In the last few weeks, while we’re adapting to this new way of living, I’m noticing that there’s an increase in the report of migraine headaches within my menopause support groups. It got me wondering the indirect impact of Covid-19 pandemic on migraine sufferers. I am hoping my writing here may help you understand your physiology and create awareness for you to consider minor adjustments in your daily living to keep your migraines at bay.
Why the worsening of migraine headaches recently?
1. The atmospheric pressure and temperature changes in early Spring is triggering migraines in those who are barometrically sensitive.
2. Anxiety and sleeplessness associated with the current situation is causing a disturbance on the neurotransmitter serotonin and their signalling in the brain, resulting the headache.
3. The reduced availability of social support or personal services create physiological and mental stress resulting heightened cortisol, impacting sex hormones changes that otherwise would keep neurosignalling in homeostasis.
4. Stress eating, emotional eating, eating out of boredom or loneliness are likely to be weakening or inflaming the digestive system, impacting the expression and function of serotonin receptors in the gut, which are known to explain some people’s migraines. The change of meal patterns and eating less nutrient-dense foods causes a drop in blood sugar, which for some people is the cause of migraine headache. Overeating, particularly if too much carbohydrates, is often coupled to eating less vegetables, which typically provides the magnesium and calcium essential for keeping migraines at by.
5. Consuming more inflammatory foods as a result home-baked goodies is a plausible explanation for increased migraine episodes. It’s been established that food sensitivity, aka delayed food reaction, is tied to migraine headaches.
6. Change in the amount of coffee consumed, either more or less than before, can decrease the threshold for onset of migraines.
7. The reduction of outdoors or physical activity lead to lowered integrity of cardiovascular function and heightened cortisol level, which together surely contribute to migraine headaches.
Migraines in Menopause
Here’s a scenario: you used to get migraines in your teens or 20s, but then in your 30s the number of episodes you had is barely rememberable, however, closer to mid-40s, migraines picked up again. Each time more disruptive than before. Sound like you?
Hormone fluctuations – natural in menopause – lower the threshold for migraines. While estrogen has a general decline in menopause, there are fluctuations everyday in every moment large enough to set off the trigger for migraines. Note, it’s not the decline in estrogen that triggers migraines, but the instability of estrogen level that cause havoc. In fact, at least 50% of adolescent girls report having frequent migraines as they have surges of sex-hormones, particularly estrogen. How migraines come about is still a mystery, albeit we have already identified common triggers. The current theory is that it has to do with erroneous electrical impulses in the brain, resulting in inflammation and overreactive nerve cells. These nerve cells in turn, send inappropriate pain signal that is perceived as migraine headache. The specific mechanism of how erroneous electrical impulses rise is still unknown, but for menopausal migraines, it is likely due to blood vessels spasming, just like that in hotflashes. In a way, you can see menopausal migraine as having hotflashes inside the brain. In your perimenopausal years, you may be experiencing more migraines than hotflashes, and in postmenopause, it may be the opposite. They are like two sides of the same coin. If you experience both migraines and hotflashes regularly, it really signifies that the muscles in your arteries and veins require support or that the autonomic nervous system controlling the constriction and dilation of blood vessels require support.
Taming Menopausal Migraines
Because migraines and hotflashes are siblings, I typically treat menopausal migraine the same way I’d treat hotflashes, with some tweaks. Support for the Nervous System Be proactive with managing your stress. What that means is that you’d engage in activities to keep your cortisol low and prevent anxiety attacks. Doing activities to prevent anxiety is just like cleaning your teeth everyday to prevent cavities and gum disease. Things that you can do in this pandemic to care for your autonomic nervous system are those I mentioned in the previous blogs – Mental Health Kit and EmergenTEAs. When you support the nervous system, you support the adrenal glands.
Support for the Adrenal Glands
It goes without saying, the dysregulation in the hypothalamus-pituitary-adrenal axis is the most imperative component when it comes to caring for menopausal wellness. A suboptimal adrenal function is 90% of the time, if not more, the reason for vasomotor symptoms like migraines and hotflashes. The adrenals produce cortisol, which regulates estrogen levels. If cortisol is too high or does not follow a diurnal pattern, healthy estrogen level will fall. Remember that estrogen potentiates serotonin – the neurotransmitter that regulates sleep, appetite, and mood – so ultimately you taking care of cortisol level (adrenals), you’d be facilitating sleep, appetite, and mood, which all are related to the onset of migraine headaches. In addition, what’s unique about serotonin is that it also plays a role in keeping migraines at bay. Medications for migraines such as ergotamine and monoamine oxidase inhibitors (MAOI) help to relieve migraines through mitigating serotonin and its receptors. If you’re looking for extra botanical support on your adrenals with specificity to migraines, check out adrenal formulations that contain:
• Siberian ginseng (lat. Eleuthrococcus senticosus)
• Asian ginseng (lat. Panax ginseng)
• Ashwaganda (lat. Withania somnifera)
Support for Estrogen Metabolism
Aside from estrogen effect on serotonin and how that plays a role in migraines, estrogen is also important in keeping your blood vessels healthy. In the presence of adequate amount of good estrogen (estradiol), your blood vessels are kept healthy and less prone to spasms that cause migraines. In the meantime, you also want to reduce the amount of bad estrogen (4-hydroxy estrone), as that can be the cause of fluctuation in estrogen, leading to migraines. Furthermore, good estrogen plays a role in stabilizing calcium in your bones. Bone loss is a process of calcium leaking out from bones and into the blood stream. That leached calcium disrupts homeostasis of blood vessels and therefore spasm occurs.
Support your estrogen metabolism with:
• Cruciferous vegetables
• Berries (bioflavanoids)
• Hops (lat. Humulus lupulus)
• Yerba Mate tea
• Lemon water (always add a pinch of baking soda)
• Vitamin B6
• Avoid excess alcohol
Support for Major and Trace Minerals
Major minerals like calcium and magnesium are important in the normal contraction and dilation of smooth muscles in blood vessels. Making sure your body has enough of these can prevent blood vessel spasms that result in migraines. Trace minerals like iron, copper, zinc, boron, strontium, and fluoride are important in stabilizing bones, so keeping these minerals in check will also prevent blood vessels from spasming.
Supply mineral with:
• Dark leafy greens
• Cal-mag supplement
• Bone strengthening supplement
Inflammation encourages plaques to build up in blood vessels. When there are blockages in a blood vessel and therefore loses its integrity, the vessel is more likely to undergo spasm, again resulting migraines if that particular blood vessel is around the outer portion of the brain.
Downgrade inflammation with:
• Dandelion root
• Omega 3 fatty acids (fish, flaxseeds)
• Vitamin C
While the root cause of migraine isn’t so clear, we can still address the spasm tendency of blood vessels by using the following:
• Cal-Mag supplements
• Chamomile tea
• Lemon balm