migraine

Perimenopause as a Hidden Trigger of Migraines

It is well-established that migraine attacks can be triggered by hormone changes. If you’re navigating perimenopause and notice an increase in headache intensity or frequency – you’re not alone. Some women find that migraines worsen during this life phase, while some experience migraines for the first time as their hormone levels shift. While many women with migraines are diagnosed in their teens or 20s, roughly 8 to 13% don’t get diagnosed until they are in perimenopause because their symptoms – including headaches, nausea, and fatigue – become much more intense[i]

 

Hormones and Migraines: The Connection

It is not clearly known why hormonal shifts can cause an increase in migraines. Some research suggests that changes in estrogen levels make certain cells more excitable – which may make you more sensitive to migraine triggers[ii]. Estrogen doesn’t just impact reproductive health; it plays a vital role in managing pain by controlling key brain neurotransmitters. When levels drop, the brain becomes more susceptible to pain signals, which can make migraines feel more intense and frequent. Fluctuating estrogen can also increase a person’s mast cells – a type of immune cell that triggers inflammation in the brain and often increases headache pain.

 

Why Estrogen Dominance Matters

Most research is on the effect of low estrogen in menopause (defined as not having a menstrual bleed for a year), but clinically I find that women in perimenopause can be affected even more frequently due to estrogen dominance.

Estrogen dominance happens when estrogen levels are high compared to progesterone. In perimenopause, a decrease in progesterone levels is the most common hormonal shift, usually happening in late 30s or early 40s. This can lead to symptoms like heavier menstrual bleeding, anxiety, and insomnia. But remember – the estrogen levels have not increased, but there is an imbalance.

Your liver also plays a role here. Women are often not metabolizing and eliminating their estrogen efficiently through their liver pathways, which can lead to additional challenges with weight gain, irritability, body pain, and of course, more frequent migraines.

 

Testing Your Hormone Levels

The symptoms of hormonal imbalance can be very clear, but there is a valuable and objective tool we recommend: the DUTCH Test. Unlike a standard blood test, this advanced 24-hour urine test measures estrogen and progesterone levels over a full day and evaluates how well your liver is metabolizing estrogen. With the DUTCH Test, we can get an in-depth look at your hormonal landscape, helping us create a tailored approach to bring your body back to balance.

 

 

Relief is Possible

The good news? Estrogen dominance and its symptoms can be addressed with strategic diet and lifestyle changes and targeted supplementation. Nutrients from cruciferous vegetables (broccoli, cauliflower, brussels sprouts, cabbage, etc.) can support liver health and help balance estrogen levels. Pairing these with dietary tweaks can make a big difference in reducing migraine frequency and severity.

Once you have identified your hormonal imbalance and have a plan, women usually experience improvements within a few weeks. Migraines can significantly affect your quality of life, but with the right support, relief is within reach.

 

Yours in good health,

Dr. Darlene Reid, ND


[i] Pavlović JM. The impact of midlife on migraine in women: summary of current views. Womens Midlife Health. 2020 Oct 6;6:11. doi: 10.1186/s40695-020-00059-8. PMID: 33042563; PMCID: PMC7542111.

[ii] Reddy N, Desai MN, Schoenbrunner A, Schneeberger S, Janis JE. The complex relationship between estrogen and migraines: a scoping review. Syst Rev. 2021 Mar 10;10(1):72. doi: 10.1186/s13643-021-01618-4. PMID: 33691790; PMCID: PMC7948327.

Unlocking Relief: How A Naturopathic Approach Can Help Prevent Migraines

Migraines can be debilitating. In Canada alone, 25% of households have someone affected by migraines;[1] as well, migraines are the 2nd most common cause of disability worldwide. [2] This disease can affect people’s quality of life enormously.

As Naturopathic Doctors, our approach is not to treat the migraines – but rather to treat the person living with migraines. This involves considering what may be the root cause(s) of the development of the painful episodes in the brain.

People living with migraines commonly have a genetic predisposition to them. While genetics are the “gun”, environmental factors “pull the trigger” and cause a migraine. These factors include hormonal imbalances, food sensitivities, nutrient deficiencies, mitochondria dysfunction, stress, and suboptimally-functioning pathways of detoxification.

 

Food Sensitivities vs. Food Triggers

Foods that commonly trigger a migraine for people include caffeine, chocolate (tyramine), MSG (glutamate), processed meat (nitrates), and wine (sulfites).

A food sensitivity does not trigger a migraine to develop, but if you are eating the food regularly and it is creating low-grade inflammation in your body, it is more likely to cause a migraine to develop. These food sensitivities can lead to the development of a migraine when there are additional variables at play such as weather changes OR hormonal decreases before your menstrual flow. If a person can identify foods that cause low-grade inflammation in their system and then avoid them for several weeks, they can reset their levels of inflammation and eat the foods less often. This approach has been helpful for countless patients.

So – how do you know which foods are increasing your likelihood of developing a migraine? There are two ways:

  1. If you are unfortunate enough to have migraine attacks daily, or every few days, you can do an elimination diet for 2 weeks to see if the migraines lessen or stop. This involves avoiding the most common food sensitivities including dairy, all grains, egg whites, nuts, and yeast. Often, we can give patients a shorter list of foods to avoid based on what their diet has been comprised of and considering other health concerns they may have.

  2. A food sensitivity test is also a very helpful option. Your Naturopathic Doctor can collect a small amount of blood through a finger prick and send the sample to Rocky Mountain Analytical (RMA) – a division of LifeLabs.  RMA can report on IgG antibody levels of between 120-225 foods that our immune systems may react to. A 2007 research study found that 43/65 patients with migraine headaches had complete remission of headaches after one month of eliminating reactive foods. Another study in 2010 found a significant reduction in the number of headache days and migraine attacks with the elimination of reactive foods. [3] [4] [5]

If a food sensitivity is identified, we can provide many options for food substitutions and can guide you on how long to avoid your trigger foods before reintroducing it in small amounts. If food sensitivities exist due to a “leaky gut” – an impaired permeability of the digestive tract – we can develop a plan to heal the lining using simple strategies.

Food sensitivities are not always a factor for patients who have migraine attacks, but it is a common one. When these foods are identified, a patient can experience improved health outcomes in many different areas including digestion, skin, immunity, and metabolism. It’s a win-win all around.

Altering your diet is not always easy, but with some compassionate support and expert guidance, many of our patients have found enormous success. We are here for you with an individualized, multi-faceted approach to help you break free from the cycle of pain.

 

In good health,

Dr. Darlene Reid, ND


[1] https://migrainecanada.org/wp-content/uploads/2023/05/languageguide-onepager-EN-finalweb.pdf

[2] https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-01208-0

[3] Drisko J, Bischoff B, Hall M, McCallum R. Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. J Am Coll Nutr. 2006 Dec;25(6):514-22. doi: 10.1080/07315724.2006.10719567. PMID: 17229899.

[4] Alpay K, Ertas M, Orhan EK, Ustay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37. doi: 10.1177/0333102410361404. Epub 2010 Mar 10. PMID: 20647174; PMCID: PMC2899772.

[5] Arroyave Hernández CM, Echavarría Pinto M, Hernández Montiel HL. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007 Sep-Oct;54(5):162-8. Erratum in: Rev Alerg Mex. 2010 Mar-Apr;57(2):49. Echevarría Pinto, Mauro [corrected to Echavarría Pinto, Mauro]. PMID: 18693538.

Holistic Migraine Management

Holistic Migraine Management - Online Workshop - Tuesday April 20, 2021 - 7pm

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Headaches can be the product of many problems. They can be related to mechanical issues in the muscles and joints of the neck and head, or they can be related to hormones, stress, diet and many other problems in the body. In this workshop we will explore many causes and treatments for all these headache influencers.

Headaches can sometimes be difficult to manage due to the complexity of all systems that can contribute. It is important when working at improving and eliminating headaches that a thorough plan is developed according to each person’s own dysfunctions and needs.

In this workshop Mackie Physiotherapy will be partnering with Saskatoon Naturopathic Medicine and Dr. Darlene Reid-Ahenakew ND to help us understand the components that are out of practice realm of physiotherapy. She will bring an in-depth understanding of physiological systems, total body health, and supplements that can be beneficial in headache treatment.

Dr. Darlene Reid-Ahenakew ND is a well-known Naturopathic Doctor in Saskatoon practising at Saskatoon Naturopathic Medicine in Stonebridge. She helps many patients with chronic headaches and migraines stop the cycle of pain by uncovering physiological root causes. Hormone imbalances, gut health, stress responses, food intolerances, and nutrient deficiencies can all promote systemic inflammation and chronic pain. During this workshop, Dr. Reid-Ahenakew ND will discuss how to identify these issues in yourself and the different treatment approaches.

What is it about?
This workshop will examine the physiological causes of headaches. Theresa Ziegler will be discussing the musculoskeletal causes; as well, we have a guest speaker, Dr. Darlene Reid-Ahenakew, a Naturopathic Doctor who has special interest in uncovering the root cause of chronic headaches. Both will be discussing the causes, prevention, and management of headaches.

MIGRAINE PRESENTATION

WEDNESDAY JULY 17, 2019 @ 7 pm

“The Highly Sensitive Brain”

An Update on Migraines from a Functional Medicine Perspective

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Dr. Reid-Ahenakew will discuss:

  • What is happening in the brain when you get a migraine?

  • Common (and not so common) food triggers

  • The role of estrogen and progesterone in migraines

  • Nutrient deficiencies that can be a factor

  • Natural medicines to improve your resilience to stress

  • The role of gut health in prevention of migraines

A registration fee of $25 will reserve your spot. All profits will be donated to LDAS

(The Learning Disability Association of Saskatchewan)

Dr. Reid-Ahenakew, ND


Join us from 7:00-8:00 pm on July 17th at our clinic.

To Register, or to learn more about this presentation:

Call the clinic at: (306) 664-2150

Or email us at: info@saskatoonnaturopathic.com