While the stupidity of perimenopause continues to thwart me, I do want to tell you a bit of a happy tale about how I'm managing the migraines. (Isn't it an irony that I've worked my ass off to mitigate their effects, only to discover a whole new batch of things which, worry not, I will not bore you with today.)
At any rate, it's taken me a good long time to feel as if I've got some semblance of a method that works. And, I'm not getting cocky! I don't have to tell ya'll that migraines are complex. Hormones are complex. People, with their individual biochemistries are complex. But last year, or the year before, I sure would have liked to have stumbled on a blog post that posited some practical approaches which actually worked on a real, live human being. So here's my method.
Managing Hormonally-Triggered Migraines
1. Do a ridiculous amount of yoga (specifically an Iyengar practice for endocrine balance):
I've referenced my yoga practice (and my new head stander which, let me tell you, has improved the quality of my life so dramatically, it's almost bizarre). No doubt, near-daily practice of supported backbends, followed by inversions, followed by forward bends is having an exceptional impact. It's also taking a remarkable amount of time but it's justifiable.
It's interesting to note that all of the yoga practices for migraine management, that I've been able to source, take a similar (endocrine-based) approach, implying (as does current medical theory) that migraines and neurotransmitters, many of which are hormones, are closely allied.
If you do yoga on a regular basis, and you struggle with migraines, this info (with which I am in no way affiliated) might also be of use.
2. Get Yourself A Good Team - And Work with a Baseline
Big props go to my naturopath, with whom I've been working (in addition to my GP and my gynecologist and my cardiologist) to intersperse a variety of approaches. What I will say is that these headaches are fuckers. They've managed to get around intense acupuncture and to defy drugs (which I can't take due to an arrhythmia). But my naturopath, with the benefit of the results of a three-part hormone-panel I took in the summer, was able to determine clearly that my issue is hormonal but it isn't all about progesterone imbalance. (Oh no, peeps, that was so three years ago.) It's the precipitous drop in estrogen, which seems to crash now whenever it feels like it, that is causing my difficulties these days. This is why the formerly knowable headache pattern has become increasingly erratic. And lengthier.
Hilariously, given the incorrigibility of these headaches, my naturopath would generally recommend a low-dose birth control pill (not that she's a BCP pusher by any stretch!) But, because some of my migraines are preceded by an aura, that puts me at a slightly statistically higher risk of stroke on the Pill. Furthermore, while my mother's cancer was not hormonally-receptive, no one's psyched to put me on a strong bunch of hormones at this point. Including me.
And yet, to some extent, one has to fight fire with fire - which is to say, to balance reproductive hormones - the only trick left in my particular arsenal re: headache management - I have to use something that my hormones will respond to. Sure, yoga (and walking and sleep and eating well) are key for endocrine balance, but they're only part of the story...
3. Supplement, Supplement, Supplement (in accordance with your baseline and your health history, natch)
As compelling as it may be (and it may), this is not the time to go willy-nilly with whack supplements you read about online.
I've opted for a (carefully-monitored) cocktail of:
- a phytoestrogen made from rhubarb (a gentle form of hormone mimicry),
- a hormonal precursor (which is upcycled by the body in whatever form is most required)
- a supplement designed to help my body to metabolize excess estrogen
- diindolymethane, also known to promote metabolism of estrogen, specifically for women who may be at a risk of cancer
- Headaches are far less extreme and occur less frequently. I still get them, but they are manageable with an Advil gel caps/sleep/yoga. Noise and light sensitivity are diminished.
- Night sweats are drastically reduced.
- The mushball stomach thing is noticeably abated. Tone has returned to my upper abdomen, if only around the edges so far.
- I have some energy. Sometimes, it's almost like the pre-pertussis days!
I sense it's going to be a while.