Headaches and migraines in perimenopause, how to get relief naturally

Ever wondered why you’re getting (more) migraines or headaches in perimenopause? Perhaps your headache remedies just don't cut it anymore and you’re feeling resigned to putting up with them, or taking paracetamol every day until you hit menopause.

This week, I’m sharing how you can put a stop to the migraines and headaches, during perimenopause.

Dive in to discover:
• What exactly is a migraine (versus a headache) and why we think they happen more frequently in perimenopause.
• How hormonal fluctuations directly impact your headaches and why certain foods can be your best friend or worst enemy in managing these changes.
• Straightforward strategies to identify and manage your personal headache triggers, including how to pinpoint and tackle unique migraine triggers during perimenopause.
• Insights from the journey of others who've successfully navigated migraines during this tricky time, plus practical tips on aligning your lifestyle with your hormonal health to turn the tide against migraines.

In this episode, you’ll find practical tips that go beyond the usual advice. Learn how dietary and lifestyle tweaks can create significant changes in how you manage perimenopause symptoms like migraines and headaches.

Understand why certain foods and habits have such a powerful impact and how to use this knowledge to your advantage.

Join me to transform your understanding of migraines. Don't just cope with them; learn how to put a stop to them and enjoy the transition to menopause.

Featured on the Show:
• FAQs! Send me an email with your question to answer in an upcoming episode: info@akesohealthcare.com.au
• Read more about migraines and headaches on my blog: The Perimenopause Naturopath Blog

Find out more about Sarah, her services and the Freebies mentioned in this episode at https://www.ThePerimenopauseNaturopath.com.au

• OPEN NOW: Discover how to use food as your most powerful medicine, smoothing hormonal fluctuations and easing perimenopause symptoms naturally. (Yes, you have more options than hormone therapy!) Say goodbye to feeling out of control and hello to feeling more like your old self every day, with PerimenoGO (because who wants to pause anyway?!)
• The Perimenopause Decoder is the ultimate guide to understanding if perimenopause hormone fluctuations are behind your changing mood, metabolism and energy after 40, what phase of perimenopause you're in and how much longer you may be on this roller coaster for.
• Been told your blood test results are "normal" or "fine" while you feel far from your best? Discover the power of optimal blood test analysis with The Blood Test Decoder: Optimal Ranges for Women Over 40.
• For more, follow on Instagram at @theperimenopausenaturopath.

Chapters

• 0:03 Migraines and Headaches in Perimenopause
• 11:19 Menstrual Migraines and Triggers
• 26:18 Perimenopause Bloating Relief and Support

Transcript

Sarah McLachlan: 0:03

Hey there, I'm Sarah McLachlan. Thanks for joining me on the Chaos to Calm podcast, a podcast designed for women over 40 who think that changing hormones might be messing with their mood, metabolism and energy and want to change that in a healthy, sustainable and permanent way. Each episode will explore topics related to health and wellness for women in their 40s, like what the heck is happening to your hormones, what to do about it with nutrition, lifestyle and stress management, and inspiring conversations with guests sharing their insights and tips on how to live your best life in your 40s and beyond. So if you're feeling like you're in the midst of a hormonal storm and don't want perimenopause to be horrific, then join me on Chaos to Calm, as I share with you how to make it to menopause without it wrecking your relationships and life. Hello and welcome back to Chaos to Calm. This is episode number 44 and you're with me, Sarah, the perimenopause naturopath, your guide through the rollercoaster ride that can be perimenopause. Today we are going to dive into a topic that's a real headache, quite literally. Topic that's a real headache, quite literally. And I wonder if you've ever thought about why migraines might be more common, why you might be experiencing more headaches now in perimenopause. So first up, some stats gotta love a good stat.

Sarah McLachlan: 1:43

Migraines affect about 12% of the population and are more frequent in women than men. You know, I kind of think this is not surprising because we have more hormone variation than they do. They are pretty. I often say to my clients and other women we live in a society that's designed around men's hormones pretty constant, seven days a week, 28 days a month, 365 days a year. Their hormones are pretty much the same, their sex hormones anyway, whereas ours, well, it can be a roller coaster Anyway. So 12% of the population gets migraines, most of them women, or more women than men. I don't even know if I know any men that have had migraines. I only ever know of women. I mean, I of course work in this scenario, but even my friends and stuff, I only ever hear women talking about getting migraines.

Sarah McLachlan: 2:45

So peak migraine prevalence occurs between early 30s and early 40s. Again, I'd say maybe not so surprising. This is a big time of flux pregnancy, post-pregnancy, early perimenopause and menstrual-related headaches. Migraines are very common in perimenopause and menstrual- related headaches. Migraines are very common in perimenopause because of the fluctuation in estrogen most likely. So another stat up to 41% of all women will have experienced a migraine by their early 50s. That's a lot. That's a lot of us just kind of, I'm sure, putting up with feeling rubbish, having migraines impact your day. I mean, I know if women having to work through migraines and still show up for in you know different ways or different roles in their life, even with a migraine. If you've ever had a migraine, that is tough.

Sarah McLachlan: 3:44

So yeah, I have my own personal experience with chronic migraines. You might not not many people realize that, because you know you often hear me talking about my weight gain and what happened to me in perimenopause. Well, I have a long history, I guess in hindsight, of hormone issues. So as a teen I had weekly migraines, like through puberty into my early twenties. I would struggle so bad I used to get the aura, the little sparkly dots in front of my eyes, and when I got it I was like I feel so deflated, like oh, here we go again. I had a little handy dandy routine which is really gross. Actually, when I reflect on it I think, oh, poor self, I would go make myself vomit and go to sleep. Why? Because I would vomit anyway from my migraines. So some of you have migraines and don't feel nauseous or don't vomit. Maybe have nausea and don't vomit. I would vomit every time and I would feel better when I vomited. So my teen self was like, let's make that happen and speed up the process. So, yeah, what a treatment plan, hey, yeah.

Sarah McLachlan: 4:59

Unfortunately not unsurprisingly though my GP never suggested that there might be an underlying cause that I needed to address, like around my hormones. They never even actually asked me if there was a pattern around them at all. It was all just about suppressing symptoms and the solution that was given to me was drugs. I was given really strong painkillers along with migraine suppressing medication. Now I looked up both of those medications recently just out of curiosity, and they're not even recommended for teens. So I mean, who knows what impact they had on my long-term health. Actually, just really grateful that nothing happened. You know I didn't well, well, not that I'm aware of had a side effect of it. Crazy that I was given those drugs as a teen. I was like 13, 14.

Sarah McLachlan: 5:53

So it felt like I grew out of the constant migraine phase. And that makes sense with what happened to me, because when you go through puberty, it can take up to 10 years for your body to set your brain and your ovaries to really make that connection, that strong connection, and sort out. You know your hormones and how much is too much and how little is too little. So yeah, as a young adult I kind of grew out of that constant migraine phase, thank goodness. But I did still have migraines again during pregnancy, which makes sense because it's you know. I'll tell you why that makes sense later. And then, when I got into perimenopause, those buggers came back again. But I really was on top of it because I had done my studies, or moved into my studies. I could see what the triggers were and what I needed to address, and I did that and they were gone.

Sarah McLachlan: 6:46

So I talked to a lot of women and they're often I'm astounded at how many of them are waking up with headaches and or having them multiple times per week or, you know, like even regularly through their menstrual cycle. You know this is not normal. This is not something to just put up with. You know we need to do something about it and you know my migraine story is really similar to a lot of women that I talk with and many of my clients, and I think it really shows the complex symphony of hormones in our body. You know they impact each other, they impact other systems and it's really important this highlights a story the importance of understanding them and their involvement and to be and manage them or address, you know, like, what's underlying them, what's causing that imbalance? Because migraines and headaches are symptoms. They're symptoms of dysfunction or imbalances in the body and so when you identify that, when you address it, the symptoms are going to resolve and you're not going to need the painkillers or the medications. It's really just band-aids, they're just symptom suppressors. Band-aids, they're just symptom suppressors.

Sarah McLachlan: 8:06

So you know, I have a client. We'll call her Annie to protect her identity, because she has quite a unusual name. So, annie, she was having migraines similar to me from puberty right through to where she was at now and they were starting to increase in perimenopause. They were stopping her from working. Now she's self-employed, so that's a problem, because no work equals no pay and things that we worked on with her was we identified her triggers so she was having significant hormone changes. So they were menstrual cycle related, stress related, and there were some foods that were significant triggers for her too, and that actually tells us a lot about her gut and immune health, which is something that we worked on. You know I used metabolic balance, personalized nutrition and gave her lots of gut health advice and actions to take in the Chaos to Calm method my program that I worked with her in and it really turned things around for her. So gut health is really key for migraine reduction for lots of reasons. It reduces your immune activation, but it also helps with your neurotransmitter and hormone levels and we're going to talk about that a bit more later on why it helps so much. But for her for Annie it was great because no more migraines and that happened quite quickly and anytime I've had migraine sufferers in my program, actually we're always really pleased because they do respond relatively quickly, like within the first month, even quicker and, yeah, we don't need to take lots of supplements or use lots of herbs to suppress that, all right.

Sarah McLachlan: 9:42

So let's have a look at what happens, why you get migraines and headaches in perimenopause, or why you're more likely to get them there as well. So first of all, you want to know the difference between a migraine and a headache. If you've ever had a migraine, you know the difference, but you may not otherwise, because a migraine is a type of headache, but not every headache is a migraine, and sometimes I hear people refer to a headache as a migraine and it's really. It's not so. Migraines are recurrent, sudden attacks of headaches that are usually pounding and one-sided, so they might be like over your left eye or your right eye. They'll often have an aura or like a visual or other sensory disturbance coming beforehand. So it could be like a change in smell, like you might notice this particular smell, or, like I described before, you might get like the dots or the, the waves in the peripheral of your vision there as well. So migraines, the pain is, it is throbbing, and you'll get those symptoms like I described, like nausea, you might vomit, you'll have no appetite, you might feel dizzy, you might feel really discombobulated, like your sensory perception or proprioception or your sense of your body and yourself in the environment around you might be out of whack, so impacting you know how you move, walk through your environment, sensitivity to light and noise is really common with migraines and you might just want to sleep or sleep it off.

Sarah McLachlan: 11:19

So I mentioned before that migraines can be menstrual cycle related, and there's also a class of headaches that are menstrual related too, and the trigger there is a decline in estrogen during your menstrual cycle. So if you're having a regular cycle, it's in the days just before you start your bleed. That's when estrogen is low and it makes sense why you might get these during pregnancy, because pregnancy is a low estrogen state, and also perimenopause or menopause it can be. It can be, sarah. Menopause is a low estrogen state. Perimenopause it can be. Yes, it can be high, it can be low and it can go vary between that from day to day and even hour to hour.

Sarah McLachlan: 12:06

But when your estrogen is low it impacts serotonin, one of your neurotransmitters, that's decreased as well and that can lead to an increase in two other substances that are released from one of your nerves, the trigeminal nerve. So substance p and calcitonin gene-related peptide are the ones that are released, if you really wanted to know the names of them. Increases in those substances causes dilation of the blood vessels in parts of your brain and increases sensory sensitization of the trigeminal nerve. Ultimately, you get a release of increase of pro-inflammatory compounds in your brain and a migraine. So family history and genetics are going to influence how likely you are to get migraines. So have a look around at the women in your family tree and see if they had migraines. And another risk factor is actually the combination pill, so it can alter that the gap between the high and the low of estrogen and premenstrually and so the same is true for perimenopause. There as well the good higher than high, higher than usual highs and lower than usual lows can really trigger that migraine there as well.

Sarah McLachlan: 13:24

There are lots of other triggers for migraines and they're not necessarily hormone related. So if you're trying to work out what's behind your migraines, then you might want to keep a calendar or diary about them but also consider where you are in your cycle and your stage of life because of that estrogen relationship. So if we're thinking about there's two different types of menstrual migraines and this is the diagnostic criteria according to the international classification of headache disorders. The third edition, a pure menstrual migraine, is a migraine that comes in a woman with her menstrual cycle and it meets the criteria for migraine that I described before and it occurs two days before and may last into the third day of your bleed, and it'll happen in at least two out of three menstrual cycles and you won't get it at other times of the cycle. So that's a pure menstrual migraine. It only happens when you have your period or just before your period, a menstrually related migraine. Well, you'll get a migraine. It meets the criteria for the migraine and it'll happen perhaps two days before your cycle, your period starts and last until the third day of your period. Might happen in two out of three cycles, but you might also get them at other times of the cycle. So that's a menstrually related migraine or you could say like a hormone related migraine.

Sarah McLachlan: 15:02

So the other things that might trigger your migraines at other times of your cycle or when you don't have one stress, anxiety, worry like that can definitely impinge and create migraines for you there. I always think of it like as a perfect storm. So you might have the genetics for it and the background the hormone imbalance what else is contributing, going to tip you over there? Stress, anxiety, worry? Is there a functional issue? You know when was the last time that you saw an osteo or a chiro or a myotherapist or someone like that that can have a look at your neck and back and muscles and bones there and make sure everything's in alignment and not impinging on your nerves and triggering your trigeminal nerve and migraines in that way?

Sarah McLachlan: 15:48

What if you've been eating? There's a whole bunch of foods, like if you've been eating foods that you know you don't tolerate or you're sensitive to, or high histamine foods like chocolate, alcohol, cheese, citrus, shellfish, sauerkraut, kombucha, all those fermented foods that you know some of those not so healthy foods there but you know fermented foods we think of as as healthy foods, but they can really trigger migraines. So if you want to know more about histamine intolerance and histamine-rich foods and stuff like that, I did a podcast with Lou earlier on about histamine intolerance and food sensitivities and things like that as well. So have a listen to that and also have a think about your food. You know, while we're talking about food, are you eating regularly? Are you eating enough?

Sarah McLachlan: 16:40

Because there could be underlying blood sugar dysregulation or insulin resistance. So remember, in perimenopause and menopause we actually naturally tend to insulin resistance. So when your blood sugar levels crash, that can certainly trigger a migraine. I know that was the case for me, particularly through perimenopause, when I would get them would always be post-sport if I hadn't eaten enough beforehand, and even in my teens, actually, that was a common trigger for me. So, like post-sport, especially if it was super glary and under the physical stress, I suppose, as well as perhaps a mental or emotional stress definitely migraine material for me there. So it's really important to know what your triggers are. So, yes, it might be menstrual related, but there could be other. You know other triggers, especially if you're not getting it every month. Water sleep Did you get? When was the last time you got your eyes checked? You know like we use computers and devices all the time that could be prompting a strain and contributing to headaches and migraines.

Sarah McLachlan: 17:47

Weather and pressure changes, like an approaching storm, can trigger migraines in some people. I mentioned sun glare, particularly as a trigger for me. I wear my sunglasses when I'm at the beach or if I'm watching sport on a sunny day and spending a lot of time in the sun. I know I have some allergies around outdoor molds and the combo of that plus sun glare can hit me up. So I like to make sure that I'm in my best state of health up. So I like to make sure that I'm in my best state of health. You know, ticked all my boxes with the basics and for you know for my best state of health in perimenopause now for me. But so I don't have a migraine and nutritional deficiencies. Do you even know if you've got any? Have you? Have you looked at it? Iron is a big there, um. So it's important to understand what's happening in your body.

Sarah McLachlan: 18:38

Now I'm always talking about it, but it, you know, really is like we don't know what's going on. Then we're flying blind. You know you're trying to find a solution, but like you're blindfolded while you're doing it. So it's very difficult. You wouldn't drive blindfolded. Why are we trying to do that with our health? It's just guessing and taking a stab in the dart. And then that's when you go to the health food store and you buy a whole bunch of different things and you don't know what's worked, if it's worked or nothing's worked, so you kind of give up, all right. So how do you do it? So you need to find out the cause, because if you don't know what's going on, you can't address it. So keep a headache diary and work out the patterns.

Sarah McLachlan: 19:20

When you do get a migraine, think about what did you eat, what did you do? What was going on in the lead up to that? Really examine that closely. You might experiment with eliminating high histamine or histamine releasing trigger foods like alcohol, chocolate, cheese, citrus, fermented foods and shellfish. So you really want to eliminate only what you suspect so you don't get nutritional deficiencies, but also you don't want to necessarily eliminate those forever. So you want to work on your gut and your liver health here, because they're really important in processing and detoxifying, eliminating your histamine compounds from your body, so that you don't from your body, so that you don't trigger that immune response and trigger your migraines in that way.

Sarah McLachlan: 20:19

So you know, working with a practitioner can make this. It does make this so much more efficient because they have the experience and knowledge to help you identify what's going on, what's underlying it, and move you through those stages of healing so that you can start adding back in those foods again there as well. So while we're talking about working with the pracca, you also want to get them to help assess you for nutritional deficiencies. So B2, B6, magnesium, coenzyme Q10 and essential fatty acids like omega-3 fatty acids have all been implicated in migraines. And how would you know? So a practitioner, we can help you with that because we know what to look for and we can also test for it as well, if you want to. Some of those, not all of those. Another thing that you want to do is increase the foods to keep the blood flowing and reduce inflammation naturally. So some of the heavy hitters there that you probably know about I love flax seeds and flax seed oil.

Sarah McLachlan: 21:24

Like all of my clients, I ask them to use flax seeds and flax seed oil. They are phytoestrogens so they really help with that hormone balance and and smoothing the fluctuations of perimenopause. Omega-3 rich, just like olives, olive oil, love those things as well. But garlic, onions, ginger, rosemary, decaffeinated green tea, turmeric you know they're your main anti-inflammatory foods and you know reducing the processed white carbs is definitely an anti-inflammatory move. Yeah, so my clients though we all.

Sarah McLachlan: 22:03

I use metabolic balance personalized nutrition with them all to address the underlying issues like blood sugar imbalance, insulin resistance, help support their liver, their gut, gut health and their hormone balances. There's a reason why I use it with all my clients because it's amazing and we don't just have to cut out whole groups of you know it's not all gluten free, it's not all dairy free. It is really personalized to what's happening in their blood and their health history there as well, and it's really great at correcting. You know the tips of the information, the way of doing things, well, and it's really great at correcting you know the tips of the information, the way of doing things. It's really important what you eat, but how you eat it is super important too. So, yeah, getting your food right, making sure you're eating to keep your blood sugar levels balanced it does so much. I did that master hormones on cortisol. I'm going to do another episode on insulin, because it really just makes a massive difference to your health when you're eating to optimize insulin and your blood sugar levels.

Sarah McLachlan: 23:04

All right, so acupuncture is really great for pain relief during your migraine, but also can be helpful in between times as well to help provide some balance in your body. To help provide some balance in your body and you know there's a lot of symptom supplements and herbs that are really valuable for migraines, but you know, magnesium feverfew, ginger, willow bark there are a few examples with evidence behind them like research evidence. There's always long traditional evidence, but most people seem to like research based evidence, which kind of limits a lot of our herb options. But anyway, I'll save that conversation for another day. So those things do need to be taken long term and at the right doses and in the right forms. This is always the case for magnesium it needs to be the right form for the condition and the right dose there as well. So it is really important to or easier if you can, seek some professional advice, get a naturopath to advise you on the right dose and form for your needs.

Sarah McLachlan: 24:07

Um, I mentioned before manual therapies to identify and correct any physical causes for your migraines, and stress reduction. You know I talk about it every week, don't I? And it is. It's a major issue for women over 40 and it does have a significant impact on our overall health. So please do seek medical advice for diagnosis, particularly if your migraines are frequent. If you get woken up from your sleep by a headache, please go and talk to your GP immediately, like that is a red flag and you do need to get that investigated. But generally speaking, if you're getting migraines particularly frequently, then you do need to make sure that there are no other red flags that's suggesting a more sinister cause to your migraines. Please don't just try and do it alone.

Sarah McLachlan: 25:01

So, yeah, understanding your triggers, making the adjustments based on what you've identified as your triggers, will definitely help you have less migraines, just like my client Annie I was talking about, and even for myself as well. It's really about understanding, identifying the issue that gives you the control of your health and over your body so that you can reduce symptoms like migraines and headaches. So I hope you've enjoyed that episode and information today and hopefully it's helped you understand the complexities behind migraines and headaches in perimenopause, what's triggering them, what you can do about them. It really is that you know you don't have to just put up with them. Relief is possible when you have the right knowledge and the right tools.

Sarah McLachlan: 25:51

So I wanted to say today if you do find Chaos to Calm podcast a really valuable resource in your perimenopause journey, then please do consider leaving a review wherever you access podcasts from, because this helps me be shown to other women like you who might be struggling with the chaos of perimenopause hormone changes, like you know, stubborn weight gain, mood swings, exhaustion and migraines because it isn't all just hot flushes and night sweats, is it?

Sarah McLachlan: 26:18

But yeah, if you can leave a review, I would deeply appreciate that, and so would the other women who then get shown or introduced to my podcast because of that.

Sarah McLachlan: 26:29

Now, if you are feeling more bloated or more easily bloated these days, then please do join me next time because I will be exploring bloating in perimenopause what causes it, how to overcome it and get relief from it, so you don't look like you're six months pregnant when your last baby is like 10 years old. And thank you again for sharing your time with me today and I look forward to speaking with you next time. It's really common for women over 40 to experience the chaos of changing hormones, mood, metabolism and energy, but I hope you know now that common doesn't have to equal normal for you or them. You can help others understand they aren't alone in feeling this way and that perimenopause doesn't have to be horrific by subscribing, leaving a review and sharing this podcast with other women in their 40s and beyond. Thanks so much for listening and sharing your time with me today in this Chaos to Calm conversation.