Ep 199 The Hormone-Migraine Link: Breaking the Cycle

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This episode dives into the complex relationship between migraines and hormonal changes, particularly focusing on estrogen. The discussion covers the prevalence of migraines, the distinction between migraines with and without aura, and the significant impact of reproductive hormones on migraine patterns, especially in women. Key topics include the discovery of the estrogen threshold, the influence of estrogen on neurotransmitter systems like serotonin and glutamate, and the potential of hormone-based treatments. The episode also examines the role of the trigeminal vascular system, calcitonin gene-related peptide (CGRP), and the impact of oral contraceptives on migraine frequency and intensity. Practical strategies for managing menstrual migraines and the importance of using headache diaries for accurate diagnosis are highlighted.

00:00 Introduction to Migraines
00:20 Types of Migraines and Auras
00:42 Sex Differences in Migraine Prevalence
00:59 Hormonal Influence on Migraines
01:53 Estrogen's Role in Menstrual Migraines
02:05 Historical Breakthroughs in Migraine Research
02:35 Estrogen Threshold and Migraine Triggers
04:10 Estrogen's Impact on Brain Function
07:29 Neurotransmitters and Migraine Pathways
11:15 Oxytocin and Migraine Prevention
13:20 Trigeminal Vascular System and Migraines
16:46 Calcitonin Gene-Related Peptide and Inflammation
20:38 Oral Contraceptives and Migraine Management
24:59 The Importance of Headache Diaries
26:45 Conclusion and Future Research

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When I started this podcast and YouTube Channel—and the book that came before it—I had my patients in mind. Office visits are short, but understanding complex, often misunderstood conditions like fibromyalgia takes time. That’s why I created this space: to offer education, validation, and hope. If you’ve been told fibromyalgia “isn’t real” or that it’s “all in your head,” know this—I see you. I believe you. This podcast aims to affirm your experience and explain the science behind it. Whether you live with fibromyalgia, care for someone who does, or are a healthcare professional looking to better support patients, you’ll find trusted, evidence-based insights here, drawn from my 29+ years as an MD.

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