Polycystic Ovary Syndrome (PCOS) and Migraine

Polycystic ovary syndrome (PCOS) is a common hormonal disorder. It affects women of reproductive age. That is, after puberty but before menopause. PCOS may have a wide variety of symptoms.1

What are the symptoms of PCOS?

PCOS has 3 main symptoms. These are called the Rotterdam criteria. If you have any 2, your doctor will diagnose you with PCOS. They are:1

  • Hyperandrogenism: Women living with PCOS have higher levels of androgens, or male hormones. This can show up as acne or increased hair on the face or body.
  • Chronic anovulation: Hormone imbalances prevent the ovaries from releasing an egg every month. This can look like irregular periods.
  • Polycystic ovaries: Both ovaries have multiple cysts on them, as seen on ultrasound.
    Many women living with PCOS also report struggling with migraine. Studies show that migraine may be linked to PCOS.2

How can estrogen impact migraine?

While experts do not fully understand the connection, estrogen levels and migraine appear very connected.
Women are significantly more likely than men to experience migraine. Also, many women report that they experience the most migraine attacks during puberty and menopause. These are 2 times when estrogen levels are changing. Finally, many women report that they more often develop migraine during their menstrual cycle and that those migraine attacks are harder to control than others.3

When do women experience low estrogen levels?

What is similar about puberty, menopause, and the menstrual cycle? Lower than usual estrogen levels! Low estrogen levels at these times can trigger migraine in some women. Interestingly, puberty and menopause are usually times of low estrogen with occasional estrogen spikes.3

What can help these hormonally-triggered attacks?

Some studies have found that estrogen supplements could help these hormonal migraine attacks. But hormone therapy can have its own risks. It is important to speak to your gynecologist about your health history before starting any type of hormones.3

Unfortunately, low estrogen is not the only trigger of hormonal migraine. Rapid increases in estrogen can also trigger migraine. Estrogen also affects pain receptors in our body and can help us tolerate pain better. When estrogen levels fluctuate, migraine attacks may feel more painful.3,4

Is there a link between PCOS and migraine?

Many experts agree that there is a link between PCOS and migraine. But the link is not well understood. In PCOS, the levels of multiple hormones are abnormal. There is an increase in androgens. But there is also often an increase in estrogen.4

Hormone levels change through the day and throughout the month with the menstrual cycle. These hormones interact with each other and with the body in many ways. Changing hormone levels may be one of the reasons why migraine is more common in those living with PCOS.4

PCOS is also closely linked to obesity and insulin resistance. And both of those conditions are also linked with migraine. Experts still do not know why those living with PCOS may also develop migraine. The best understanding at this time is that they are linked by hormone fluctuations. More research must be done on this topic to understand it better.4

If you are struggling with migraine or believe you may have PCOS, ask your doctor or gynecologist for more information.

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