Trying to explain a migraine to someone who’s never had one is like describing a storm to someone who’s only ever known sunshine. It’s impossible to fully grasp until you’ve been caught in it yourself. The pain can be blinding, pulsing, and deeply disruptive—yet remains invisible to the outside world. This invisibility is what makes it so difficult to articulate, and all too easy for others to dismiss. 

A study published in the Women’s Midlife Health Journal indicates that women are three times more likely to experience migraines than men, making it the fourth most prevalent cause of disability among women. Several sexual hormones can trigger migraines, particularly in women. The primary hormones involved include: 

• Estrogen: Shifting estrogen levels—like those during menstruation, pregnancy, or menopause—are a common migraine trigger. Many women notice migraines just before or during their period, when estrogen drops.

• Progesterone: Changes in progesterone, especially during the luteal phase when levels rise, may also play a role in triggering migraines.

• Testosterone: Though less common, testosterone fluctuations can affect migraines too. Conditions like PCOS, which involve higher testosterone levels, may increase migraine frequency.

Being informed is an act of self-care that helps you understand your body and empowers you to take action. In this article, you’ll learn about migraines: the science behind them, their impact on women, and strategies for prevention.

What is a migraine?

Migraines are a complex neurological condition influenced by both genetics and external triggers. They affect 15-20% of the population and have a significant socioeconomic impact due to lost productivity and healthcare costs. 

Up to 80% of individuals with migraines have a first-degree biological relative who suffers from the condition; however, migraines can develop due to environmental, hormonal, or lifestyle factors as well.

Unlike conditions that show up clearly on brain scans, migraines behave more like a software glitch than a hardware issue—your brain’s structure may look normal, but its signaling system is out of sync. The exact cause is still being studied, but research suggests that predisposed individuals (i.e.; those with migraine-related genetic markers) typically possess a lower threshold for migraine triggers, making them more susceptible to attacks. It’s important to note that these triggers don’t directly cause migraines, in the same way that bacteria causes an infection. Triggers act like a catalyst that can provoke an attack and result in symptoms.

Common triggers include:

• Stress that affects mental state and overall well-being
• Hormonal changes
• Too little or too much sleep
• Skipped meals
• Excess physical stress on the body 
• Sudden changes in weather or environment (barometric pressure changes)
• Exposure to sensory stimuli like bright lights, loud noises or strong odours
• Certain medications

Migraines often unfold in a series of stages, each with its own set of symptoms. The migraine cycle is helpful for understanding patterns, but individuals may not always experience the full four stages. This list highlights the most well-reported symptoms for each phase:

• Postdrome stage (up to 48 hours): Fatigue, brain fog, neck stiffnesse to irritation, inflammation, and pain, resulting in countless vaginal and urinary symptoms.

• Prodrome stage (hours to days before): Sleep disturbances, mood changes, difficulty concentrating

• Aura stage (in some people, 5–60 minutes prior): Visual disturbances, tingling, weakness, ringing in the ears, speech difficulty

• Attack stage (4 to 72 hours): Throbbing pain (often one-sided), nausea, vomiting, light/sound/smell sensitivity, sometimes facial, neck, or jaw pain

How migraines can change through a woman’s life

About 75% of people with migraines are women—a difference attributed largely to hormonal fluctuations, particularly estrogen withdrawal. Migraine patterns often shift across reproductive life stages:

Before puberty: 

• Prevalence appears similar between boys and girls; hormones have not yet emerged as a factor.

Menarche (woman’s first period) through childbearing years: 

• Menstrual migraines are linked to the drop in estrogen and progesterone before menstruation and can be more predictable due to the regularity of many women’s cycles.
• These migraines affect 50-70% of reproductive-age women and typically occur from 2 days before to 3 days after menstruation, but can occur at any point in the cycle.

During pregnancy: 

• Research suggests that pregnancy often—but not always—reduces the frequency and severity of migraine attacks, particularly in the second and third trimesters. This is likely due to steady estrogen levels during pregnancy, although the exact mechanisms remain unclear. However, migraine with aura may persist or even worsen in some cases.

During perimenopause: 

• Characterized by irregular cycles and fluctuating estrogen levels, this life phase may increase the frequency or severity of migraine attacks in some women. Other women may experience migraines for the first time (pure menstrual migraines), which affects 7-12% of reproductive age women.
• During this time, hormonal shifts are erratic, marked by sharp peaks and sudden drops. Due to these fluctuations, some studies suggest that high estrogen levels can trigger a migraine with visual disturbances (aura), while lower estrogen levels likely cause migraines without them. The hormonal unpredictability during perimenopause may make migraine attacks more difficult to manage for some women.
• In addition, perimenopausal symptoms—such as hot flashes, night sweats, and insomnia—can interfere with migraine triggers like sleep, potentially lowering your migraine threshold and increasing your vulnerability to attacks.

At menopause: 

• Menopause is defined as the point in time when a woman has gone 12 consecutive months without a menstrual period, occurring on average at age 51. After this transition, estrogen levels tend to stabilize at a lower baseline, with fewer fluctuations.

Post-menopause:

• Many women report improvement in migraine symptoms after natural menopause. Estimates suggest that up to two-thirds of women may experience a reduction in migraine frequency or severity. However, migraines may continue in some women, particularly those with chronic migraines or those whose migraine history began in childhood or adolescence.

Note: Hormonal sensitivity is highly individual. If headaches are interfering with your life, consult a healthcare provider for personalized support.

Practical strategies to protect yourself

The menopausal transition can bring added stress, sleep disruption, and mood shifts—all of which can lower your migraine threshold. These symptoms can interact with migraines, intensifying their frequency and duration. For these reasons, preventative lifestyle adjustments can be very helpful. There isn’t a cure for migraines, but avoiding migraine triggers is a simple and powerful way to protect yourself: 

✓  Maximize your sleep quantity and quality. Individuals with migraine and poor sleep report lower quality of life, more mood disorders, lower socioeconomic status and higher stress.Try to keep your bedroom dark and cool, and use it primarily for sleep to help signal your brain it’s time to rest.

✓ Exercise with a goal of 30-60 minutes, 3-5 times per week. Start slowly and work your way up. Choose an activity you enjoy, and soon it will become a habit!

✓ Keep a migraine journal. Tracking when a migraine happened, how you felt, and how long it lasted can help you identify triggers and take the steps to avoid them. 

✓ Eat well-balanced meals and avoid skipping meals. There is no single “migraine diet,” however adequate hydration, limiting caffeine, and eating 3 full meals a day will set you up for success. There are many studies ongoing on this topic and most say that some people may find that eating less carbohydrates reduces migraines intensity, duration and even onset. It’s important to remember that not everyone responds to dietary changes in the same way. Some individuals may find low-carb or ketogenic diets helpful, while others may not experience significant benefits.

✓ Manage your stress (as best you can). Our lives can be incredibly hectic and your mood can be a very common trigger for migraines. The relationship is often bidirectional, meaning stress can trigger migraines, and the pain and disruption of migraines can also increase stress, creating a cyclical pattern.Try to incorporate relaxation techniques, mindfulness, or breathwork to calm down your nervous system.

The power of listening to your body.

Remember to always listen to your body and seek help when you feel something is not right. If lifestyle changes aren’t enough, your healthcare provider may recommend acute or preventive migraine medications, depending on your needs. Some medications help reduce migraine symptoms such as pain, nausea, or sensitivity to light and sound. Other medications may help prevent migraines by reducing how often and severe migraines affect you. If migraines are getting in the way of your daily life, don’t wait—talk to a healthcare provider. The right treatment can help you manage your symptoms and feel more in control.

Disclaimer: The information provided here is for informational purposes only. It is not intended as medical advice. Always consult with your doctor or healthcare provider to determine what is best for your individual health needs.

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