PCOS and Migraines: Ow! My Aching Head!
Is there a relationship between PCOS and migraine?
If you spend time in the large community of women that have migraines, a number of other health conditions are mentioned. One condition that frequently comes up is PCOS.
Reports vary, but it is estimated that somewhere between 37 million and 45 million Americans suffer from migraine and about 70% of those people are women. PCOS effects about 5-10% of women of reproductive age. There may or may not be a relationship between the two conditions, but there are certainly some important things to know to keep you feeling your best and being healthy. For many women, hormones clearly play a role in migraine, so having an endocrine disorder would certainly make the potential for migraine greater for anyone predisposed the condition.
What is migraine?
Migraine is a genetic, neurological disorder. The biochemistry of the brain of a person with migraine is different from that of a person without this lousy condition. Migraine is not just a bad headache and has a number of common symptoms that vary from person to person. In addition to moderate to severe pain, some of those symptoms are sensitivity to light and/or sound, neck pain, nausea and/or vomiting, dizziness, visual changes, facial pain, slurred speech and weakness. The neurological symptoms can last for a few hours or days and can be quite debilitating. Migraine is the 6th most disabling illness in the world. In the US, there are 1.2 million ER visits each year for acute attacks.
There are several theories about what happens during a migraine but the medical community doesn’t know for sure. The theories center on the migraineur having an especially “excitable” brain. For someone with this genetic tendency, there is a neurological malfunction when certain stimulation occurs and a wave of electrical current or a “brain storm” spreads through parts of the brain. This wave causes the release of neurotransmitters in certain parts of the brain. These chemicals become imbalanced and cause different symptoms. Migraine is thought of as a neurovascular event as it seems that a cascade of activity involving over-excited nerves, chemical imbalances and altered blood flow are responsible for the pain and long list of accompanying symptoms that so many of us experience.
Migraines and being overweight or obese
There is no evidence that being overweight causes migraines. Being overweight or obese is a significant risk factor for occasional or episodic migraines progressing to chronic migraines. Chronic migraine is defined as 15 or more days of migraine per month. Several medications for migraines cause weight gain for many people, so that is one possible explanation for the observed link between migraines and obesity, but there could also be other physiologic factors at play. If someone is overweight and has migraines, losing weight does not improve the condition but changing eating habits usually helps control the frequency and intensity of symptoms.
Common food triggers
If you are noticing that you are getting more frequent or more intense headaches or migraines, your diet is the first thing you can look at to help minimize your pain and other symptoms.
The most common food triggers are:
fermented/cultured products like Asian sauces, yogurt and sour cream
food additives like colorings, nitrates/nitrites, sulfites and mono-sodium glutamate (MSG).
That’s quite a list! Some of the foods listed may be a big surprise as we think of them as healthy and wholesome. Most of my clients come to me after they have tried eating “clean and healthy” but have had little or no success in getting significant relief.
Step 1 with all of my clients is understanding what foods and other environmental factors are contributing to them breaking through their unique symptom threshold. It’s very important to understand that food triggers can be quick and bring on pain within 30 minutes as well as delayed and subtle. Sometimes, pain or other symptoms start a day or two after the food is eaten. It is also important to understand that sometimes you may not feel any symptoms if you have smaller amounts of the triggering foods, but when you have larger amounts or eat them in combination with other triggers, you may bring on a big, bad head-banger.
What can you do if you have PCOS and migraines?
First, educate yourself! Since you have gotten this far in the blog, that is exactly what you are doing, so read on! Half of managing any chronic condition is getting the right healthcare team assembled and the other half is understanding what YOU can do. As you already know, there is no magic pill to “fix” your PCOS or migraine. Managing these conditions requires understanding of how to optimize your lifestyle to minimize your symptoms. Here is what I wish I knew and what I tell all of my many clients with migraine:
Step 1 – Keep a food record and note the weather, unusual stressors and day of your menstrual cycle. Weather, stress and hormonal fluctuations are common triggers. If your migraines are occasional (1-2 per month), when the migraine hits, write down everything you have eaten for the prior 48 hours. If they are more frequent or chronic (15 or more days of migraine days per month), keep a daily food record.
Step 2 – Refer to the list of common triggers listed above and note any patterns involving the common trigger foods, rain and/or your period.
Step 3 – If you are taking any prescribed medications for migraine or over-the-counter remedies like ibuprofen or Excedrin, be careful to limit yourself to only treating twice per week. If you are taking pain relievers for some other ailment, the pain reliever may be contributing to your migraine. One of the leading causes of occasional migraines progressing to chronic migraines is overuse of prescribed migraine medications and/or over-the-counter pain relievers. This should be shouted from the mountain-tops! Many doctors continue to prescribe these medications without warning their patients. This usually happens as they are trying to help but unaware of this common complication. When migraines become chronic, the condition becomes harder to reverse.
Step 4 – Consult a neurologist who specializes in headache medicine. There are many wonderful neurologists out there but you want the specialist who focuses solely on treating migraine rather than treating epilepsy, Alzheimers, dementia, etc.
Step 5– Read Heal Your Headache by Dr. David Buchholz. This is a must-read for people with frequent headaches and migraines. Dr. B knows his stuff and wants you to get better with minimized medication.
There is good evidence that certain nutrients are needed in greater amounts for people prone to migraines. Magnesium has been studied the most and is commonly given intravenously for severe migraine attacks. Most neurologists specializing in headache medicine routinely advise their patients to supplement with magnesium. The form of magnesium is very important as you want to take an easily absorbable form that doesn’t cause gastrointestinal cramping or diarrhea. So, skip the common magnesium oxide and choose magnesium glycinate, magnesium threonate or magnesium malate.
Coenzyme Q10 and riboflavin have also shown to be effective in reducing the frequency and intensity of migraines for those who take these supplements regularly. These supplements are considered helpful when taken regularly for several weeks and are not helpful for relief during a migraine attack.
When to seek professional nutrition or health coaching advice
If you have diligently worked through the above 5 steps and are not getting enough relief, your triggers may be trickier than the average person with PCOS and migraine. Migraine with PCOS is complex and can result in feelings of anxiety, hopelessness, isolation and frustration. There is relief for you. We can accomplish more with a team than on our own. Reach out for a registered dietitian with expertise in both migraine and PCOS and get your vitality back.
Danielle Aberman RDN CHWC CLT, has brought lasting relief to countless people suffering with migraines through her private practice and strong social media presence. Having chronic migraines herself plus extensive training in food and chemical sensitivities makes her uniquely skilled at implementing a personalized plan that helps people quickly get back to feeling like themselves again.
Danielle graduated with a Bachelor of Health Science in Clinical Nutrition from the University of Florida and is a Registered Dietitian Nutritionist and a Certified Health and Wellness Coach. She can be contacted through her website: http://migrainereliefcoach.com/