Hormonal Headache Treatment
What is Hormonal Headache?
Hormonal Migraine, also referred to as Menstrual Migraine, is a common disabling condition for women on the Gold Coast. 60% of female migraineurs are likely to experience a migraine with their monthly period, while 14% will exclusively experience their headaches at this time [1].
As with other types of migraine, symptoms generally include a moderate-severe, pulsating or throbbing pain on one side of the head. They can also include associated symptoms, such as; sensitivity to light, sound and smell, nausea or vomiting and visual disturbances or loss. With a Hormonal Migraine, the symptoms occur during the monthly menstrual cycle, and can last up to three days.
What causes a Hormonal Headache?
Originally, changes and fluctuations in oestrogen levels during the monthly cycles was to blame for Hormonal Headaches. However, studies have recently shown that there is no difference in hormone fluctuations, when compared between migraineurs and non-sufferers. Also detracting from this theory, research has shown very little success at treating menstrual migraines with medication or Hormone Replacement Therapy (HRT). This suggests that there must be another reason for these headaches.
The most recent migraine research points to a sensitised Trigeminal Cervical Nucleus (TCN) as a primary contributing factor for these headaches. The sensitised TCN may detect these normal fluctuations of oestrogen incorrectly, triggering a headache in reaction [2]. The TCN, located in the brainstem, can become sensitised by its connection to a dysfunctional cervical spine, and the afferent nerves that communicate between the two. It is then, the interpretation of perceived threat of these oestrogen changes, by the brainstem, that is the cause of Hormonal Migraines [1, 2].
I’ve done it all, is there anything else that can help me?
Most of our patients, who suffer from Hormonal Headaches, have tried every type of treatment they can find. They often report trying; HRT, contraceptive pill changes, dietary changes, and some have even tried surgical intervention. Sometimes these measures have worked, but often they are short-lived or ineffective. We now know that this is because these treatments aren’t trying to treat the cause of your Hormonal Migraines. Getting an assessment, to see whether problems in your cervical spine and a sensitised brainstem are the cause should be your next step.
At The Headache and Migraine Clinic, we specifically assess the cervical spine and your brainstem, according to the latest research to see if they are the cause of your headaches. If we can prove that this is the case, then we can start treatment immediately and we would expect results within 5-6 sessions, as we do with 85-90% of our patients. The best part is that our treatment is gentle, safe, non-invasive and medication-free.
Watch the video to understand more about hormonal headaches
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What are Cluster Headaches?
Cluster Headaches are a rare type of headaches that affect around 0.1% of the population, according to the International Headache Society. While they are rare, it does affect males 3-4 times more frequently than females [1].
Despite being uncommon, Cluster Headaches are regarded as being the most severe and debilitating type of headache. Research has shown Cluster Headaches frequently described as having the highest pain levels [2], out of all 300 different types of headache and migraine. Cluster Headache attacks occur in cycles, and will often wake sufferers during the night, or at regular times during the day. Attacks generally last between 15-180 minutes, and can happen multiple times per day, or once every couple of days [1, 2]. People who suffer from Cluster Headaches generally experience periods of attacks, or “cluster periods” that can last weeks or months. These periods are then followed by periods of remission lasting weeks, months or even years. The pain is often severe, on one-side of the head, and generally around the eye and/or temple region. Cluster Headaches have adopted the nickname, ‘suicide headaches’ due to their severe and debilitating nature [2].
What are the signs and symptoms?
Cluster Headaches are often severe enough that a sufferer cannot keep still during an attack. They may pace back and forth, have to take a shower, or even resort to banging their head in an attempt to reduce the pan.
Symptoms commonly associated with Cluster Headaches include [2]:
- Severe pain around one eye, that can radiate further around the face or neck
- Restlessness, shortness of breath and/or a sweaty face
- Watery/teary eyes or eye redness
- Swollen or droopy eyelids
- Runny or congested nose
- Pale or flushed skin
- Pain is unilateral, or affects only one side
What are the different types of Cluster Headache?
There are 2 types of cluster headache.
Episodic Cluster Headache
Cluster Headaches most commonly occur episodically. This is when sufferers experience bouts of “cluster periods” that can last for weeks or months, followed by an extended period in remission that can last up to years. They can occur seasonally or at set times each year. Episodic Cluster Headaches account for up to 80% of all Cluster Headaches [1, 2].
Chronic Cluster Headache
When Cluster Headaches occur without a prolonged period of remission, they are termed a Chronic Cluster headache. Sufferers often have “cluster periods” that will last over a year. While they may have days without attacks, the remissions will not last longer than a month.
What are the risk factors?
- Men are 5-6 times more likely to experience cluster headaches
- Sufferers are generally heavy smokers
- Higher alcohol consumption may be a factor
- Cluster Headaches most commonly affect people aged 20-50, but can occur at any age
- People with family members who are sufferers may be at a higher risk
What causes Cluster Headaches?
Historically, it was believed that cluster headaches, as well as migraines, were caused by the dilation of blood vessels in the head, causing pain. This was thought because medications, like triptans, are effective at relieving the pain if taking early enough in an attack. It was believed that triptans prevent this vessel dilation. However, recent research has shown that Cluster Headache and migraine sufferers do not experience blood vessel dilation at any different levels to people who do not suffer. So, how do these medications work?
Modern research has shown that Cluster Headaches and migraines arise from increased sensitivity in the central nervous system [2], more specifically, a sensitised brainstem which is located in the upper cervical spine (the upper neck). Faults in the upper neck can lead to this sensitised brainstem, which then can refer severe pain and associated symptoms into the head and face [3]. Triptan medication has also more recently been shown to de-sensitise the brainstem [4], as well as its original purpose of constricting blood vessels in the head. This would explain why they work, as well as identifying a sensitised brainstem and the cervical spine as a cause of cluster headaches.
I've tried it all, is there anything that can help me?
While Cluster Headaches are very uncommon, they are still experienced in the Gold Coast region. The severity of symptoms causes sufferers to try a range of therapies in an attempt to resolve them, with mixed results. Often, they have tried; medications, injection therapy, or even surgical interventions such as, nerve blocks or blood vessel cauterisation.
At The Headache and Migraine Clinic, we aim to use the most modern research to find the root cause of your cluster headaches. If we can determine that a sensitised brainstem is the cause of your headaches, then we can use world-leading treatment techniques to address the faults in your neck and de-sensitise the brainstem. We have seen plenty of Cluster Headache sufferers at our clinics, and have an 85-90% success rate with our treatment technique. The best part is that it is safe, non-invasive and medication-free.