What causes headaches at menopause, and how can you reduce them?
Qualified nutritional therapist Rosie Letts explains what’s going on – and how it’s possible to eat your way to fewer headaches as you move through menopause.
Hormonal headaches and menopause
Around a third of most women’s life is spent either transitioning into their menopause or within the menopause. This is a daunting prospect for those who suffer from headaches and migraines associated with hormone disturbances.
Hormonal headaches are a common issue for many women, combining sometimes debilitating pain with an array of other symptoms such as fatigue, nausea, sensitivity to light and aura. Any headache sufferer knows that they can put your life on hold for several hours or days at a time.
Why do we get more headaches around menopause?
Hormonal headaches are generally triggered by a sudden drop in estrogen, which alters how are brain chemicals and neurotransmitters operate. When estrogen levels drop suddenly, the nerves in your brain can become more excitable, triggering hormonal headaches and migraines.(1)
This is why – in younger years – many women suffer from a migraine in the days leading up to their period, when estrogen levels are at their lowest. During perimenopause, women experience wide fluctuations of estrogen which may increase the number of headaches and migraines. Worse still, these fluctuations aren’t cyclical like your periods were, so suddenly headaches strike with limited predictability in timing(2), making it difficult to make plans, work effectively or manage family commitments.
Whilst some women’s symptoms do improve, a recent study suggested unpredictability as to whether women experience “a worsening, an improvement, or no change in headache during the menopausal transition”(3) with other triggers such as skipping meals, stress, sleep disturbance and dehydration coming into play.
Dr Anne MacGregor, menopause and migraine specialist formerly of the UK’s National Migraine Centre, recommends using the free N1-headache app which allows you to identify and then address your triggers.
How to manage menopause headaches with diet and lifestyle
Thankfully, there are number of ways you can improve your hormonal headaches and nutrition can play a key part:
Check your water intake
Sometimes it’s easy to forget the basics. Don’t wait until you’re thirsty to drink as even mild dehydration can cause headaches. Keep water on hand, and drink it often! Look to drink two litres of water over the course of the day – flavor it with sliced citrus fruits, cucumber, mint or rosemary for added nutrients. If in doubt, check the color of your urine – apart from the first one of the day, which may be a little darker, a pale straw color indicates adequate hydration in most people.
Manage your blood sugars
Eat regular, low glycemic load meals to keep your blood sugar levels stable. Skipping meals puts the body in a state of stress which may be a trigger for you. Find out more about the Glycemic Load (GL) approach using the resources box at the end of this article.
Keep calm
We know that worry and stress, including a succession of low level stressors – like missing the bus, too many work deadlines, the kids playing up, or too much on your to-do list – can make your headaches worse(4).
When it’s not possible to modify your lifestyle, you can support your body with magnesium, nature’s tranquilizer. This amazing mineral is involved in over 300 key processes within your body, two of which are stress reduction and a decrease in headaches(5) . Most women’s magnesium levels are insufficient(6) but a warm bath with a cup of magnesium-rich Epsom Salts twice a week is a good way to top up magnesium levels(7).
Sleep like a baby
This is easier said than done if night sweats and nocturnal waking disrupt your shut eye. It’s important to avoid stimulants such as caffeine, and alcohol, replacing them with soothing teas containing lemon balm(8) or chamomile(9), because losing out on sleep can actually increase your perception of the pain(10). You might also be interested in trying yoga to improve sleep, or learning how to make your bedroom a cool, calm sanctuary.
Be aware of – and reduce – inflammation
Recent research has revealed that along with hormonal triggers, inflammation is a primary cause of migraines, and therefore reducing inflammation in your body can reduce migraines(11).
If you are experiencing inflammation in other parts of your body, it’s crucial to gain an understanding of where it is stemming from and work to soothe the problem area. I recommend working with a qualified nutritional therapist to achieve this. Localized inflammation can be targeted with nutrition, my top tips are:
- Quercetin is a powerful antioxidant and anti-inflammatory agent found in apples, berries, onions, olive oil and green leafy vegetables(12) Aim to eat quercetin rich foods daily.
- Lower both inflammation(13) and the frequency and severity of headaches(14) with foods containing Omega-3 from salmon, mackerel, sardines; hemp, pumpkin, chia and flaxseeds plus walnuts. Aim for 2 portions of the oily fish per week, or add an Omega-3 supplement to your diet to be sure.
- There’s good evidence that daily doses of turmeric(15), ginger and rosemary(16) may reduce inflammation and provide free radical zapping antioxidants, as do all vegetables and fruit(17) so aim for at least five 80g portions a day.
Busy? Struggling to balance your diet? Add some supplements…
It can be difficult to get good doses of some key nutrients from the food we eat on a daily basis, so you may wish supplement. Below I have outlined the most well evidenced supplements to help relieve menopausal headaches and migraines.
Omega-3
Omega 3 fatty acids are typically derived from fish or krill oil but vegan alternatives are available. Omega-3 fats play a role in relaxing blood vessels and relieving inflammation in veins, which can significantly reduce the severity of migraine headaches(14),(13). Omega-3 supplementation is particularly important if you do not eat oily fish regularly.
Magnesium
Modern farming methods have left our soils magnesium depleted, so even if you eat a well-balanced diet, you may still benefit from supplementation. Ideally supplemented as the well-absorbed citrate form, magnesium promotes sleep, reduces stress and anxiety(18) and can reduce the severity of headaches(19).
Vitamin B complex
Women transitioning through the menopause may find that they have multiple stressors whether family commitments, work, friendships or finances.
Though many of these factors may be outside of your control, a good vitamin B complex can improve the way that you cope with stress, reducing anxiety and giving you the energy to deal with life(20). Improving your resilience to stress is also likely to have a positive impact on the frequency and duration of your headaches. And remember that B vitamins help raise your energy levels, so you should take them in the morning.
About Rosie Letts
Rosie is a qualified and registered nutritional therapist. She has worked with hundreds of women experiencing menopausal symptoms, helping to combine nutrition and lifestyle changes that have helped to prevent or reduce the severity of symptoms including sleeping problems, mood changes, weight gain, and headaches.
Her qualifications, memberships and awards include: BSc in Nutritional Therapy – University of Westminster; ICHAN outstanding practice 2018 award; Member of the Complementary & Natural Healthcare Council (CHNC); Member of the British Association of Nutritional Therapists (BANT).
You might also be interested in…
Headaches – a Doctor’s overview
Useful resources:
N1-headache app – recommended by the UK’s National Migraine Centre.
Find out more about the Glycaemic Load (GL) approach here.
References
1 Vetvik, K., et al. ‘Symptoms of premenstrual syndrome in female migraineurs with and without menstrual migraine.’ Journal of Headache Pain 2018;19, p.31
2 Mattson, P. (2003). ‘Hormonal factors in migraine: a population-based study of women aged 40 to 74 years.’ Headache, 43. pp.27-35
3 Lauritsen, C., et al. (2018). ‘Current Treatment Options: Headache Related to Menopause—Diagnosis and Management.’ Current Treatment Options in Neurology, 20(4).
4 Martin, P. Lae, L. & Reece, J. (2007). ‘Stress as a trigger for headaches: Relationship between exposure and sensitivity.’ Anxiety, Stress, & Coping, 20(4), pp.393-407. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17999239 [Accessed 1 February 2019].
5 11th European Headache Federation Congress jointly with 31st Congress of the Italian Society for the Study of Headaches. (2017). The Journal of Headache and Pain, 18(S1). [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC57092… [Accessed 1 February 2019].
6 Boyle, N., et al. (2017). ‘The Effects of Magnesium Supplementation on Subjective Anxiety and Stress—A Systematic Review.’ Nutrients, 9(5), p.429.
7 Waring, R. (2004). ‘Absorption of magnesium sulfate.’ [online] Mgwater.com. Available at: http://www.mgwater.com/transdermal.shtml [Accessed 1 February 2019].
8 Scholey, A., et al. (2014). ‘Anti-Stress Effects of Lemon Balm-Containing Foods.’ Nutrients, 6(11), pp.4805-4821.
9 Savage, K. et al. (2017). ‘GABA-modulating phytomedicines for anxiety: A systematic review of preclinical and clinical evidence.’ Phytotherapy Research, 2018 Jan;32(1), pp.3-18.
10 Snel, J.& Lorist, M. (2011). ‘Effects of caffeine on sleep and cognition.’ [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21531247 [Accessed 1 February 2019].
11 Waeber, C. & Moskowitz, M. (2005). ‘Migraine as an inflammatory disorder.’ Neurology, 64 (Issue 10, Supplement 2), pp.S9-S15.
12 Lättig, J. et al. (2007). ‘Mechanism of inhibition of human secretory phospholipase A2 by flavonoids: rationale for lead design.’ Journal of Computer-Aided Molecular Design, [online] 21(8), pp.473-483. Available at: https://www.ncbi.nlm.nih.gov/pubmed/17701137 [Accessed 1 February 2019].
13 Calder, P. (2013). ‘Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology?’ British Journal of Clinical Pharmacology, 75(3), pp.645-662.
14 Ramsden, C. et al. (2013). ‘Targeted alteration of dietary n-3 and n-6 fatty acids for the treatment of chronic headaches: A randomized trial.’ Pain, 154(11), pp.2441-2451. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC38507… [Accessed 1 February 2019].
15 Ganjali, S. et al. (2014). ‘Investigation of the Effects of Curcumin on Serum Cytokines in Obese Individuals: A Randomized Controlled Trial.’ The Scientific World Journal, 2014, pp.1-6.
16 Justo, O. et al. (2015). ‘Evaluation of in vitro anti-inflammatory effects of crude ginger and rosemary extracts obtained through supercritical CO2 extraction on macrophage and tumor cell line: the influence of vehicle type.’ BMC Complementary and Alternative Medicine, 15(1).
17 Arulselvan, P. et al. (2016). ‘Role of Antioxidants and Natural Products in Inflammation.’ Oxidative Medicine and Cellular Longevity, 2016, pp.1-15. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC50756… [Accessed 1 February 2019].
18 Sartori, S. et al. (2012). ‘Magnesium deficiency induces anxiety and HPA axis dysregulation: Modulation by therapeutic drug treatment.’ Neuropharmacology, [online] 62(1), pp.304-312. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC31988… [Accessed 1 February 2019].
19 Rybicka, R. et al. (2012). ‘The role of magnesium in migraine pathogenesis. Potential use of magnesium compounds in prevention and treatment of migraine headaches.’ Journal of Elementology 02/2012. [Online] Available at: https://www.researchgate.net/publication/278730484… [Accessed 1 February 2019].
20 Long, S. & Benton, D. (2013). ‘Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis.’ Psychosomatic Medicine. 2013 Feb;75(2), pp.144-53
