a neurologist who prescribed a triptan—a class of medications that stimulate the neurotransmitter serotonin to prevent pain signals from being sent to the brain. I tried it a few times. Once, I’m sure I waited too long, as the medication is most effective when taken at the onset of a headache. Another time, I took it as directed and found no relief.
Already resistant to the idea of taking prescription medication consistently for my migraines, I soon gave up on migraine medications. Instead, I went to physical therapy and found some relief from neck strengthening exercises and pain management techniques.
I told myself that this was as good as it was going to get, and that I wasn’t going to let the pain ruin the day. I got very good at acting “normal” even with pain throbbing behind my eyes and shooting down my neck, back, and the tops of my arms. But there were days when the nausea was so severe that I vomited—when I couldn’t do anything but shut off all the lights and bury my head in a pillow for hours.
Headaches, hormone imbalances, and PCOS
Once I began charting my cycle using the Creighton Model (a FAM), I tracked both signs of my fertility and migraine episodes. What I didn’t fully understand until I had been charting for several months was that my worst headaches were tied to a specific point in my cycle—just not the one I originally expected.
While some women experience migraines just before or after their period begins due to a drop in estrogen, there are a variety of headache-inducing hormonal imbalances that may occur during a woman’s cycle. As a woman with irregular cycles, I didn’t realize until I was staring down months of charted data that my intractable migraines were nearly all occurring when anovulation (my body’s failure to release an egg during a menstrual cycle) created an imbalance in my hormone levels.
In my case, irregular cycles were one symptom of polycystic ovarian syndrome (PCOS). In fact, chronic anovulation is one of the most common symptoms of PCOS. As my body prepared to ovulate, my estrogen levels rose and my uterine lining thickened. But because elevated levels of androgen hormones prevented the maturation and release of an egg, progesterone levels did not rise in response. For me, this eventually resulted in an abrupt withdrawal of estrogen, which caused two weeks of light vaginal bleeding and painful migraines.
I now know that at least 12 recent, peer-reviewed studies hypothesize that estrogen withdrawal can cause migraines, particularly when estrogen levels fall below a certain level after an extended period of consistently high estrogen levels. As women’s health doctor and “period revolutionary” Dr. Lara Briden explains, estrogen withdrawal “disrupts the neurotransmitters serotonin and glutamate.”
For many women, including me, these hormonal migraines are particularly resistant to treatment. When I tried to alleviate my symptoms using the medications prescribed, I was fighting a losing battle.
How charting your cycle can help identify migraine triggers and treatment options
If you suffer from intractable migraine, there are a few different treatment options available to you. If your migraines are relatively infrequent, a doctor might prescribe a “rescue” medication like triptans that can be taken at the first sign of a headache, and that can prevent a full-blown migraine attack. If your migraines are chronic, you may be prescribed a daily preventative medication that can reduce their frequency.
Although it’s significantly more work on the patient’s part, you can also try to determine your unique migraine triggers and make lifestyle adjustments accordingly. Putting in this work could potentially save you from many hours of debilitating pain.
Doctors often recommend keeping a headache diary in which you record your symptoms and their severity. For example, Mayo Clinic advises: “The first step in foiling your frequent headaches is determining what type of headache you have.” The problem with the resources offered, such as this one from Mayo, is that you are looking at your symptoms in isolation from potential root causes.
Finding solutions for hormonal migraines and other types of headaches
After charting my cycle over several months, I understood that I have several different “types” of headaches. Some of them are resistant to medication and have been better addressed by the lifestyle changes I describe here and here. Incorporating changes to balance my hormones has significantly reduced the number of migraines I get each month.
I’ve also learned that while medications are ineffective for my intractable hormonal migraines, they are effective at alleviating headaches caused by my nonhormonal triggers. Today, I have a variety of tools at my disposal to both prevent migraines from occurring and help alleviate pain when they do.
With the knowledge I have now, I regret how much time I spent just trying to get through the day. I regret all the events I remember only through a haze of pain, and all the pain-free hours I spent worrying if a headache or migraine would arrive and ruin the day.
While my primary focus here has been migraines, it’s important to reiterate that learning to chart using a Fertility Awareness Method can help you identify solutions for not only this painful problem, but also irregular cycles, PCOS, and more. Understanding your cycle will provide you with newfound knowledge about your body that can help you seek effective treatment for a myriad of health issues.
Additional Reading
Menstrual Migraines and Hormonal Headaches: How understanding your cycle can help
What’s the connection between migraines and hormones?
Migraines, Weight Gain, and More: Women Explain Why They Stopped Taking the Pill
