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What are your options for hormonal migraines & menopause symptoms?

Updated: Oct 25, 2022

This month I had hormonal migraines and it has been such a long time that I really was surprised.

And it turns out that my progesterone levels in the second phase of my cycle when they should have been at their highest, were actually almost non existent while estrogen was too high. So what does that mean? I have estrogen dominance!!!

And that’s why I got a migraine: my estrogen levels were too high (and progesterone not strong enough to balance it off). So when I got my menses and all hormones dropped, the drop in estrogen was too strong and that’s what’s known to cause migraines.

I used to have these hormonal migraines in my twenties and early thirties, so you don’t have to be in peri menopause to deal with them, it simply means your hormones are imbalanced….

And as long as our ovaries are still producing hormones (and even up until the first years into menopause), we can still use natural remedies to support our hormone levels. Herbs like vitex berry or also known as chaste tree are great for instance for progesterone support - read my article on progesterone support for more tips here.

We can also support estrogen excretion with detox techniques, specific foods (like cruciferous vegetables) or supplements as I explain in this article.

But what happens when we come the end of peri menopause, when we enter menopause?

After not having had a period for 12 months, we are officially in menopause. This should not sound like a (death) sentence ;-), it just means that our ovaries are done: they are no longer producing hormones. We are now depending on our adrenal glands to supply us with hormones (mainly progesterone) and our fat tissue mainly for estrogen production. But clearly, the levels will not be as high as before and therefore impact our health.

Let’s consider the adrenal status of most 50-year-old women for a moment:

  • raised children

  • juggled a budget

  • been the family chauffeur

  • has a career

  • rarely takes time for herself

  • has probably over-consumed coffee and sugar to keep going

  • no or very little time to exercise

Meaning that her adrenals are completely NOT prepared to step up to the task of supporting hormone balance once the ovaries slow down.

Changes in these hormone levels can cause uncomfortable symptoms. Common menopause symptoms include:

  • Hot flashes

  • Night sweats and/or cold flashes

  • Vaginal dryness; discomfort during sex

  • Feeling a need to pee (urinary urgency)

  • Trouble sleeping (insomnia)

  • Mood swings, mild depression or irritability

  • Dry skin, dry eyes or dry mouth

But as I said, this also has an impact on our health: without sufficient estrogen levels we are prone to osteoporosis and elevated risk of heart attack.

But also progesterone plays a major role in new bone formation in women. Testosterone promotes new bone growth, strength and toughness and estrogen slows bone loss.

If we experience estrogen dominance (even if estrogen is too low, but our progesterone is even more so), we are at higher risk of breast cancer, hormonal migraines, weight gain and all that sh***.

In fact, far more women suffer from the effects of estrogen dominance during and after the transition to menopause…

So what can we do once plant remedies are not doing the trick anymore?

Here we have 2 options: take 1) synthetic or 2) bio identical hormones

Whether or not you should consider taking hormone replacement therapy is a discussion to have with your healthcare provider. There are many health benefits, but also risks associated:

Synthetic vs. bio identical hormone replacement

Functional, integrative, or naturopathic physicians tend to utilize bioidentical hormones in their practices. Traditional doctors may offer synthetic hormones instead.

But what’s the difference?

Unlike synthetic hormones, bio-identical hormones are chemically identical to those your body used to produce. They are used to replace what your body can’t provide anymore and to help mitigate the symptoms of hormone deficiency.

Be sure to bring up the difference with your physician, as bio-identical hormones tend to produce greater patient satisfaction and decrease the risks and side effects of conventional hormone replacement therapy.

There actually are (even pharmaceutical) natural hormone products that you can use especially towards the end of perimenopause and in menopause to keep up your progesterone (or even estrogen) levels.

The natural form of progesterone is simply called progesterone. The synthetic form of progesterone is called progestin (and there are different forms and names like Levonorgestrel which is used in the Mirena IUD).

Why I do not recommend synthetic hormones

Although the names of these two hormones sound very similar, they are not the same. The main thing to remember is that progesterone is produced naturally by your body, and progestin is synthetic.

Even though progestin can cause similar responses in your body, it also carries a higher risk of negative side effects.

Progestins are synthetic versions of progesterone found in contraceptives. Progestin is actually more structurally similar to testosterone than progesterone.

This is why synthetic hormones have more side effects (see symptom list above).

The best form of progesterone is of course the one created by your body. If you and your practitioner have determined that supplementing with progesterone is the right choice for you, you want to make sure it is all-natural. Natural progesterone for supplements is derived from soybeans, cactus or yam roots.

This natural progesterone has the same chemical structure as the progesterone created by your body, that’s why it’s called bio-identical.

Some of the more severe side effects that can come with synthetic hormone replacement include:

  • Heart attack

  • Stroke

  • Blood clots

  • Gallbladder disease

  • Cancer

In any way, it’s important to retest your hormone levels regularly and to use saliva hormone tests to make sure you have the accurate levels.

You can influence how peri menopause goes for you!

As I’ve explained before, our progesterone production naturally declines with age. This is what happens in perimenopause. But our progesterone production can also be impacted by elevated stress levels, gut dysbiosis (overgrowth of bad bacteria in our gut) and other factors before perimenopause. In any case, it’s always best to support ideal hormone production by eliminating stressors and hormone disruptors and nourishing your body (and hormonal glands) with a whole foods and nutrient-dense diet.

Take these steps to lay the groundwork for hormone balance:

  1. Take care of your adrenals (self care, mediation, mindfulness, reduce stress!…)

  2. Minimize inflammation: keep your blood sugar levels stable, work on eliminating underlying sources of inflammation in your gut, stress, nutrient depletion…

  3. Eat a whole foods and nutrient-dense diet (beware of carbohydrates as we tend to tolerate them less in peri menopause)

  4. Move your body daily and implement weight bearing exercise to maintain muscle mass and stimulate bone health

Contact me if you would like help with managing your hormones.

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