Chronic Daily Headaches After Birth Control Nightmare

[bradyp]

I’m posting for my daughter who is struggling with Chronic Daily Headaches after a debilitating experience with birth control pills meant to treat amenorrhea and possible PCOS. She is a 24-year-old female with daily persistent headaches, tachycardia, fatigue, poor sleep and low appetite with intermittent migraines beginning August 2021.

After a year of daily pain, numerous tests to rule out other issues, and various treatments including acupuncture, Chinese herbs, maca root and other supplements, we finally found a doctor who recommended a Dutch Cycle Test. Results show that my daughter is not ovulating and has low estrogen and low progesterone throughout the month. (Dutch Summary: E2 1.7; Progesterone: 3.3; Testosterone: 15.5; DHEA: 3037)
The doctor prescribed cyclic Prometrium at 100mg, knowing that might be too low. She has been taking it for 10 days now.

From reading your book (which is incredibly helpful and I’m very sad I was not aware of it before!) along with your blog and forum, I’m hoping you can provide a bit more guidance given your expertise in this area. I see a lot of information about migraines and hormonal imbalance but I don’t see anything about new chronic daily headaches. My daughter has had some migraines over the last year but the daily chronic headaches seem to also relate to hormonal imbalance.
1. Her headache pain consistently increases throughout the day – generally at a higher level approximately 8 to 10 hours after waking. Could this possibly be due to daily hormonal fluctuation? I found this on endocrinology.org:
The hormonal peaks have been found to occur in the morning for progesterone, in the afternoon for FSH and LH, and during the night for oestradiol.
Of note, since starting the Prometrium on July 14th, OTC medication seems to be more effective in reducing pain.
2. If her chronic headaches are related to a rise in estrogen late in the day, would it make sense to take the Prometrium mid-day instead of at bedtime?
3. What would you look for as a signal to increase her dose to 200mg? From your book, I understand that it may take three months for ovarian follicles to travel. Could more progesterone benefit her?
4. We are concerned about the risk of migraine with the drop in progesterone when stopped after 14 days. I’m not sure how to avoid the “migraine window” when we don’t know when her cycle will happen. Any thoughts?
5. If we increase to 200 mg, would it make sense to take 100 mg twice daily? Or possibly only take additional progesterone on certain days during cycle?

She has had two cycles with minimal bleeding in the past year – once after several months of acupuncture and Chinese herbs and once after a couple of months of maca root supplementation. Both of those treatments increased her head pain – possibly due to hormonal impact – so we discontinued them. We are hopeful that answers to some of the questions above will help in mitigating any negative head pain impact with the progesterone.

Thank you for any thoughts you can share. I completely understand that you cannot diagnose or treat. Luckily, we have a doctor who is willing to prescribe Prometrium and I believe she will be interested in your expert opinion.

Prior to last August and the birth control disaster, my daughter was an active, strong young woman. Due to headaches, fatigue, brain fog, and general weakness, she has been unable to continue her studies or work. It’s been a very hard year but we are hopeful that the progesterone will begin to turn things around.

If you think her situation would make a good case study, please let me know. We have numerous test results we can share along with details about the bad birth control experience that started this nightmare.

Thanks for all you are doing to help women.