Is my headache hormonal?

About 50% of women with migraines find their menstrual cycle affects how frequent and how bad their migraines are, and some only get migraines around the time of their period...

We all know how miserable a headache makes you feel. As if feeling bloated and moody wasn't enough, being premenstrual often brings on headaches too. About 50% of women with migraines find their menstrual cycle affects how frequent and how bad their migraines are, and some only get migraines around the time of their period.

Migraines can get better or worse after the menopause, although most sufferers find they get better within a few years of periods stopping. But your hormone levels go up and down for three or four years around the time of your last period, so your migraines often get worse during that time. Oddly, taking HRT can also help migraines in some women but make them worse in others. Changing to a different type of HRT or switching to HRT patches might help.

Self-help measures depend partly on what kind of headaches you have, but eating regular meals, getting enough sleep and trying to keep stress levels down can help everyone. Some people are sensitive to caffeine - try cutting out tea and coffee for a few weeks and monitor your headaches. Do get your eyes checked regularly - eye strain may cause headaches. It can be really hard to reduce your stress levels, but with a bit of trial and error you should find what works for you, whether it's yoga, meditation or hypnotherapy.

Migraines and the contraceptive pill

Taking the combined oral contraceptive pill (sometimes called 'the pill') very slightly increases your risk of stroke. For most women this risk is tiny, but migraine increases it a bit. If you get migraine with aura (temporary changes in eyesight, numbness etc before your headache starts) you mustn't take the pill or use a contraceptive patch. If you get any migraines you'll almost always be advised to stop the pill at age 35.

Tension headaches - you've all had one!

Pretty much everyone gets headaches and the most common are 'tension-type' headaches. More than two in three adults have had at least one in the last year. They often feel like a band round your forehead; they rarely stop you functioning; you don't feel sick although you might be slightly sensitive to light or sound.

For occasional headaches, anti-inflammatories like ibuprofen from your pharmacist are very effective and safe unless you've been told otherwise by your doctor.

Medication overuse headaches

The National Institute for Health and Care Excellence (NICE) estimates a million Britons could have frequent headaches actually caused by taking too many painkillers. Codeine is the biggest culprit, but even paracetamol and anti-inflammatory medicines taken three times a week for three months can trigger a cycle of 'rebound' headaches which leaves you taking more and more medicine. Speak to your GP if you think this might be you.

Mind your muscles!

Most tension-type headaches are related to muscle strain, which can make other types of headache worse, too. That's partly why anti-inflammatory tablets like ibuprofen are so effective. But improving your posture could help stop them happening.

Headache - when should I worry?

Of course headaches can be due to a serious cause - but don't forget, the vast majority aren't! However, you should see a doctor:

Straightaway if:

  • You have a 'thunderclap' headache which comes on very suddenly, reaches a peak within 5 minutes, is the worst or different from any headache you've ever had
  • You have neck stiffness, are extremely sensitive to light and/or have a rash that doesn't fade when you press a glass against it
  • You also have an acutely painful red eye or weakness in one part of your body, slurred speech, drowsiness etc
  • You've had a recent head injury.

Soon if:

  • You're over 50 and have a one-sided headache you've never had before
  • Your headache wakes you from sleep or is worse when you lie down, cough or strain to go to the toilet
  • Simple painkillers don't touch your pain.

With thanks to 'My Weekly' magazine where this article was originally published.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.