Migraine sufferers know their headache symptoms well—throbbing pain on one or both sides of the head, nausea, vomiting, fatigue and extreme sensitivity to light and sound. When symptoms hit, they are debilitating and disruptive. And while migraine strikes 28 million Americans, three times more women than men struggle with the condition. That has led researchers to study the impact of hormones—particularly estrogen—on the high numbers of female sufferers.
Nearly 70 percent of female migraine sufferers are affected by the hormonal changes that accompany their menstrual cycles. Migraine symptoms often appear three to seven days before a woman’s period begins, which is when levels of estrogen sharply decline. Scientists think the drop in estrogen may be to blame for women’s migraine pain because it results in a decrease in serotonin, the brain chemical known to reduce the sensation of pain. With less serotonin available, women become more prone to migraine triggers such as food additives; alcohol; caffeine; chocolate; and certain legumes, vegetables and fruits. Still other women experience migraines in the middle of their periods when low estrogen levels and higher levels of prostaglandins (compounds derived from fatty acids, which perform hormone-like functions such as regulating blood pressure) trigger pain.
Women on hormone therapy sometimes experience more frequent—and more severe—migraines. Fluctuating hormone levels during menopause and pregnancy have also been shown to trigger symptoms among migraine sufferers. Fortunately, many women experience relief from migraine symptoms after menopause.
The same Botox, or Botulinum toxin type A, used by plastic surgeons to treat patients with forehead furrows is being studied for its potential in relieving migraine pain. Researchers think Botox can be helpful because it prevents muscle tension that can trigger migraines and affects nerve cells that signal pain.
Although the Food and Drug Administration has not approved Botox for headache treatment, doctors can use it for other purposes. Treatments are about $1,000 a session and may not be covered by insurance. Pain relief lasts about three months, but it may take a few weeks for the injections to start working. Some researchers recommend trying conventional therapies until more is known about the benefits and potential side effects of using Botox.