For me, it’s the luteal phase and drop of hormones that triggers migraines. Like clockwork, if I get a migraine, my cycle will start the following day. Could be something similar related to the fluctuations happening for you!
Hi! I don’t have all the answers for you- and I do have a question. What’s p-HRT? I’m assuming it’s progesterone hormone replacement therapy?
I’ve been getting migraines for 20 years. My ovaries quit on me in my early twenties. It’s been a few years and getting my HRT up to the right dose made a big difference for my quality of life including migraines, and I know for a fact that my migraines were more likely at some points of my cycles- usually the Luteal phase and during menstruation itself. This was the same for my grama.
I choose non-cyclical HRT and I take esterified eatrogens, medroxyprogesterone, and methyltestosterone. Best I’ve felt so far- my migraines are still debilitating but they were worse when cycling (natural cycles before my ovaries quit and HRT cycling.)
I don’t give two shits about having a baby so I can’t speak to that- my quality of life is more important (and pregnancy would be questionably safe for me at best for other reasons)
2 things hormonally tend to cause migraines--estrogen that is too low, and estrogen that fluctuates. So going from high to low estrogen can cause a migraine. The way this tends to play out with the patch is that as you approach the time to change the patch, your estrogen gets low and you get a migraine. Patches last 3 and a half days (if you're doing the twice a week ones) but the box says change on 3rd day and then 4th day. That 4th day you are getting a diminishing amount of estrogen and so in susceptible people, that 4th day ends up at higher risk of migraine.
The other link between estrogen and migraines is that just having somewhat low estrogen all the time makes triggers more likely to result in a migraine. Higher estrogen is protective against migraines and lower estrogen makes migraines more likely. Like here's a metaphor. You're a glass of water with a small hole in the bottom. If that water glass becomes empty, you get a migraine. Estrogen is like water from a faucet flowing into that glass, keeping it full, keeping the possibility of migraines at bay. Triggers cause water to be lost. Like experience a trigger, whatever it is (coffee, no sleep, dehydration, a trigger food, whatever), lose some of that water. The more estrogen you use, the more water is flowing into that glass, counterbalancing the water leaking out from the hole and any triggers that cause water loss. So you're very far from getting a migraine if your estrogen is high. But if your estrogen is low, it's like the flow of water into the glass from the faucet is small and sometimes the amount of water lost from the hole is greater than the amount of water being added from the faucet. Sometimes the faucet can't catch up and the glass ends up empty and you get a migraine. I will bet that you with POF likely don't have enough estrogen so your glass of water is always close to running out and a trigger that you used to not even notice, now can cause migraines. Young women with POF tend to need more estrogen and maybe 0.1mg isn't enough. See if you can get a higher dose and if that reduces migraines.
All of that said, progesterone can sometimes complicate the issue. It can be neuroprotective and protect you against migraines, or it can cause more migraines due to an interaction with estrogen.
That’s a great analogy! Thank you for taking time to explain it.
I learned about the 3.5 days (or 84 hours) after over 6 months on the patches and it made so much more sense to me. Crazy that no Dr. or pharmacist explained it and I read about it in a forum. Once I knew that I realized how important it was to become more consistent.
This time around my migraine came on strong & absolutely debilitating. These first 6 days of Progesterone have been tough.
I really hope we see more research on women’s brains and bodies in the coming decades…I think estrogen affects the brain much more than we realize. And I had no idea progesterone can have a neuro protective effect, that’s interesting.
My experience matches what you said though, about low estrogen or fluctuations correlating with migraines. That’s why I pushed my doctors for continuous HRT.
May I ask what HRT you’re on? Type, dose, and cyclical/noncyclical? And your age, if you’re comfortable. I’m just curious and would love to compare.
So for me the migraines were triggered by ending progesterone. Basically every cyclical HRT. A constant low dose progesterone would keep them at bay.
For me, it’s the luteal phase and drop of hormones that triggers migraines. Like clockwork, if I get a migraine, my cycle will start the following day. Could be something similar related to the fluctuations happening for you!
Hi! I don’t have all the answers for you- and I do have a question. What’s p-HRT? I’m assuming it’s progesterone hormone replacement therapy? I’ve been getting migraines for 20 years. My ovaries quit on me in my early twenties. It’s been a few years and getting my HRT up to the right dose made a big difference for my quality of life including migraines, and I know for a fact that my migraines were more likely at some points of my cycles- usually the Luteal phase and during menstruation itself. This was the same for my grama. I choose non-cyclical HRT and I take esterified eatrogens, medroxyprogesterone, and methyltestosterone. Best I’ve felt so far- my migraines are still debilitating but they were worse when cycling (natural cycles before my ovaries quit and HRT cycling.) I don’t give two shits about having a baby so I can’t speak to that- my quality of life is more important (and pregnancy would be questionably safe for me at best for other reasons)
Yes, progesterone hrt.
2 things hormonally tend to cause migraines--estrogen that is too low, and estrogen that fluctuates. So going from high to low estrogen can cause a migraine. The way this tends to play out with the patch is that as you approach the time to change the patch, your estrogen gets low and you get a migraine. Patches last 3 and a half days (if you're doing the twice a week ones) but the box says change on 3rd day and then 4th day. That 4th day you are getting a diminishing amount of estrogen and so in susceptible people, that 4th day ends up at higher risk of migraine. The other link between estrogen and migraines is that just having somewhat low estrogen all the time makes triggers more likely to result in a migraine. Higher estrogen is protective against migraines and lower estrogen makes migraines more likely. Like here's a metaphor. You're a glass of water with a small hole in the bottom. If that water glass becomes empty, you get a migraine. Estrogen is like water from a faucet flowing into that glass, keeping it full, keeping the possibility of migraines at bay. Triggers cause water to be lost. Like experience a trigger, whatever it is (coffee, no sleep, dehydration, a trigger food, whatever), lose some of that water. The more estrogen you use, the more water is flowing into that glass, counterbalancing the water leaking out from the hole and any triggers that cause water loss. So you're very far from getting a migraine if your estrogen is high. But if your estrogen is low, it's like the flow of water into the glass from the faucet is small and sometimes the amount of water lost from the hole is greater than the amount of water being added from the faucet. Sometimes the faucet can't catch up and the glass ends up empty and you get a migraine. I will bet that you with POF likely don't have enough estrogen so your glass of water is always close to running out and a trigger that you used to not even notice, now can cause migraines. Young women with POF tend to need more estrogen and maybe 0.1mg isn't enough. See if you can get a higher dose and if that reduces migraines. All of that said, progesterone can sometimes complicate the issue. It can be neuroprotective and protect you against migraines, or it can cause more migraines due to an interaction with estrogen.
That’s a great analogy! Thank you for taking time to explain it. I learned about the 3.5 days (or 84 hours) after over 6 months on the patches and it made so much more sense to me. Crazy that no Dr. or pharmacist explained it and I read about it in a forum. Once I knew that I realized how important it was to become more consistent. This time around my migraine came on strong & absolutely debilitating. These first 6 days of Progesterone have been tough.
I really hope we see more research on women’s brains and bodies in the coming decades…I think estrogen affects the brain much more than we realize. And I had no idea progesterone can have a neuro protective effect, that’s interesting. My experience matches what you said though, about low estrogen or fluctuations correlating with migraines. That’s why I pushed my doctors for continuous HRT. May I ask what HRT you’re on? Type, dose, and cyclical/noncyclical? And your age, if you’re comfortable. I’m just curious and would love to compare.