When HRT Doesn’t Stop the pain

It can feel impossible to pinpoint your migraine triggers in the midst of hormones and busy schedules.

Juggling the responsibilities of motherhood and dealing with severe headaches can feel downright overwhelming.

Hormones like estrogen and progesterone are central to our menstrual cycle and pregnancy, but their effects don’t end there.

They also play a role in inflammation. When this is chronic, it is often the root of migraine headaches.

Keeping estrogen levels steady can help keep your headaches at bay, but any dips or spikes are bound to make things worse - especially as you enter the sensitive hormonal periods of perimenopause or postmenopause.

If this is you, you're not powerless. In fact, you have the ability to influence how these hormonal changes affect you.

You can significantly reduce the frequency and severity of migraines during your cycle when you can understand and manage your hormonal fluctuations.

Many doctors recommend hormone replacement therapy (HRT) or bioidentical hormone replacement therapy (BHRT) for women experiencing hormone-related symptoms.

Today, we’re talking about what it is and why it’s not the silver bullet for everyone.

Why Your Menstrual Cycle Triggers Migraines

Around half of women with migraines say their menstrual cycle directly affects their head pain, and it’s been this way since they had their first period as a teen.

The menstrual cycle as a whole, not just your period, is associated with biological changes in your body. Studies suggest that migraine attacks can be triggered by a drop in estrogen levels, which is what happens just before your period starts.

When the pain hits, many women turn to common treatments such as ice, heat, relaxation, physical exercise, acupuncture, OTC pain relievers, and prescription pain medication.

When The Remedies Don’t Work

If symptoms persist or get worse, doctors may suggest HRT or BHRT.

This is highly common for women who are experiencing perimenopause or postmenopause and have symptoms like hot flashes and night sweats that accompany their migraines.

Why HRT May Not Be The Solution

HRT is not a magic bullet and can affect migraines in different ways for different people:

HRT may temporarily help reduce the likelihood of migraines by controlling migraine-triggering menopause symptoms such as hot flashes and night sweats.
HRT can make migraines worse in some people, especially if it's started early in perimenopause when estrogen levels fluctuate.
HRT may have no effect and may not provide migraine relief.

The Risks with HRT

There are many options for women to consider before starting HRT.

Studies show that taking hormone replacement therapies can increase a woman’s risk for several serious diseases, including:

Lung and colon cancer
Heart disease
Stroke
Blood clots
Urinary incontinence
Dementia and memory loss

The Women’s Health Initiative Hormone Program* found that women on estrogen replacement drugs were more likely to develop breast cancer compared to women taking no hormone therapy medications at all.

The use of estrogen plus progestin doubles the risk of developing dementia among postmenopausal women aged 65 and older.

Hormone therapy or estrogen alone has been shown to significantly increase the risk of stroke, blood clots, and heart attack while taking medications.

BHRT: The Not-So-Safe Alternative

Many women turn to BHRT when they hear about the HRT risks because they believe it is a safer option for them.

Bioidentical hormones are considered “natural” because the hormones used are chemically identical (according to molecular studies) to those produced by the human body.

BHRT aims to increase or balance specific hormones, including estrogen (in the form of estrone or estradiol), and progesterone. This can sometimes also include testosterone, dehydroepiandrosterone (DHEA) and adrenal hormones.

The FDA states that it’s “concerned that BHRT claims mislead women and health care professionals, giving them a false sense of assurance about using potentially dangerous hormone products … ‘BHRT’ is a marketing term not recognized by the FDA, and the FDA is taking action against pharmacies that make false and misleading claims about BHRT drugs.”

Whether you put stock in what the FDA says or not, we’ve lost sight of the main issue…why is your estrogen off to begin with?

HRT and BHRT Are Band-Aid Solutions

HRT and BHRT are just management tools. They will not uncover the root of your estrogen imbalance, nor will they help you fix the problem.

They actually cover up the issue, so you can ignore it, leading to potential issues down the road.

Think about what happens when you put duct tape over your check engine light. You might not be able to see the warning reminding you of the problem, but it's still there.

The real question is. . . what is causing the problem?

Why Is Your Estrogen Off?

Too much estrogen can be caused by stress, alcohol, sugar, flour, starches, exposure to some plastics, lack of sleep, and lack of exercise.

Too little estrogen can be caused by some medications, eating disorders, autoimmune diseases, excessive exercise, and substance use disorders.

So, What Do You Do About It?

You can control the balance and creation of hormones, even if you are in peri or post-menopause. It’s entirely possible to clean them up so you can continue to stay balanced and feel great.

As you transition to peri and post menopause, your estrogen levels will fluctuate, but there are still steps you can take to feel great and be healthy, too.

Estrogen and Your Liver

It’s important to keep in mind that your liver plays a role in the regulation, removal, and maintenance of hormonal balance.

When the body has an excess of hormones, either naturally or through hormone replacement therapy (HRT/BHRT), the liver may have trouble processing them quickly enough.

This can lead to an imbalance that causes liver disruption and other health issues if the excess hormones aren't eliminated.

Estrogen is the primary hormone the liver regulates.

When the liver isn't functioning properly, estrogen can be reabsorbed into the body through the digestive system. This quickly leads to a buildup that can cause estrogen dominance.

This can be especially problematic for women going through perimenopause and can cause symptoms like heavy, painful periods, painful breasts, bloating, and migraines.

Before You Reach For Hormone Replacement Therapy

Before you decide if HRT or BHRT is right for you, take a good look at how you are living and how it may be affecting your hormones.

Can you make changes to your lifestyle and environment?

Can you reevaluate the medications you take?

This can help you discover potential shifts before adding HRT or BHRT to your plate.

Making Lifestyle Choices For Positive Impact

Every choice we make has consequences on our health, whether they are negative or positive.

Here are a few changes you can begin taking today:

Ride your bike versus taking the bus.
Cook dinner versus eating take-out.
Read a book versus watching TV.
Have some water instead of wine.
Enjoy an apple instead of a cookie.
Store your food in glass containers versus plastic.
Evaluate your medication use with your doctor.

These are just a few of the daily choices you can make that add up to big results.

If All Else Fails and Your Migraines Won’t Budge…

You may consider researching HRT or BHRT and discussing it with your doctor.

I only recommend this after addressing and tweaking the 6 key areas we cover in the Migraine Freedom Protocol.

HRT, like any other medication or supplement, should be approached with informed carefulness. Once the underlying issue has been effectively identified and treated, it's important to develop a strategy of discontinuation.

And remember - individual responses vary greatly.

If the idea of HRT or BHRT weighs you down and you want a different path to hormone balance and migraine relief, I'm here to help.

Send me a DM! Together, we'll take a close look at your migraine experience and explore immediate actionable steps to help restore balance and find your migraine freedom.

*Program sponsored by the National Heart, Lung, and Blood Institute, the National Cancer Institute and parts of the National Institutes of Health.

ABOUT THE AUTHOR

Debbie Waidl is the Owner of In The Balance Health Coaching LLC, and Founder of The Freedom From Migraines Method™ & The Migraine Freedom Protocol™
She supports busy moms living with Migraines.

Debbie will uncover what is holding them back from migraine freedom so they can live their life pain and symptom free, work productively, spend the time they want with family and friends, and stop missing out on the things they enjoy.

A message from Debbie:
"I was once right where you are now. 100% believing there was NO WAY to end migraines and my only option was to learn how to live with them or find that magic pill that maybe would work for a while. If anyone told me back then that I could end my pain once and for all, I would have called BS and popped another pill!

Skeptical times 10 was my middle name for sure because when you try it all and everyone tells you they can help you and they don’t. You stop believing… you lose HOPE!

I now realize I was approaching my migraines all backward.

I was trying to cover up symptoms versus trying to end my pain."

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