HEADACHES AND HORMONES

There are various types of headaches and some may be related to hormonal disturbances, which we should all be aware of.

The brain in itself does not have any pain receptors. These receptors are located in blood vessels (which may dilate or contract), in the muscles of the neck and head, which may become “tense”, in articulations in the jaw and neck, which may be damaged, in nerves which transmit signs of pain (cranial and spinal nerves), in teeth which may be damaged (rotting), in the paranasal sinuses, which may become swollen due to allergies, colds or infections, in the muscles surrounding the eyes, which may become tense from eyestrain from prolonged use of near sighted vision, and in the meninges which may suffer from irritation or traction.

Most headaches are provoked by muscular contractions, or disturbances in blood flow.
Factors which trigger headaches:
– Head injury
– Tumors
– Stress
– Dilation of blood vessels
– Muscular tension
– A low level of endorphins

Types of headaches:

– A Sinusitis Headaches is when the paranasal sinuses are inflamed or congested. The pain is usually located in the frontal region of the head, or the upper jaw

– A Cluster Headaches is usually located around one of the eyes, along with ptosis, congestion and tearing in the eye on the side of the head where the pain is located, and accompanied at times by a stuffed nose. Cluster headaches is unilateral and recurs every day, at the same time, for various weeks and then suddenly goes away.

– A Tension Headaches is the most common. They may occur sporadically, for less than a day per month on average, or they may be chronic. In the latter case, they may occur for periods of up to three months, lasting at least 15 days in each month. They are characterized by increased sensitivity and determined pressure points (the upper trapezius, the masseter muscle, the temple, the sternocleidomastoid, among others). The patient usually feels pressure around the head as if something were squeezing it.

– A Vascular Headaches, whose main type is the “migrane”, is caused by anomalies in the blood vessels which contract and dilate. In its most classic form, the pain is accompanied by nausea and blurred vision.

– Hormonal Headaches, like the morning headaches common to hypothyroidism, which occurs when at rest, menstrual headaches, which occurs as a result of a deficit of estrogen during this period, pre-menstrual headaches, which occurs from a deficiency in progesterone during this period, headaches triggered by inflammation and stress resulting from a lack of cortisol, and less common nocturnal headaches which results from a lack of melatonin and dehydration. Try to always drink water when you have a headache.

We will further detail hormonal headaches and how to correct it, taking all the factors into consideration as they may also be a possible cause for headaches.

HORMONAL HEADACHES

– Decreased Thyroid function – results in morning headaches which surface from “nowhere” when the person is at rest. Treatment using the thyroid hormone reduces the frequency and severity of the headache, and often the headache is completely eliminated. I would like to highlight that the prevalence of hypothyroidism, if we consider clinical criteria, affects 85% of the adult population, but it is not diagnosed in the majority of cases given that according to analytical criteria the prevalence falls to less than 10% of the adult population. Recognizing the classic and more common symptoms of hypothyroidism is essential (cold hands and feet, obstipation, tendency toward depression and for weight gain even when eating healthily, pain and rigidity in articulations, waking up with swollen eyes and face, difficulty concentrating, focusing and remembering…)

– Low estrogen levels – these headaches are common during menstrual periods. The vascular headaches, such as the migrane starts, in 33% of cases, during the women’s first menstruation, and is more common in women (18% in females and 6% in males in average studies).
Headaches, which typically occurs during the menstrual period, is due to the decrease in sex hormones that is observed at this time. Some women who suffer from “migranes” only report having them at these times. It is not a question of high estrogen levels, as in pregnancy, or low levels, as in menopause, but a sudden decrease in estrogen at that time. Many women’s symptoms improve during pregnancy because their estrogen levels stabilize. The ideal treatment would entail a suppression of the ovary’s cyclical activity paired with an estradiol implant and by administering progesterone cyclically for periodic shedding of the uterine lining. By maintaining a constant level of estradiol, we are able to suppress the cyclical variation that triggers a migrane. For women who do not wish to implant a supplementary low dose of estradiol before, or during, the first days of their menstrual cycle, this is an option given the fact that some women’s daily routines would make it inviable. In these cases, patients may experience heavier periods, which should be taken into consideration and balanced using progesterone.

Pre-menstrual headaches, which affect many woman during this phase, are associated to low levels of progesterone. They are therefore often accompanied by the typical pre-menstrual symptoms, also a consequence of low progesterone levels: breast tenderness, irritability, abdominal pain, mood swings, sugar cravings, difficulty sleeping, and poor digestion are amongst the more common symptoms. Corrective measures using bioidentical progesterone should be started, not only to alleviate the bothersome symptoms during this phase but also as a prevention of breast and uterine disease (nodules and cysts) resulting from a surplus of estrogen common to these women. A lack of progesterone during this phase means that the woman has a surplus of estrogen. Estradiol causes water retention and consequently headaches appears, as a result of edema (an accumulation of liquid in the brain). Diuretics, or a progesterone anti-mineral corticoid-based pill (fourth generation) may work but once more I stress that prescribing the pill may alleviate the symptoms but it is neither the adequate nor healthy choice.

Due to low cortisol levels, headaches usually occur during infectious, inflammatory or stressful situations. All the forms of headaches we have discussed are exacerbated when there is a cortisol deficiency. In these cases, a corticosteroid should be prescribed to alleviate the situation and prevent a reoccurrence.

Headaches, resulting from a lack of melatonin, occurs frequently at night. The patient will usually wake in the middle of the night with a pulsing headache that only goes away in the morning. Sometimes this is also associated to cysts in the pineal gland which produces melatonin. Treatment consists of prescribing melatonin. In closing the topic of Headaches, I would like to add that a thyroid and estrogen deficiency aggravates the type of vascular headaches, migranes being an example of this type of headaches.