Migraines: symptoms and treatment

Over the last fifty years, the incidence of migraine has increased, worldwide. Approximately 1 in 10 people experience migraine headaches, with women having an incidence of migraine three times that of their male counterparts.

Not all headaches are migraine headaches. There are many types of headache that one may experience, including tension headache, sinus headache, temporomandibular joint headache, cluster headache, migraine headache and secondary headaches. Secondary headaches are those that are caused by some other disease process.

A migraine headache is distinguished from other headaches, in that the headache is severe and disabling and does not respond to the usual over the counter, pain medicines. The pain tends to be pulsating, pounding or throbbing in nature and light and sound usually aggravate it.  For many migraine sufferers, pain worsens when they move, or bend over.  Nausea and vomiting are common in migraine, usually as a direct response to the severity of the pain. With a migraine headache, vision may be blurred, movements of the head may cause dizziness and one usually needs to lie down and withdraw to a dark room.

A migraine headache can last from several hours to several days.  Some migraine sufferers experience facial numbness or weakness, others experience weakness of an arm or leg (similar to a stroke). Migraines are divided into two categories, classical migraine and common migraine. In classical migraine, one experiences an ‘aura’ and in common migraine, one does not.

An aura is a sensation that is experienced before the migraine occurs and it consists of flashing or flickering lights, partial loss of vision, or a déjà vu type of sensation. An aura typically precedes the onset of a migraine from a few minutes, up to an hour.

Other types of migraine include hemiplegic migraine, whereby one experiences a stroke like paralysis on one side of the body;  ophthalmoplegic migraine, which is centred around the eye and causes visual symptoms; and basilar migraine, where pain occurs at the base of the head and upper neck and is accompanied by dizziness. Benign exertional headache is usually brought on by heavy physical activity, such as running. Status migranosus occurs where the headache lasts for a week or longer.

There are a number of theories on the cause of migraine headaches, including an imbalance in the neurotransmitters serotonin and noradrenaline. Other hormones may be involved in women who experience migraines at certain times within their menstrual cycle.

A deficiency in progesterone (or an imbalance in the ratio of oestrogen and progesterone), appears to be the root cause of migraine in many women.

Progesterone is a hormone that is produced in both women and men, although women make much larger amounts. It is produced primarily by the ovaries and to a lesser extent by the adrenal glands. Every cell in the body has receptors for progesterone, which means that every cell, on every organ, is affected by the progesterone circulating around the body.

The brain is especially sensitive to progesterone, which in women, is produced in large amounts in the second half of the menstrual cycle. Progesterone levels drop markedly in the week before the period and it is during this time of rapidly falling progesterone , that migraine headaches are most common. Modifying this massive drop with a rogesterone supplement, eliminates these hormonal migraines.

Synthetic progesterone does not have the same effect as the natural, bioidentical hormones and it is also associated with a significant number of side effects (including suppression of the bodies own normal production of progesterone).

Bioidentical progesterone in therapeutic doses is uncommonly associated with adverse side effects and the dose required to control hormonal migraine is 100th the amount produced by pregnant women.

Some of the beneficial effects of progesterone, apart from hormonal migraine relief, include improved emotional wellbeing, regulation of the menstrual cycle, lighter periods, reduction or resolution of period pain and PMS,and  an antidepressant effect.

It is important to note that not all migraines have a hormonal cause, so it is imperative that  one has a thorough history taken,  a full medical examination and hormonal profile performed ( to exclude other causes of migraine), before diagnosing hormonal migraine and before instituting any hormonal balancing therapy.