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Individuals with PCOS are up to 1.5x as likely to experience migraines than those without the condition.[1]  In this article we explore the link between PCOS and migraines.


Migraines can last for up to 72 hours and present with debilitating one-sided head pain and a range of other symptoms including fatigue, upset stomach, changes to vision (including “floaters” and dark spots)[2] and mood changes.[3] 


The exact cause of migraine is currently unknown[4] but a link has been established between the aura phase which precedes the headache and calcitonin gene-related peptide (CGRP), a protein in the brain and nervous system involved in the transmission of pain.[5]  CGRP levels have been shown to be elevated in patients during migraine attacks[6] and medications that inhibit CGRP have been brought to market to treat migraine.[7]


Whilst the specific linkage between PCOS and migraines has not been established,[8] there is a clear link between migraines and hormones.  Women are, in general, 3x as likely to experience migraines than men.[9],[10]  Migraines often occur just before or during menstruation[11] with 1 in 3 women stating that migraines coincide with their periods.[12]


Migraine incidence is linked to hormonal changes in a number of ways:

  • Luteal phase/menstruation: migraines are commonly thought to occur at this phase of menstruation due to the drop in estrogen levels[13] with estrogen believed to suppress the activity of CGRP and similar chemicals that induce migraines;[14]

  • Hormonal medications: taking oral contraceptives or hormone replacement therapy (HRT) may trigger migraines or, in some cases, reduce the severity by reducing the drop in estrogen;[15],[16]

  • Puberty: until puberty, migraines affect boys and girls equally but after the onset of puberty, there is an increasing prevalence in girls;[17]

  • Pregnancy: migraines may worsen in the first few weeks of pregnancy as estrogen levels increase rapidly but improve during the second and third trimesters;[18],[19]

  • Perimenopause: migraines may become more frequent and severe with fluctuating hormones leading up to menopause;[20]

  • Menopause: menopause is associated with increased prevalence of migraines[21] whilst some people no longer experience migraines after menopause (although tension type headaches tend to increase).[22]


Non-hormonal triggers for the onset of a migraine can include:[23],[24]

  • Exposure to stress;

  • Use of certain medications, including overuse of medications used to treat migraines;

  • Changes in sleep, including jet lag and too much / too little sleep;

  • Changes in weather conditions, including pressure changes;

  • Overexertion or too much physical activity;

  • Consumption of caffeine, tobacco or alcohol;

  • Consumption of foods containing tyramine[25],[26], including aged cheese, cured meats, alcohol, fermented foods, pickles, sourdough bread and some fruits and vegetables;[27]

  • Consumption of foods containing nitrates, including hot dogs, ham and bacon;[28]

  • Consumption of foods containing monosodium glutamate (MSG), sometimes listed as “all-natural preservative” or “hydrolyzed protein” on packaged foods and naturally occurring in some foods such as potatoes, peas, tomatoes, mushrooms, grapes and some cheese;[29]

  • Missing a meal or dehydration;[30] and

  • Exposure to bright lights, loud noises or strong odors.


Risk factors for migraines include:[31]

  • Genetics: up to 80% of people with migraines have an immediate family member with the condition;

  • Gender: with women experiencing migraines up to 3x more commonly than men; and

  • Other underlying health conditions: including depression, anxiety, sleep disorders and epilepsy.


Some underlying health conditions, including sleep apnea, absence of periods (amenorrhea) and vascular disease, are more likely to occur in individuals with PCOS so may also contribute to the increased prevalence.[32]


Reviewed by Sonia Kalra, CEO of NatureMary, biologist and advocate for women’s health

PARTNER SPOTLIGHT

Welcome to Naturemary, where we're pioneering natural solutions for bodycare & pain relief.  Our founder Sonia's expertise in Biology & Neuroscience, coupled with her personal struggle with PMDD, inspired her to pioneer effective natural solutions.  Harness the power of nature with Bioterpene™ Technology, a cutting-edge innovation in pain relief and body care. Bioterpene™ Technology is designed to provide fast-acting and targeted relief for skin and body.


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Samphire Neuroscience is a medical technology company focused on neurotechnology-based solutions for women's health.  Their product Nettle is the first medical-grade solution to address both cognitive and physical symptoms associated with PMS and menstrual pain, and recently got cleared as a class 2a CE-marked medical device in Europe and the UK.  A limited number of devices are launching in the UK on June 25th, and you can use the code INNERCIRCLE to get a 10% discount.


Sources
[1] https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.14382
[2] https://www.eyephysicians.com/blog/2018/11/05/flashes-and-floaters-caused-194741
[3] https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches
[4] https://www.who.int/news-room/fact-sheets/detail/headache-disorders#:~:text=The%20exact%20cause%20of%20migraine,and%20is%20often%20life%2Dlong
[5] https://headaches.org/cgrp-need-know/
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050542/
[7] https://www.webmd.com/migraines-headaches/cgrp-inhibitors-for-migraine
[8] https://www.medicalnewstoday.com/articles/pcos-and-migraine-link-treatment-and-birth-control#impact-of-hormones
[9] https://www.medscape.com/viewarticle/migraine-really-female-disorder-2023a1000v35
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311830/
[11] https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729
[12] https://www.usnews.com/news/health-news/articles/2024-04-15/one-in-3-women-with-migraines-say-attacks-occur-during-periods?mc_cid=dd1c2efcef&mc_eid=46368009b9
[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948327/
[14] https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-023-01664-4
[15] https://www.advil.ca/resources/migraine/triggers-and-causes/
[16] https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729
[17] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311830/
[18] https://www.nhs.uk/conditions/hormone-headaches/
[19] https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729
[20] https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729
[21] https://www.medscape.com/viewarticle/migraine-really-female-disorder-2023a1000v35
[22] https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/in-depth/headaches/art-20046729
[23] https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches#symptoms-and-causes
[24] https://www.webmd.com/migraines-headaches/migraines-causes
[25] https://www.webmd.com/migraines-headaches/tyramine-and-migraines
[26] https://www.advil.ca/resources/migraine/triggers-and-causes/
[27] https://www.advil.ca/resources/migraine/triggers-and-causes/
[28] https://www.advil.ca/resources/migraine/triggers-and-causes/
[29] https://www.advil.ca/resources/migraine/triggers-and-causes/
[30] https://www.webmd.com/migraines-headaches/migraine-dehydration-lin
[31] https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches#symptoms-and-causes
[32] https://pubmed.ncbi.nlm.nih.gov/34651295/

Want to learn more about neurological conditions associated with PCOS? Check out the sections on ADHD, autism and dementia.

Complications - Neurological

PCOS and Migraine

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