Periods and headaches

An introduction to periods and headaches

Periods and headaches often go hand in hand. Many women just accept that this is a normal part of the menstrual cycle, but is this the case? And if so, why is it happening?

Headaches can occur for a number of reasons so it is important to try and determine how much influence your hormones are having. Try keeping a period symptoms diary, then after say 3 months, you can refer back to it and see if there is a pattern forming. If you find you have a headache 2 days before your period each month it suggests falling levels of hormones are likely to be the cause.

However, it’s not as simple as just oestrogen and progesterone exerting their effects – as we touch on in the next section – there may be other players involved!

Menstrual headaches can be severe – they can impact on your life, they can last for several days and they are often accompanied with other unpleasant symptoms such as sensitivity to light or nausea.

On this page I discuss how menstrual periods could be causing your headaches and how diet, lifestyle, herbal remedies and conventional treatments can help. However, if your headaches are severe or unexplained, it is advised you pay a visit to your GP.

How can your period cause headaches?

At certain times of the month you might find you are most susceptible to headaches. I discuss what’s going on and why this might be the case.

• Sex hormones – The female sex hormones oestrogen and progesterone have a lot to answer for. They fluctuate throughout the month (oestrogen more so) and women are very sensitive to these fluctuations. During the second part of your cycle, after ovulation has occurred, oestrogen is prone to bigger fluctuations and this is also when many women suffer from headaches and migraines.  In the last few days before your period oestrogen levels fall off substantially to give rise to your period. This drastic change is thought to be a common trigger for a sore head. Another important consideration is what happens if oestrogen is higher to start with; for example in women who are oestrogen dominant, or women who are on an oestrogen-based pill. When oestrogen finally drops to give rise to your period in this case, your symptoms can become worse as there is a more substantial drop. Bigger fluctuations also explain why women going through pregnancy or menopause often suffer from hormonal headaches too

• Prostaglandins – Prostaglandins are pro-inflammatory, chemical mediators. They have their role in menstruation as they are released from the lining of the womb to give rise to the contractions which are important for initiating menstruation. However, in excess, prostaglandins can be problematic. Prostaglandins can diffuse across the womb and into your blood stream. Once in your system they can exert their effect elsewhere in the body, such as the blood vessels in the head which we are particularly sensitive to. If your headaches generally occur in the first 48 hours of your period, it is possible that prostaglandins are at the root of the problem

• Serotonin – Low levels of serotonin (an important neurotransmitter important for regulating mood) has also been linked to headaches. In the same few days prior to menstruation when levels of your sex hormones drop off, levels of serotonin are thought to fall too. Serotonin affects how your blood vessels constrict which is the main mechanism involved in producing headaches.

Diet, lifestyle and home remedies

So, is there anything you can be doing at home to take the edge of these menstrual headaches? I describe some useful first steps:

• Identify any dietary triggers – Although diet isn’t the primary cause of headaches around the time of your period, they can exacerbate your symptoms. Alongside your symptoms diary, include what foods you have eaten. This makes it easier to highlight potential triggers. Some people find wine, cheese or red wine, for example, can be troublesome and might be best avoided, especially around the time of your period when you are most vulnerable. Also, ensure you are drinking enough water, dehydration can also trigger headaches

• Limit stress – Like diet, although stress (either emotional or physical) might not necessarily be the primary cause of your headaches, it could be acting as a trigger or making them worse. Address your stress and you could notice a reduction in the frequency of your headaches

• Apply a cold compress – Hormonal headaches can cause blood vessels in your head to dilate. By applying a cold compress to your head, it allows your vessels to constrict and can help to reduce some of the pain

• Up your essential fatty acid intake – Prostaglandins are a type of fatty acid. By increasing your intake of anti-inflammatory essential fatty acids you can help to counteract some of the pro-inflammatory effects. Include plenty of omega-3 in your diet by incorporating oily fish, eggs and walnuts as well as evening primrose which is rich in gamma-linolenic acid (GLA) – an anti-inflammatory source of omega-6 which can help to balance prostaglandins.

Herbal remedies to help

There are some herbal remedies which could help to keep your headaches under control.

If you suspect elevated levels of oestrogen are to blame and you suffer from other symptoms such as sore breasts, water retention, irritability and mood swings, Agnus castus may help to address some of these issues. Please note, if you are taking hormonal contraceptives such as the pill, hormone-balancing herbal remedies may not be suitable for you.

If stress is a big factor and is a potential trigger of your headaches try AvenaCalm. AvenaCalm contains extracts of Avena sativa which is useful in helping to address mild stress or anxiety.

How can my doctor help?

If your headaches appear at the same time each month, for three months or more, and home and herbal remedies fail to help, it might be time to visit your doctor.

Hormonal contraceptives are a possibility, for example progesterone-only options such as the mini pill or the implant. By minimising oestrogen, it is possible you can reduce some of the fluctuations which can trigger a headache.

Anti-inflammatory or painkillers can be bought over the counter to treat headaches once they have arrived. However, beware of the side effects of these medications. Ensure you don’t take too many at once and you should always seek advice if you plan to take these preventively.