How Do Hormones Influence Headaches?
Hormones are produced and secreted by the endocrine glands to regulate a wide range of functions throughout the body. Hormones are also central to how we perceive and process pain. According to Dr. Diamond, “we couldn’t feel pain at all without hormones.”
Briefly, here’s how hormones work with regard to the body’s pain response: When we experience any type of dysfunction, disease, or trauma, our body reacts at a cellular level. The affected cells, which may occur anywhere throughout the body, become damaged or at least stressed.
These damaged or stressed cells secrete hormones such as serotonin and histamines to induce a pain response in the nerve endings. Other hormones (prostaglandins) enhance the nerve endings’ sensitivity to pain. Neuro-transmitters (also hormones) serve as the chemical messengers that carry the painful sensation to the brain, crossing over the synapses between nerve cells.
The body’s normal biochemical reaction to pain is to produce naturally occurring pain-relieving hormones (endorphins) to block the neurotransmitters, thereby preventing the pain signals from reaching the brain. (It is interesting to note that people who suffer from chronic migraine pain tend to have less beta-endorphin, the primary natural pain-relieving hormone, flowing throughout their central nervous system.)
As this description implies, hormones are not the actual cause of headache pain, or any other type of pain, but part of the complex biochemical chain reaction by which our body processes that pain.
Frequently, this cascading pain response is initiated or influenced by another hormonal dysfunction or fluctuation related to the pituitary, thyroid, pancreas or adrenal glands.
The pituitary is sometimes called “the master gland” because it produces many of the hormones that control other glands. Pituitary hormones that have been linked to headaches include follicle-stimulating hormone (FSH), luteinizing hormone (LH), adrenal-cortex¬stimulating hormone (ACTH), thyroid-stimulating hormone (TSH), and prolactin.
For example, during migraine attacks, many women experience some sort of dysfunction regarding their body’s prolactin-regulating systems, typically resulting in hyperactive prolactin production.
The explanation for this hormonal association with headaches is still unclear, but the evidence suggests a relationship may present itself with further research.
In Who Needs Headaches?, Dr. Cass Igram notes that your pituitary gland can become inflamed or swell when you are under prolonged stress. This swelling places pressure on the thousands of nerve endings around the area of the pituitary, causing pain. For this reason, Dr. Igram believes that pain behind the eyes is almost always related to the pituitary gland.
Thyroid hormones are critical to the proper function of nearly every aspect of the body. The three thyroid hormones most often associated with headaches are triiodothyronine, thyroxine, and calcitonin. Chronic headaches and other serious health problems may result from either an insufficiency or an overproduction of these hormones, which is why it is so important to talk with a healthcare practitioner if you suffer from chronic headaches. Continuous, prolonged headaches and/or migraines are one of the most common symptoms of hypothyroidism.
Dr. Igram observed that people with hypothyroidism also tend to have an impaired immune system, he says “partly as a consequence of the role the thyroid gland plays in controlling body temperature.”
In essence, the lower body temperature associated with hypothyroidism hampers the proper synthesis of white blood cells. What this means for headache sufferers is that they have fewer white blood cells to ward off or combat allergic reactions, thus their headaches tend to be more frequent and/or more severe.
Improving thyroid hormone balance with the appropriate hormone supplementation will help maximize the immune system response, which may result in fewer and/or less severe headaches. However, Dr. Igram contends that the type of treatment does make a difference. He states that Synthroid, the most commonly prescribed thyroid medication, provides very little headache relief and that a thyroid extract made from the thyroid glands of animals is more effective in blocking or preventing headaches.
The adrenal glands synthesize over 45 different hormones, including stress hormones (such as adrenaline and noradrenaline), sex hormones (such as progesterone and estrogens), glucocorticoids (such as cortisol and cortisone), dopamine, and others. Most notably, adrenal hormones trigger the “fight or flight” response when we are frightened or stressed. They are also essential for proper metabolism of proteins, fats, and sugar, and for maintaining fluid balance and glucose levels, among other things. Although the sex hormones seem to have the biggest influence on headaches, any adrenal dysfunction may result in headache symptoms. Chronic, severe headache pain that is resistant to pain medication is often associated with an adrenal insufficiency or another serious hormonal dysfunction.
Because the American diet is generally high in refined carbohydrates, and because this is a leading contributor to hypoadrenalism, many of us tend to have some level of adrenal insufficiency (even if it is not diagnosed). Add to that high levels of stress, plus alcohol or tobacco consumption, and our adrenal glands can easily become overworked to a point from which they cannot recover. When this type of adrenal dysfunction occurs, the weakened adrenals are no longer capable of coping with the elements that provoke headache pain. Dr. Igram states that “if migraine patients had stronger adrenal glands, it is likely that the same stimulus which normally provokes headaches no longer would.”
The pancreas also plays a large role in maintaining proper glucose levels. The pancreas produces the hormones insulin, glucagon, and somatostatin, which work together to maintain blood sugar (glucose) so that your body has the energy it needs to function properly. When you stress the pancreas by skipping meals or consuming alcohol, blood sugar levels can fall dramatically, which can trigger or worsen a headache.
Hormonal fluctuations, particularly of progesterone and estrogens, seem to trigger headaches in most women.
Headache symptoms are commonly associated with premenstrual syndrome (PMS), pregnancy, and menopause. Although not all women get them, most women experience at least mild headaches during times of strong estrogen dominance, such as is present in each of these conditions.
Dr. Robert Milne et al. also observed an increase in the serotonin levels of his patients during hormonal fluctuations. Given the role of serotonin in the pain response, headache pain (or any other pain) is likely to be exacerbated during these fluctuations.
Fluctuating levels of estrogen, especially when they are not balanced by progesterone, often trigger headaches. This explains why headaches occur with increasing frequency among girls after puberty, when their menstrual cycles start.
Dr. Diamond explains that “headache activity increases, for example, when estrogen levels are in flux, either rising or falling, or when there is a change in the estrogen-to-progesterone ratio.”
Many researchers have identified a direct connection between too much estrogen and migraine headaches. Women who experience migraine headaches tend to have higher than average levels of estrogen to begin with. It appears that these high estrogen levels “crash” during the premenstrual phase, making these women more susceptible to headache triggers.
In fact, taking estrogen in the form of birth control pills or another hormone replacement therapy may increase the frequency or severity of headaches, or actually induce headaches in women who had not previously reported them. For example, women who take birth control pills often report getting headaches in the middle of their cycle, when their own natural estrogen levels are rising most dramatically.
Some women think that their headaches will subside when they reach menopause because their hormone levels diminish. But not all women find relief from hormonal headaches at menopause because hormonal fluctuations may still exist, just in different amounts or ratios, or on a different time frame.
Some practitioners believe that headaches may actually be one of your body’s warning signals.
Dr. Diamond explains that “In the same way that the pain resulting from touching a hot stove is meant to protect your skin from a serious burn, headaches may actually be a protective mechanism designed to safeguard you from damaging agents and situations.”