Can hormonal imbalances cause migraines?

Erica Digap, Maurice Beer M.D.
March 23rd, 2022 · 4 min read
Medically Verified
Suffering from migraines is usually a lot worse than just dealing with a bad headache. Migraines often come with debilitating symptoms like throbbing pain, nausea, vomiting, light sensitivity, and more that can leave you incapacitated and wanting to hide from the world for hours or even days.
Migraine susceptibility is often hereditary, passed down genetically through families. But while you can’t control your genetics, research is also showing that your hormone levels can also trigger migraines, and that knowing where your hormone levels could be a powerful tool for stopping those painful attacks before they start. Here’s what we know about how hormones can contribute to migraines, and what you can do to take control. 

Worried about your hormones?

Take our quiz to build a bespoke testing plan that will help you identify hormonal imbalances and improve your health.


What hormones can contribute to migraines? 


Stressful situations are often major triggers for migraines, and some researchers believe that this could be due to cortisol, one of your “stress hormones” that helps your body respond to dangerous situations.  One of cortisol’s jobs is to reduce pain, so there’s interest in how the spiking and then decreasing levels of cortisol during stressful moments can trigger a migraine, especially after the acute stress has passed. There’s evidence that people who suffer from migraines are often likely to develop one in the hours and subsequent days after dealing with something particularly stressful. These types of migraines are sometimes referred to as “let-down headaches.”


Your thyroid is a gland that’s responsible for producing several hormones important for your metabolism and cell energy. These hormones could also be playing a role in migraines, though researchers are still working to understand the exact relationship between the two. What we do know is that people with hypothyroidism, a condition where your thyroid is underproducing its important metabolism-dictating hormones, often experience headaches as a symptom. Similarly, people who frequently experience migraines and other headaches seem to be at an increased risk of developing hypothyroidism down the line. The good news? A study on people with hypothyroidism and migraines found that those who received thyroid hormone medication saw a decrease of almost 78% in headache frequency!


Low testosterone levels could also be a migraine trigger. Testosterone is the primary sex hormone in people assigned male at birth, but everyone has it in varying levels.
One small study found that men who experienced chronic migraines had significantly lower testosterone levels when compared with other men of a similar age. In another study, researchers found that testosterone implants helped significantly alleviate migraine pain in women! This suggests that finding safe ways to increase your testosterone levels is a promising solution for all kinds of people suffering from migraines.


Insulin has a very important job: it’s responsible for shuttling glucose (aka sugar) into your cells to be used for energy. As such, this hormone is a hugely important part of your metabolism, blood sugar, and how your body uses energy. But unfortunately, your body can lose sensitivity to insulin, leading to high blood sugar, weight gain, and other metabolic consequences. These instances of insulin resistance are thought to contribute to those debilitating migraines, with a couple of studies finding that insulin resistance is common among people who suffer from migraines.

The connection between estrogen and migraines

Migraines are three times more common in women than in men, and this is likely due to the various hormonal changes women have to deal with throughout their life. Estrogen, a female sex hormone, is especially implicated here: severe drops in estrogen levels have long been associated with headaches and migraines. Unfortunately, there are several times that women may experience these severe estrogen changes.

Migraines during menstruation

If you find that your migraines always coincide with your menstrual cycle, there’s a good chance that fluctuating estrogen levels is to blame. Right before your period begins, your estrogen levels drop significantly, as does another female hormone, progesterone. This could be the reason that your PMS symptoms come with a whopping menstrual migraine.
On a related note, some people with periods find that taking hormonal contraception like birth control pills helps alleviate these estrogen-related migraines, while others find that the “placebo week” with no hormones makes their migraines worse.  

Migraines during menopause

By definition, menopause is a time where estrogen levels fluctuate dramatically and eventually decline. This hormonal roller coaster can trigger migraines, especially during perimenopause, the period before menopause in which your estrogen and progesterone levels can get especially unpredictable.
The good news is that many women report their migraines reduce in frequency once their estrogen levels bottom out and stabilize in true menopause (officially, after twelve consecutive months with no period). 

Getting to the root of your migraines

Keeping track of your migraine triggers is a great first step for discovering the root causes of your migraines. It’s also an excellent way to start making an action plan to avoid them altogether. Are your migraines following certain foods? Stressful days at work? Your menstrual cycle? Writing these down will help you decipher where your headaches are coming from and what to avoid moving forward.
If you suspect that your imbalanced hormones are part of the problem, at-home hormone and diet testing is an excellent tool for getting real data on what’s going on inside of your body. Base offers a couple of different tests that can guide you in the right direction to getting to the bottom of your migraines:
  • This Base test measures estradiol (a type of estrogen) progesterone, testosterone, and cortisol
  • This Base test measures thyroid hormones, blood sugar biomarkers, as well as any potential nutrition deficits
There are several options for dealing with the pain of migraines, ranging from over-the-counter pain relievers to prescribed migraine medications. But if you’re able to figure out that your migraines are stemming from your hormones, you can take it one step further and address your migraines at their root!
For instance, if a test reveals that you have cortisol-related migraines, you might benefit from finding ways to relax — truly relax. Gentle exercise, meditation, and getting enough sleep are all proven ways to naturally improve your cortisol levels. Making dietary changes like limiting caffeine intake may also be recommended based on your own personal levels.
Take testosterone-related migraines as another example. While everyone starts seeing decreasing testosterone levels over time, improving your diet and exercising frequently are both effective for giving yourself a moderate boost. Testosterone-replacement therapy (TRT) might be an option, but it should be managed under the supervision of a medical professional.
With estrogen-related migraines, low-estrogen and/or continuous birth control could help stabilize your estrogen levels. In the case of menopausal migraines, some women might also benefit from hormone replacement therapy. If these are paths you want to explore, speak to your doctor here to determine your best option.

Worried about your hormones?

Take our quiz to build a bespoke testing plan that will help you identify hormonal imbalances and improve your health.

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