MENSTRUAL MIGRAINES; HOW TO IDENTIFY YOUR ROOT CAUSE AND WATCH THEM RESOLVE

Sep 30

Resolving migraines is probably up there with acne as one of my fave client wins. Thankfully I’ve only had to experience a handful of menstrual migraines personally, but I know many aren’t so lucky and have had several clients suffer with monthly migraines since puberty with medications offering little respite.

Thankfully with these clients we were able to identify their root causes and within a few months migraines were a thing of the past!

"That’s a definite improvement. I’d usually definitely have (the migraine) for the day or even if it went I’d be groggy from the medication for the day and I wasn’t at all.
Plus I’d sometimes get another migraine the following day and again, nothing!"
True Skin Nutrition client, former lifetime migraine sufferer

MENSTRUAL MIGRAINES

In women of reproductive age, the incidence of migraine attacks peaks on or around the first day of menstruation. Several direct and indirect hormonal and non-hormonal mechanisms have been proposed to explain this cycle dependent variation in women, but the exact underlying pathophysiological mechanisms are still not completely understood.

GETTING TO THE ROOT CAUSE(S)

The two main pathophysiological mechanisms of menstrual migraine recognised to date are oestrogen withdrawal and prostaglandin release, which are not mutually exclusive.

CHANGES IN HORMONES DURING THE PREMENSTRUAL PHASE

The premenstrual phase of the menstrual cycle is characterised by declining plasma concentrations of oestrogen and progesterone. In a series of small studies, the premenstrual drop in oestrogen was consistently associated with migraine.1

CHANGES IN HORMONES AFFECTING NEUROTRANSMITTER SYNTHESIS ASSOCIATED WITH PAIN

Female sex hormones can modulate the activity of several neurotransmitter systems involved in migraine pathophysiology, as well as in pain transmission in general. The activity of these systems varies with changes in hormone concentrations.

For example, oestrogen modulates activity in the µ-opioid system. The late luteal low-oestrogen and low-progesterone state is associated with reduced capacity to activate the µ-opioid system, resulting in a state of susceptibility to pain. Oestrogen can also modulate the activity of the serotonergic system, and a change in the serotonergic tone accompanying oestrogen withdrawal has been proposed as a possible trigger of attacks.

RISE IN PROSTAGLANDINS DURING MENSTRUATION

Much less is known about the role of prostaglandins in the pathophysiology of menstrual migraine. During the first 48 h of menstruation, prostaglandins are released from the endometrium into systemic circulation. Migraine attacks occurring at the beginning of menstruation might thus be triggered by prostaglandin release.

In a small trial injection of prostaglandins E2 and I2 induces migraine-like attacks in patients with migraine.

Notably, women with dysmenorrhoea (in whom pain is mediated by prostaglandins) are at greater risk of having menstrual migraine than are women without dysmenorrhoea.

OTHER MECHANISMS THAT COULD BE FEEDING INTO MENSTRUAL MIGRAINES:

Poor blood sugar management
Gut dysbiosis
Histamine intolerance
Inflammation
Stress
Anaemias
Hypothyroidism

A FUNCTIONAL APPROACH TO MIGRAINES

As you can see there are body systems involved in menstrual migraines that are outside of just our sex hormones. Therefore a holistic systems based approach is fundamental to identify root causes and provide lasting relief.

A full health history, diet and lifestyle and symptoms review is required to help identify what root causes we are most likely working with.

TESTING TO IDENTIFY YOUR ROOT CAUSE(S)

A comprehensive metabolic blood profile can help us to identify if any of the mentioned mechanisms can be feeding into your migraine. You can find out more about blood testing here.

For premenstrual and menstrual migraines I also like to run the Lifecode Gx DNA Hormone panel as it can help identify if there are ways that we can enhance sensitivity to the drop in oestrogen and progesterone via oestrogen and progesterone receptors. It can also give us insight as to how your body likes to produce, utilise and eliminate sex hormones and if there is a preference for oestrogen dominance, as well as your HPA function (how well you respond to stress). More information of the DNA Hormone Panel can be found here.

WHAT CAN YOU DO TODAY TO SUPPORT YOUR MENSTRUAL MIGRAINE?

Help keep a diary to monitor where in your menstrual cycle you are getting migraines
Work on stress management by regularly engaging with activities that activate your parasympathetic nervous system such as walking in nature, yoga, breathing exercises, meditation
Ensure you are allowing your body to have 8 hours sleep per night
Book in a discovery call with me to discuss how I can help

I hope you found this information helpful, relief is out there and I hope this is the next step you need in your path of healing.

"That’s a definite improvement. I’d usually definitely have (the migraine) for the day or even if it went I’d be groggy from the medication for the day and I wasn’t at all.
Plus I’d sometimes get another migraine the following day and again, nothing!"
True Skin Nutrition client, former lifetime migraine sufferer

Chloe

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