Natural Treatment of Menstrual Migraines

menstrual migraines

According to a new Lancet review paper, menstrual migraines are more severe than migraines at other times of the cycle.

The authors of the paper explain that menstrual migraines are caused by estrogen withdrawal at the end of the cycle together with an estrogen-dependent release of prostaglandins and histamine. They propose progesterone as a possible prevention strategy.

How hormones affect migraines 

Menstrual migraines are more common with high, fluctuating estrogen and relatively low progesterone, such as during perimenopause. That’s why menstrual migraines are more common between the ages of 40 and 55.

High, fluctuating estrogen promotes migraines by 1) stimulating immune cells to produce more prostaglandins and histamine, and 2) leading to steep estrogen withdrawal, which disrupts the neurotransmitters serotonin and glutamate.

👉 Tip: New research suggests that migraines may be caused by “plumes” of the excitatory neurotransmitter glutamate moving in waves through the brain.

By reducing glutamate and calming the brain, progesterone may help to prevent menstrual migraines.

Natural treatment of menstrual migraines

Hormonal birth control can worsen migraines

All types of hormonal birth control can worsen migraines and estrogen pills carry a significant stroke risk for women with migraines.

👉 Tip: If you develop a severe throbbing headache on the hormonal IUD, check with your doctor because it could be a condition called intracranial hypertension.

Dr Lara Briden

119 thoughts on “Natural Treatment of Menstrual Migraines”

  1. Hi Lara
    I am a big fan of yours , entire monster feeling of perimenopause gave me a perspective after started reading your book
    I am on prometium, it’s helping me in a lot of areas you mentioned, but I couldn’t get debilitating breast pain under control, is there any equivalent pills available in Australia or Nz for “violet pill”?
    Thanks for your response
    Cheers Uma

    Reply
    • Violet is 3 mg iodine with selenium.
      An alternative is Iosol brand from iHerb which gives 1.8 mg per droplet. (single droplet — like a teardrop size). But be careful and test for thyroid antibodies if you can. And then take selenium separately.

      Reply
  2. Thank you. I’m 48 and have just started having period migraines along with an itchy rash. It all makes sense now, considering my stage in life. I am going to order your book.

    Reply
  3. I’m struggling with debilitating migraines (plus fatigue and nausea) which I can see are directly related to my hormones. I get them 72 and 24 hours before menses and then days 3-5 of menses every miserable month (plus another migraine just before ovulation for good measure) 🙁
    I’m getting very limited help from my doctor/consultant who just repeatedly prescribe me with pain killers rather than addressing the underlying issue. On Monday I asked my consultant for a trial of Prometrium as per Lara’s Hormone Repair Manual and they wouldn’t even entertain the idea or hear me out (said it was unsafe… although quite happy to pump me full of fremanezumab every month)! My blood work has always come back fine which is also frustrating as it’s stopping me getting a referral to see an Endocrinologist which is ultimately who I think I need to see. Has anyone in the UK had any joy in getting Prometrium prescribed? I’m guessing I cant just pop down the local chemist and buy myself a tube?! Any help/advise would be much appreciated!

    Reply
    • I have tried Utrogestan – my period is late for 10 days (first time this happened) and I went to gynaecologist where she saw a cyst on ultrasound, so she suggested to take Utrogestan for 10 days twice a day morning and evening 100mg to initiate the period and dissipate the cyst.
      I have taken 3 pills so far and developed such severe headache, I cannot even describe how bad, it has waken me during the night and the pressure was so severe I wanted to go to the hospital. So, I don’t think I can continue on this Utrogestan because of this and plus I am prone to migraines in general. But how will the cyst disappear and my period will start? I am worried about that… is it okey just to wait? What if it does not pop and my period does not start for months? could you help me???
      Much appreciated!!!

      Reply
  4. Hormonal migrane sufferer here. Can be mid cycle, 2 days before my period or lately on day 4 to 6 of my cycle. Absolutely miserable. Progesterone really helps excepts the day 4-6 migrane.
    .
    I was having a furious migrane which I couldn´t shift. My lunch was salmon. After lunch I realised the migrane had gone!

    I am desperate to feel better & will try anything so I ordered some Omega 3(!) and waited till the next round of attacks. This is the third migrane that Omega 3 has helped and I can´t believe it. The first day I had to take a second dose in the afternoon but my migranes have disappeared to the point I can function normally. I tried to take them as soon as I noticed it coming on.

    There is some research on the internet about omega 3 and migranes.

    Hope this helps someone!

    Reply
  5. I tried progesteron as is written in book,but didn’t help to my migraines…2 pills after ovulation till my migraine came,than 4 pills as it is written in new book.
    The only result- I have had headaches and my menstruation did not come…

    Reply
    • It’s a longer-term effect. By using progesterone over several months, it can lessen the frequency and intensity of migraines. And just to confirm, it was real progesterone, correct? As in, Prometrium or Utrogestan?

      Reply
  6. Hi,

    My iron levels are at the low side of the “normal range” so doctors don’t see a problem. I do get end of period migraines. Do I take iron only in those days? Or the whole month?

    Thanks Dr!

    Reply
  7. Hi Lara, I’m currently reading Period Repair Manual and loving it. I wanted more information on the relationship between histamine and estrogen and your book is the answer! I do have an issue and wonder if you have a recommendation or experience with this- I know you especially recommend magnesium and B6 when dealing with histamine issues, I’ve taken B6 before (in the form of P5P) and it causes cystic acne in me, my ND has worked with me regarding this in the past and confirmed this. We found very few articles about this. Any idea what I can do instead of B6 or any direction you can lead me in? Thank you!

    Reply
  8. Hi Lara, I’ve been seeing a lot lately on Cycle Syncing- which is a practice whereby you alter your diet and exercise routine around different phases of your menstrual cycle to regulate hormones- does this method regulate hormones?

    Reply
  9. Firstly I have bought your second book the Hormone Repair Manual and it is excellent. Highly recommended.

    I had been struggling for years with migranes which occur mid cycle & before my period, utrogestan helped massively. The last 6 months or so I struggle with violent migranes day 4-6. I have tried iron pills, magnesium & taurine but nothing seems to work. I did switch to daily utrogestan (with higher doses on the migranes days) but again this didn´t seem to help with day 4-6 migranes.

    After reading Estrogens Storm Season (which you mention in your book) I wonder whether I am sensitive to the changes in hormone levels, so I will continue with the daily progesterone with a break when I know I´m likely migrane free. My doctor is nice but clueless as to what can help. I have asked for estrogen patches (estradot) and will try them for the week around my period as I wonder whether the drop in estrogen is setting off those migranes. I´m 50 and still having cycles……..

    Is this a sensible/safe option to try?

    Thanks for all the work you do. I listened to the podcast with Dr Mariza & I have to say yours was brilliant!

    Reply
  10. Hi Lara

    I’ve been having delibitating migraines a few days after my period ends. How do I tell if it’s estrogen or iron deficiency. I am anemic

    Reply
    • Hi Jules,

      I have same issue with awful migraines at end and after period.
      My Ferritin levels were low but just on edge of the so called “normal range” however this was no where near the optimal levels recommeded by functional medicine.
      Having read Lara’s book I worked to get my iron up into optimal range working with a naturopath/functional medicine practitioner. It has helped a bit with fatgued, restless legs but even when ferritin optimal it hasn’t improved my migraines, so im wondering if it is the sudden drop in oestrogen that triggers me??
      Good luck with your health journey.
      Rachel

      Reply
      • I wonder too, Rachel. I hope to get answers. I did add some progesterone cream over the weekend and that seemed to have kept the migraines at bay. Estrogen cream didn’t do that for me

        Reply
  11. Hi Lara,

    Have you come across migraines towards end and after period?? I get migraines at ovulation & when period start and on top of that the worst long ones come at end of period until about day 10-12 of cycle. Is this common in perimenopause, Im 42yoa.
    What are possible causes for periods at this time of cycle?

    Iron levels are now up and optimal after working on them for a year so don’t think it is that.
    THANKS!
    Rachel H

    Reply
    • Hi Rachel,

      These are the same for me. The mid cycle and just before my period are treatable with utrogestan and progesterone cream. The migranes that come on day 4 to 7 are hideous and I don´t actually feel better until after the midcycle part. I always used to feel good during this part…so something is changing again.

      I´ve tried iron too and I´m now going to try estradot patches for the week of my period in case the drop in estrogen is causing them. I have to find a solution. I´m 50 and have 2 pre teens at home.

      Did you discover anything else with yours?

      Please let me know if you did! Thanks Sam

      Reply
      • I am the same ladies! The ovulation and before period migraines I’ve come to know, but the day 4 or 5 ones are new. Please make it end!

        Reply
  12. I really appreciate your work and helpful guidance on a Ways to Ease a Hormonal Migraines, awareness & Prevention that is very helpful to everyone!
    it is imperative. Reading this post will make everyone feel better about the Migraine pain.

    Reply
  13. Hi! I have recently read some interesting things about melatonin and PCOS (which I have), and here you are mentioning it for headaches (which I also struggle with). Unfortunately, I also have an autoimmune disease (Sjogren’s syndrome), and I just now read elsewhere that people with autoimmune diseases should avoid melatonin because it affects the immune system. I’ve also read this about ashwagandha and even garlic. Can you shed any light on supplements that are helpful for PCOS but which may be best avoided by people who have both PCOS and an autoimmune disease? E.g., I take zinc and vitamin C, which both affect the immune system. (I know there are even some scientists who hypothesize that PCOS itself is an autoimmune disease.)

    Thanks for all your great work!

    Reply
  14. How much Ustrogestan should you take the two weeks before your period please? Does one have to take oestrogen too (ie can I take progesterone without oestrogen?). And what do you do if your periods are unpredictable? Plus could Mirena work instead? Thank you!

    Reply
    • In my book, I recommend a dose range of 100-200 mg taken at bedtime. Of course, the exact dose depends on your situation and what your doctor thinks is best.

      And yes! progesterone can be taken without estrogen and in perimenopause, progesterone-alone can be the best treatment. There are, of course, times when it’s important to take estrogen as well, especially in the case of early menopause or surgical menopause (ovaries removed)

      Reply
      • Dear Lara. I’m star struck that you replied thank you! I’ve read and reread your book and recommended it to everyone I know. I can’t wait for the next one. Thanks for the info. If I’m a migraineur can I take Ustrogestan continuously so avoid any fluctuations and as a coeliac could I use it vaginally rather than orally? I do have some symptoms of perimenopause but I suspect it’s the progesterone that I need rather than the oestrogen as I’ve got fibrocystic breasts, thickened womb with very heavy periods and ovarian cysts. My gynae wants to do a hysteroscopy (without anaesthetic!) and put in a Mirena but I’m unsure what to do for the best. Thanks again and all the best to you. Liz.x

        Reply
        • Progesterone can be taken daily.
          For migraines, progesterone probably works better orally because that way, more of it converts to the calming neurosteroid allopregnanolone. I believe the standard capsules are gluten-free or you could obtain oral micronized progesterone from a compounding pharmacist.

          Reply
          • I’ve just reread this article and I think the low iron could be a missing piece of the puzzle for me. I’ve just found out I’m horribly anaemic. I’m hoping that getting my levels up with also help migraine. Thanks for all that you do.

  15. Hi! I have suspected adenomyosis and have really found your book helpful as it was so hard to find information specifically for adeno. Do you think using Progessence Plus (YL) would have similar benefits to taking natural progesterone. My friend gave me a bottle and I’m not sure if I should use it every day or just specific days of my cycle. Thanks!

    Reply
  16. Hi Lara,

    I am wondering if you have any data about stevia and painful periods and even headaches?

    I have been dieting for about 6 months. I am down 52 pounds but realize I am hooked on stevia. I am currently winding around the most painful, ugly period of my entire life so I googled.

    Apparently some cultures used stevia as birth control. I am definitely coming off of it but wondering if you have any insight on this?

    Thanks!

    Reply
  17. I have recently read your book Period Repair Manual. It is an excellent read and I am learning a wealth of information about my body and my cycle. I cannot thank you enough for sharing your knowledge with women. I specifically read your book because I suffer from migraines (I HAD ZERO CLUE SO MANY WOMEN HAVE WHAT I HAVE WHAAAT?!) I am a 32, 120lb who in the last 3 years has started suffering from intense migraines mid period or end of the cycle. I have visited a neurologist who ruled out any issues there. I’ve seen a dietician who doesn’t believe this is caused by diet and quite truthfully neither do I. My Ob-gyn hasn’t noticed any abnormalities either. I should include that I have been on hormonal birth control for the last 10 plus years. After reading your book I CANNOT believe I was on it for as long as I have been and how much of a disservice, I have been putting my body through. I wish I had known all of this information before getting on it. Nonetheless, I have been on it for “preventative” measures and not because I had abnormalities with my cycle. As of February 2020 I decided enough was enough. Lets see if getting off of HBC will alleviate these migraines. To my surprise, the intensity has lessened. While on HBC the pain was excruciating, debilitating, depressing, and has kept me from doing daily tasks. I have missed two consecutive Christmas Eve’s with my family because of migraines. Lets just say I am desperate for a solution!

    Now that I am off of HBC the migraines are a bit better. Their arrival is less predictable and their intensity has lessened up until last month. For some reason the pain was so intense last month that it caused a moment of psychosis for me towards my spouse. I decided to make an appointment with an Endocrinologist who would do some blood work and take a look at my hormone levels. She has said that for the most part everything seems normal. Other than my “sex hormone binding globulin”. It is elevated. Looking back to a 2019 blood exam it was elevated in the 400’s then too but I was on HBC at that time. She said that it still appears elevated due to HBC whereas now its about 140. She doesn’t seem to find this alarming because I don’t have hyperthyroidism or diabetes. Of course, she suggested getting back on HBC with the help of my ob-gyn. I explained that I am trying to detoxify my body of synthetic hormones and so I would not accept that as an option.

    I am at a loss! I want to be migraine free so I’m going to try the supplements you suggested like magnesium, vitamin B2, B6, zinc, iron, and melatonin to make my sleep better. I have read the portion of your book where you correlate migraines with a cycle and how to remedy them. I am afraid of not finding that and possibly making matters worse. I’m also afraid of living like this forever without a possible solution like others. I want to start a family with my husband but not while I have this underlying issue. Thank you for being a powerhouse of information for us women and periods. Thank you for teaching me how to speak up for my health. I am hopeful for a fix to my mysterious issue.

    Reply
    • I too started migraines with on bc pills. I had a flood of them when I stopped taking bc and an emerg doc prescribed rizatriptan. I still get migraines 8 years after stopping, but they have lessened with the use of magnesium bisglycinate, 4-600mg daily. Now I get 2 or 3 per month at certain points of my cycle when my hormones are changing force and they are fairly easily managed with the rizatriptan-ibuprofen-caffeine combo. If you let a migraine (or headache) get to full strength it can have rebound ones, like aftershocks. knocking it down right away stops those.

      I tried 25 mg progesterone cream for the second half of my cycle and experienced weird bloating of my lower belly so my pants wouldn’t fit and I had constant pee urges.

      I am taking CanPrev Healthy Hormones supplement and it really really helps regulate my mood and my period, 1 daily, 2 daily in luteal phase. My Naturopath suggested it helps eliminate estrogen from my system. I tried a tincture she made that is supposed to do similar but after 2 months I am giving up on it because my moodiness is increased and my migraines are unchanged. Whatever is in the Healthy Hormones pill my body seems to need.

      There is a history of celiac in my family, causing migraines, but I tried a gf diet and it didn’t change anything for me.

      I too want to figure out the underlying issue but in the mean time maybe try rizatriptan or sumatriptan to manage the migraines so you can function.

      Reply
  18. I have pain on the left side of my scalp and it’s one sided I got off my birth control in January of this year I was wondering if that is a migraine I did a CT and MRI and it came back normal… I don’t actually have the type of migraine that I need to lay down or I’m dizzy or nauseous.

    Reply
  19. Hello Lara, Thank you for this post, I have had menstrual migraines for over 30 years, tried the natural progesterone cream with no relief, do eat a very strict diet, no gluten take magnesium B 2 for years and still suffer like clock work with migraines. I have not had period for 3 years now as in menopause, put on 10kg weight even though I eat very low carb and get hot flushes still. I can still see my cycle working with migraines on my calender. I want to go to my Dr to get the progesterone you talk about in this article, but wonder how to take when in menopause? and also wonder about what tests I could ask my Dr to get?

    Reply
  20. Thank you, I´ll give Utrogestan a try continuously & get my iron levels tested. I do try and eat more iron foods in the run up to my period but maybe this is not enough with heavy periods.

    My doctor is sweet but I had to plead for Utrogestan for perimenapause as she had only ever prescribed it for pregnant women who were at risk of miscarriage. I´ll trust your experience and my judgement based on how I´m feeling.

    Thanks again for giving me your time.

    Reply
  21. Dear Dr. Briden, thank you very much for another informative and important article. I am 46, my periods are getting lighter, and I usually have a migraine on day 3 of the cycle. It makes sense that it is related to the brief iron-deficiency.

    Is it true even for a light period?

    Would you recommend supplementing iron throughout the month or just for several days (if yes, how many days prior to the period)?

    If I want to test my iron and ferritin levels, shall I avoid doing it during my period and for several days after that?

    Thank you very much!

    Reply
  22. Utrogestan has “cured” my pre menstral migranes but I´m still struggling with the ovulation headaches. I seem to be ovulating earlier in my cycle, day 7 sometimes. Is this due to aging ovaries? I´m 49.

    How much progesterone can I take without distrupting ovulation? Then would I continue taking them and stop after 14 days or take them for the earlier ovultion, stop and resume at day 14?

    The last 4 months I´ve been suffering from what I assume is EMM headaches … day 5 or 6. This this month day 2 and 3…..it is getting hard to figure out what is going on!

    Many thanks for any help.

    Reply
    • speak to your doctor, of course, but many of my patients in their late 40s with headaches, find they benefit most from taking progesterone continuously throughout the month– with maybe a 3-5 break just after the period. At 49, there’s probably no reason to worry about whether you’re suppressing ovulation or not. The main thing is to reduce symptoms and get through to menopause.

      Also, for what it’s worth end-menstrual headaches can be from iron deficiency. Have you had your iron levels checked?

      Reply
  23. I was diagnosed with anemia years ago but I have not been tested recently or with the test you recommend. Due to severe constipation I have a hard time with iron pills. Would grass fed beef liver pills from Ancestral Supplements provide enough iron?

    Reply
  24. Hi Dr. Please help me. I have had migraines for 15 years but my migraines are not like all the typical menstrual migraines. I don’t get any at the beginning of my period, they start in the middle of my period and most severe are right after my period ends. I can get them for 10 days straight. I sometimes get them mid month but not like the others. I have been on different forms of magnesium as well as potassium and sodium as well as cod liver oil and that helped some but not enough. I have not taken birth control pills for 15 years. My periods are kinda heavy with lots of clots but not terrible. Please let me know what you recommend. Thank you!

    Reply
    • post-menstrual migraines like you describe can e from iron deficiency.
      Have you been tested for iron studies or serum ferritin? Normal haemoglobin does not mean you have normal levels of iron.

      Reply
  25. Hi Lara. I discovered your blog while researching copper IUD. Thank you for providing some great information.
    I suffer from menstrual migraine headaches. It begins the day before my period and lasts two to three days. I dont like to take medicines and can’t tolerate hormone birth control. I started to drink soy milk (adding it to my morning smoothy) the day I start to feel the onset of headache and for the first day of my period. This has helped reduce the severity of my migraine significantly.
    I was diagnosed with abnormally high levels of estrogen when I was younger (25 yrs ago). My doctor tried to control this with hormone birth control which only created more problems. I am highly sensitive to all forms estrogen, even being around other women with estrogen fluctuation can cause problems. I found this out when I was working in an office where several staff members were on estrogen therapy for various reasons. I started to have irregular periods with more sever pain and mood fluctuations. That is how I found out about the soy milk solution. A friend said she couldn’t have any soy products because of her estrogen therapy. After researching menstrual headaches and finding that a common cause is the estrogen drop I tried using a little soy to bring my levels back in balance and this has worked effectively for several years. It does not eliminate the pain but it does make it more tolerable.

    Reply
  26. Hi Lara,
    Do your recommendations above work for migraines that occur DURING menstruation?
    I used to have migraines like the ones you have been referring to (before or after menstruation) but it never usually occured during it. The last six months, I have been having migraines every single month during menstruation around about the 2nd-4th days. Would it be a similar cause to the ones you are talking about here?
    Thanks
    Bron

    Reply
  27. Hi, I suffer from migraines 2 days before my period which last about a week. I also have pmdd.
    Please could you tell me what dose of prometrium to start on?
    I’ve cut out all migraine triggers from my diet, and looking into dairy and gluten free now.

    Thanks for sharing all your findings!

    X

    Reply
  28. Interesting thanks Lara. I will talk to my practitioner about taking it a bit longer into my period to protect me from oestrogen drop, shelter the brain.

    Reply
  29. Hi,

    I am really interested to hear all these improvements with regards to hormomal migraines on bio-identical progesterone.

    I use the oral bio-identical progesterone from a private DR 100mg day 10-28 but it has only helped a litttle. I still get x10-15 days of migraine a month at ovulation and with period and after.

    I am interested to know from Lara or others…. what sort of dosage is used and when is the best time of cycle to take it to get best results. I am aware that the migraines happen after an eostrogen surge followed by a drop. Can taking progesterone e.g prometrium stop ovulation and will that help or make things worse?

    Thoughts?

    Reply
    • High dose prometrium can suppress ovulation but that is not usually the goal. With my patients, I recommend using steady dose progesterone through all of the “danger windows” (ovulation, premenstrual — often right up to day 3). It can shelter the brain from the drop in estrogen.

      Reply
  30. I´ve suffered terrible hormonal headaches for 6 years, I´m 48. I used to get 2 days around ovulation, 2 days a few days before my periods and 2 days after my period.

    I started using bioidentical progesterone cream which really helped the ovulation and pre period headaches but it wasn´t strong enough to prevent the headaches, only relieve them once I had literally covered myself in the cream!

    From your website I discovered Utrogestan which my doc prescribed only once I gave her a mini lesson in bioidentical progesterone for perimenapausal women! Actually she was happy because she said she had other patients who could benefit from it!

    Wow, now I don´t suffer from hormonal headaches at all. I sometimes ovulate early so I start them day 10-14 depending. I do have to take them vaginally as orally causes the most horrific heartburn.

    I craved cabbage, sardines and beef so I knew I needed extra iron for the post period headaches.

    I learned so much from this website. You have all this information here. It is a fabulous resource. Thank you.

    Reply
  31. Hi, I have pmdd and migraines which start before my period and last for days. I’ve tried various supplements and life style changes with no avail and I have low iron due to heavy periods. In desperation I started a combined pill last month. Interested in your findings re progesterone, and melatonin. Can melatonin be prescribed in the UK?

    Reply
  32. I get a migraine at ovulation as well as at time of period would these both be related to the same thing? I currently experience approx 8 days of migraine per month.

    Reply
  33. My cycle is normal also?? Always has been. Possibly more heavy now I am off the pill. Clots, lil cramps. Very regular. I do still get hormone headaches week before my period! Thank you for explaining

    Reply
  34. Holy hell! Thank you!
    Took the pill for 12+ years (Diane) and suffered with migraines. ENT, Neurologist, Neurologist-Psychiatrist appoints and years later…it was the pill!!! I ended up being put on anti depressants as it was ME causing my own migraines…All of them told me it wasnt the pill!! Come off the pill, lost almost all of my hair, hormonal acne.
    Recently diagnosed with “PCO”- whatever… im now 34 yrs old. Had more than average follicles and have been off the pill for years. Acne is bad still (not as bad), hair came back, still very fine. Androgens still high.
    Thank you! Finally someone to explain! I work in a compounding chemist dealing with natural hormone replacement. Thank you for helping us girls out xx

    Reply
  35. Hi Dr. I have suffered with menstrual migraine since 16 years old, I am now 44 still suffering. Started taking natural progesterone and it didn’t help, caused bad acne and made my sleep worse. Take magnesium and many others vitamins and herbs with nonrelief. Any insight is appreciated.

    Thanks

    Reply
  36. When I went on LoEstrin, my blood copper levels doubled (2000+) and I started having migraine auras (all the visuals and brain fog, but no pain). When I quit the Pill, I had no more auras after 2 weeks and after 3 months my copper levels were 1000.

    Reply
  37. Hello

    I have just stumbled across your amazing website and free book chapters. Think they could be truly revolutionary for me.

    Do you mind if I share my story.
    I am 40yo.
    In my teens periods were fairly regular though I had some pms and pain.
    In my 20s I was on the pill. My mood was flat but less mood swings. I had depression in my late 20s. And symptoms of IBS and regular thrush.
    In my 30s I came off the pill and things took a while to settle.
    I then had 2 pregnancies; one which ended in a loss at 5m. The grief and pms afterwards was awful. The second pregnancy resulted in my now 5yo son and PND. Both pregnancies I was very irritable.
    Over the last 12-18m I have had awful pmt… 10 days of low mood and crippling anxiety.
    I went back on the pill and antidepressants as it was taking over my life.
    7 months on… my mood is better and the pms gone.
    But I have insomnia, low sex drive, vaginal dryness andali thrush, bloating, sinus problems and awful headaches.
    The pill seems to suit me even less than in did in my 20s!

    I am planning to stop the pill (though continue with the antidepressants) asap.
    I have B vitamins and magnesuim at the ready. (Though I am unsure of the best doses)

    Is there anything else you would advise on?

    Bare in mind I live in Uganda so have limited access to vitamins/ supplements etc

    Rachel

    Reply
    • Dear Lara
      Can I share my story?

      I am a woman of 49 living in switzerland.
      And desperately seeking for a solution for my heavy bleedings and headaches.
      I am reading your book at the moment, but till now seems to handle more about younger women 🙂

      My menstrual cycle always has been heavy. Taking at least 5 days till a week.
      I have become a mother of 2 children at 37 and 40. Since 3 years the bleeding has become so heavy that I could hardly leave the house. I needed iron. Was very tired etc. My Dr. Recommended the mirena spiral(?). Since than the bleeding is less, but…now I loose urine all the time. I did fysiotherapy. I have migraine headaches hat last for days almost every week. Also the bleeding is not over but all the time a bit and than heavier again.
      Long story but I hope you can advise me what to do.

      The reason I stayed with the mirena is that at least the bleeding is less heavy. But these headaches are so tiring and the urinloss as well. I just want to find a natural solution.

      Kind regards
      Eline

      Reply
  38. Hi Dr. Briden. My name is Catherine. I have been reading the “period repair manual 2nd edition” and am SO motivated to get off of hormonal birth control pills (which I’ve been in for about 10 years I hate to say). I definitely relate my cyclical migraines/headaches to the pill. They are worse when I am on the pill, they are more tolerable when I was off. I am extremely hesitant to get back off the pill though. My bigger concern is anxiety…

    About 2 years ago I completely got off of the pill hoping for all the benefits of getting off (libido, migraine relief, better mood, etc). What happened instead was extreme anxiety almost immediately and panic attacks almost daily. I tried to stay off for about a year but could not handle the anxiety/attacks. I even was on anti anxiety medication after getting off the pill which did not seem to help. I decided to get back on the pill and the anxiety almost immediately went away (for the most part).

    With that being said, I am still very motivated to get off the pill again but am terrified to. I assume my anxiety is somewhat hormone related? Although anxiety runs in the family, the fact that it was such a drastic difference when on and off the pill makes me think it correlates with each other.

    I would love to know where to start. Is this a common symptom? Should I try seeing a naturopathic doctor or a functional medicine doctor before getting off the pill again? Should I do blood work for hormone testing? Am I likely lacking (or over producing) some hormone? I have no idea where to start! Any information to help get me in the right direction would be so greatly appreciated.

    Thank you,
    Catherine

    Reply
    • post-pill anxiety can be from either 1) estrogen deficiency (such as would occur with complete amenorrhea or no periods), or 2) from histamine-estrogen reaction (which would be associated with anxiety that’s worse before ovulation or during PMS).

      Did you get periods?

      Reply
      • I did get periods, but I don’t recall that they were “great” (as in nice red coloring and not clotting and the recommended norm for amount of fluid- mine were lighter). I do believe my anxiety was always worse closer to my period or during, but it was really bad throughout that I didn’t even think about it being better or worse at the time.

        Do you think this means it’s more related to histamine estrogen reaction then? And if so, what steps should I take?

        Catherine

        Reply
  39. So I started using vitex because a friend said it worked for hormonal headaches. I was on it for about a week and a half (on and off) before I realized I shouldn’t be using it with birth control pill (I know I should have known better, should have read first). Anyways with in that week and a half There were activities in the bedroom…. could that week and a half been Enough to offset my birth control that I may get pregnant?

    Reply
  40. I haven’t been on the pill for approx 7 years, the last for of BC I used was the copper IUD but had it removed as it never seemed to settle in my body. I have regular periods. No major concerns other than that I get migraines about 2 days before my period starts and if usually lasts into the first day of my period. No pain killers work.

    Any suggestions for non-BC related migraines? They really put me out!

    Reply
    • all the treatments I discuss in the post should help with the kind of hormonal migraines you describe (magnesium, b2, natural progesterone etc)

      Reply
        • Australia has many good magnesium products including the powders from Orthoplex, Metagenics, Ethical Nutrients, and Bioceuticals.

          Reply
          • I get these same migraines- 2 days before my flow starts. They began when I used low dose birth control 2009-2013 and I can’t seem to kick them. Recently I started trying different meds and vit/mineral/herbal supplements to stop the migraines, but they shifted around to earlier in the week, or right when my flow would start, or I’d get two. I haven’t tried natural progesterone, just a mini pill, and that made me spot nonstop while I took it, leading to incredible frustration. It’s so hard to be intimate with your spouse when you are leaking with no end in sight! I tried cutting out gluten with no change. I tried Lorna Vanderhague EstroSmart with a small positive change in mood only. no change from taking EPO or Borage Oil, Omega 3-6-9, B100. Magnesium stopped the migraines I experienced when my daughter’s flow would start, but has done nothing for when mine starts. I just began using CanPrev Health Hormones 3 weeks ago and although I still had 2 migraines around the start of my flow it made my flow half the volume. the new ingredients in it that I haven’t tried before are i-3-c and black cohosh. Oh, and I now use triptans for my migraines, which works very effectively but I’d rather not need them in the first place. I will check out the histamine possibility as you mention. I”m ready for the experimenting to end!

  41. Hi Lara! I was directed by your Instagram manager to leave a comment here in order to reach you. 😊

    Quick post-birth control question. I read your book and came off birth control on July 8. While I haven’t had a period yet, my body is trying to reset, as I’m having hot flashes and night sweats, which I expected, but I’m also experiencing weight gain, which I didn’t expect. 15 lbs so far. Can you direct me to any articles of yours that can help me address this? Thank you so much!

    Reply
    • I expect a big part of that weight is fluid. Does that seem right? Depending on which birth control you were on, some of them are strong diuretics so your body is withdrawing from that effect. Also, you own estrogen kicking in could be causing some fluid retention. It should settle over time, and in the meantime, you could look at natural diuretics like vitamin B6 and iodine, but of course, speak to your clinician. Read Why I Prescribe Iodine for Breast Pain and PMS.

      Reply
      • Yes! I just looked up the ingredients in Ocella and you’re right! Drospirenone is a diuretic. I had no idea. I’ll check out B6 with my doc. (Can’t take extra iodine due to my Hashimoto’s) Thank you so much!

        Reply
  42. Hi Lara. I’m writing to you because I’ve been struggling with irregular cycles since I was 12. I’m 20 now and I’ve had some blood tests during the last year. The first one suggested my testosterone was too high. In the second one it was fine but my TSH and prolactine were slightly high. On my latest blood test, my prolactine was still somewhat too high, but my TSH completely normal (2.1). All this occured without me making any major health/life style changes. I have no idea what to do next. Do you have any advice?

    Reply
  43. Hi Lara! I get hormonal migraines at both ovulation and menstruation. I’m planning on pregnancy hopefully in the next few months. What tends to happen to these migraines during pregnancy when the normal ovulation/menstruation cycle is interrupted? (I’m secretly hoping you’ll say the headaches tend to go away??)

    Reply
    • I’m just a fellow reader, but I also suffer that ov/menstrual migraine pattern. My experience with pregnancy was that I had bad headaches (not migraines) during the first trimester, and no migraines the rest of the pregnancy. The migraines returned once I was cycling again, although I didn’t get my period back for at least 4-5 months after my daughter was born (if I am remembering correctly – I guess breastfeeding suppressed ovulation for a while?). I would love to hear Lara’s take on this. And please say they go away after menopause! : )

      Reply
      • There does seem to be quite a lot of individual variation with migraines and pregnancy and menopause. That said, yes, many of my patients report migraines improving with pregnancy (due to all the progesterone) and also improving with menopause (due to the flattening out estrogen).

        Reply
  44. I have found your blog searching the internet on hormone info. I have never been on the pill but have always struggled with depression since my first baby was born 16 years ago. These days I feel pretty good in the morning but around supper time I start feeling panicked no matter what’s going on. I have had sinus infection for years but I believe it’s due to the desert climate because when I vacation in more humid areas it goes away. What causes hormones to peter out by the end of the day?

    Reply
  45. Hi, I’m after a bit of advice. I’ve been wanting to come off the pill for ages now for the simple reason I know it’s not good for me. However, I’m not sure I’m ready to risk any chance of getting pregnant. I mean I still ensure condoms are used on top of the pill to eliminate any risk. Therefore, I’m wondering if switching to the hormonal IUD would be a slightly better move for my health?
    The copper IUD is not an option for me as I have low iron.
    Any advice would be much appreciated!
    Thank you in advance!

    Reply
  46. Hi Lara, I’m 19 and was diagnosed with PCOS age 16, when quite underweight during recovery of an eating disorder, I have very high DHEA’s but no LH / FSH issues, all other bloods are normal, recently i’ve increased my dietary fats which previously were cut out (dairy and meat) and regained a normal 30 days cycle after 2 years! my acne is dissapearing however, my hirsutism and hair loss remains the same, do you think my hormones are settling down, and do you have any general advice/ supplements for lowering DHEA’S levels? thank you x

    Reply
    • If DHEAS is your only androgen, then it’s more of a situation of “adrenal PCOS,” which I discuss in the new pink version of my book. And I recommend some strategies for lowering DHEAS including zinc, B-vitamins, magnesium, and licorice, but please check with your doctor. I also discuss adrenal PCOS in my androgen excess blog post.

      Reply
  47. Hi Lara! I am so glad to have found your blog and I have enjoyed reading many of your posts. I have a couple of issues that I wanted to know if you could give me your advice on. First off, I have been on birth control pills for many years, about 16-17 yrs, and I am thinking about coming off of them because of risks with long term use. My family doctor first put me on them many years ago because it eventually got to where every month my menstrual cramps were so painful that I would have to just go to bed for part of that first day and pray that they would go away. So first question is would I need to completely finish the pack that I am on and then just not start the new pack? And is there anything I can do to maybe help from having those awful cramps. I just don’t want to go back to that place again. I have tried to reach out to my gynecologist a couple of times within the last week and ask her advice about this but haven’t gotten a response. The last time I went for my annual Pap test, she did change my pills to a low dose because she felt like the ones I have been on for so many years was a little to strong for me now. Also, I have always been one of those people who have had very regular periods even before going on the pills, but in June my period was very light and only lasted three days and then in July it was a little heavier and lasted about five days. My periods always last about seven days so this is very unusual for me. I mentioned to my gynecologist that maybe I was starting Perimenopause, I turned 39 in February, and she said that she had no way of testing my hormone levels because I am on the pill. Is there anything I can do to keep my hormones from being such a mess if I do decide to come off the pills and especially if I am starting Perimenopause? I would really appreciate your insight on any of these issues. Thank you!!

    Reply
  48. Love this article! Have been on and endless search for birth control that actually works and doesn’t cause all these additional problems. Feel like I have tried or vetoed nearly every option out there – even copper IUDs some researchers now say elevates copper and messes w mood! Ugh!!

    What do you think about this option? https://www.smartwomenschoice.com

    They say zero/4000 test cases became pregnant?! Do you think it qualifies as truly non-toxic?

    Reply
  49. I used to have severe pain due the pill. I went to many doctors they said “its because stress,the pill has nothing to do with it”. So I continued taking it and a lot of analgesic. The pain never left. Months ago I left the pill. My pain lessen but no disapear . I took it again for a month and the pain returned worse than ever.
    So I linked my pain (and a lot of other simptoms like low libido) with the pill . Now I have head pain before period but less severe and some times I have it after it. My life is 500 % better without the pill.

    Reply
  50. I can’t agree more about strong correlation between headaches and birth control. I’ve been taking them for 1,5 years and my headaches were terrible (sometimes headaches became migraines and I was stuck to bed all the evening). After I came to neurologist, they asked me about pills, but no one of them made this correlation (and I visited 3 of them). I don’t understand why. It should be the first question if woman take birth control and suffer from headache (and loss of libido). And now when I come to OB/GYN, they almost ignore my past complaints and try to prescribe birth control again, because they think that my ovaries need some rest. Crazy world 🙂

    Reply
  51. Hi Lara , I have been keeping a diary of my seriously awful headaches. They have a regular pattern of starting on day 5 of my cycle and lasting for approximately 3 days and nights . They even wake me up during the night. I am not taking any hormonal contraction . I do take a good iron supplement and magnesium. What else would you recommend?
    Thank you

    Reply
    • Headache on day 5 suggests it’s the “end-menstrual” iron deficiency headache I speak about in the post. I know you take iron. How is your ferritin level on a blood test? It’s possible you need more or are not absorbing.

      Reply
  52. Does one need a prescription to obtain the micronized progesterone capsules? I’ve been on the cream for a few years and it does seem to help, but I’d rather take capsules if they do indeed work better. I’m not on birth control, but am near the end of perimenopause.

    Reply
  53. I suffer a migraine at every single ovulation. No other times of the month post eliminating gluten… please shed some light! Do I need more progesterone? Less estrogen?? Thanks

    Reply
    • It could be the slight drop in estrogen that occurs with ovulation. In which case, possible strategies include working to keep estrogen as low as possible and/or a little bit of progesterone just before ovulation. Or it be could be a histamine intolerance issue. Please read my Histamine and PMS post.

      Reply
      • Thank you for your reply. I find your book so incredibly helpful and recommend it to my friends.

        I wrote my question without background info as I was so keen to receive your advice! I am 40 and I suspect perimenopausal (my mum and maternal aunt went in to menopause in their early 40s and my cycles are shortening). My periods last 4 days and aren’t heavy.

        My migraines (with aura) started when I was 18 and took the pill. I came off it at 20 as I was getting numbness and tunnel vision with the migraines. They came and went in my 20s and 30s and have been regular at ovulation after the birth of my 2nd child when I was 36.

        If I try a little progesterone how much should I start with?

        Thank you so much Lara.

        Reply
  54. My migraines began either when I began the pill or got off it about 18 years ago. I’ve not been on the pill since, but the (hormonal) migraines persist. I’m perimenopausal now. At the beginning of perimenopause, they got worse, but now when I don’t ovulate, they’re not as frequent. I never made the connection between the migraines and the pill until recently. The migraines also got much worse and more regular after my daughter was born 11 years ago. I don’t know how that fits in, but I’m fairly certain the pill started it all. Please keep up the good work you are doing Dr. Briden.

    Reply
  55. HI Lara, great post! After reading, I clued in that my migraines definitely began when I first started birth control and I have suffered with them for most of my adult life (thankfully they seemed to lighten up during and following my pregnancies and the decade following that). Once I was menopausal they worsened considerably and I could barely go 2-3 days without taking Maxalt (rizatriptan). My general practitioner suggested proprananol, however I had taken this for a couple of years before menopause and was not interested in going back on it as it did little to help and a listed side effect is hair loss.

    I went to a hormone specialist and began taking bio-identical progesterone cream 10 months ago (started with 10 mg, and am now using 20 mg daily). It has been life changing, and has reduced my migraines to 1 a month. I am so happy that my quality of life has improved, but a little dismayed that I had to suffer for close to 5 years because my doctor had no idea that a hormone imbalance might be worth investigating.

    Reply
      • This is so interesting, I am considering using natural progesterone too. I have 10-15 hormonal migraines per month and my Dr prescribed Lo Loestrin (continual, no placebo). Since I started it I have been experiencing itchy rashes and hives – I am also allergic to horses and I am wondering if there is a connection?

        Reply
  56. Hi Lara, From going from no migraines to about 6-9 a month over the past two years I worked out they are hormonal but not related to the pill. I suspect they are related to an ectopic (tube cut) and having my remaining tube clipped but there doesn’t seem to be any data to confirm this. I eventually had triptans to help but now have just started taking propananlol and will see if they reduce them. I also take a Raw B complex and magnesium every day but perhaps I need a higher dose of magnesium to make a difference. I am interested in trying some of the natural treatments you have suggested to see if they will help, particularly removing wheat. Thanks for your blogs and your book, which I have downloaded and look forward to reading.

    Reply
    • My go-to prescription for hormonal migraines is high-dose magnesium with taurine plus gluten-free plus vitamin B2 plus natural progesterone. Sometimes all parts are required to see relief.

      Reply
      • Hi Lara, I get hormonal migraines too and have been taking mag for years. Have decided to trial the other parts of the treatments you have recommended. I was wondering if it is necessary to take B2 on it’s own or if it is sufficient to take as part of a good multi? And what’s the dosage of B2 for relieving hormonal migraines? Thanks for your articles and book – it is a maze to try and figure out how to harness and calm our hormones without having to fight off the ill effects of “commonsense” practices like using the OCPs to combat migraines, acne, and whatever else is baffling about women’s bodies.

        Reply
        • the dose used in clinical trials was 200 mg twice daily. which is a lot. with my migraine patients, I Sometimes go with 200 mg once daily (on its own). Check with your doctor.

          Reply
      • Hi Lara, your go-to prescription did wonders for reducing the severity of my Migraines but I guess changes to my body also meant new changes and perhaps a settling or more of a routine to my migraines. My Dr was absolutely no help when I asked to try progesterone and even with referrals and advice from the hospital they would not let me try. They did give me estrogen that I wasn’t sure about but thought I would try. This was terrible and at times thought I had blood clots in my legs or my heat would beat irregular. Dr, funnily enough suggested I stop taking it. I tried a different Dr for a second opinion only to be told that NZ does not recognise Progesterone for Migraines and any Dr would be irresponsible to prescribe it. I left the research from Prof. Prior with her but suspect it was thrown in the bin after I left. Completely disheartened, I turned to a local herbalist who prescribed a Metagenics product, that has been amazing. I still get an almost migraine on day 3-5 of period but I can usually stop it before developing with aspirin. I’m sure there a few more tweeks I can work on but am getting there with your very useful blogs, advice and it seems some natural supplements that are just as good as prescribed progesterone. Thank you.

        Reply

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