Why do I only get Migraines with my period?

Migraines are a debilitating entity that only those who have ever suffered one can truly understand. They are not a headache, they are a shut down of your brain, similar to a mini stroke. Yes, they knock you about and destroy your quality of life when you have them, but the groggy feeling for days afterwards can be just as debilitating for many.

In some women these migraines seem to be triggered by their cycles through hormonal and prostaglandin changes. Let me explain how:

There are many theories as to why women get migraines around their cycles and why migraines occur. One of the theories is that there is a specific neural pathway coming from the face to the blood vessels of the brain that becomes dysfunctional known as the trigeminovascular pathway.

The thought is that when this pathway is stimulated, nerve endings become sensitized triggering what is known as allodynia. This is similar to what happens when you cut yourself and the surrounding tissues become tender.

When these nerve endings become sensitized the result is we start feeling the regular pulsations of blood vessels that we don’t normally feel. This often results in that throbbing pain feeling. But why do these things happen specifically with your period…?

Well, there are a few potential issues with this when it comes to menstruation. Let me explain how.

1. Receptor stimulation – Certain areas of the body have what we call receptors that allow that area to sense and detect changes in the blood stream. It is known that estrogen stimulates specific receptor sites on this neural pathway that can potentially increase the input into this mechanism. Though it is less understood and occurs less often, this can increase the irritation experienced from areas such as the jaw and potentially increase the risk of migraine. This is probably more likely to be the case if you’re having your migraines leading into your period rather than on the other side of it.
2. Estrogen shifts – There is some evidence to suggest that the sudden drop in oestrogen that occurs when you get your period may trigger a migraine event in some individuals. Whilst there is a higher level of evidence with this association, the mechanism of how this induces migraine or why some women are more predisposed is not well understood. It is understood though that cortisol, our main stress hormone, can potentially elevate oestrogen and disrupt this delicate hormone balance.
3. Prostaglandin shifts – Prostaglandins are fatty substances that help regulate inflammation. We use prostaglandins to heal, to dilate during labour and even in menstruation. For some reason some people seem to react to a specific form of prostaglandin known as PG1 and this can trigger their migraines. The production of prostaglandin 1 can be influenced by insulin, a hormone released with the consumption of carbohydrate.

Migraines are a debilitating condition that has brought many great people to their knees. It can be a complicated entity that many struggle to understand. With thorough investigation into trigeminal nerve health, reproductive hormone function and prostaglandin production many sufferers can find relief through simple corrections to their structure or changes in lifestyle.