Hormone shifts can turn mild headaches into disabling migraines—or make old patterns flare again. We identify your triggers, stabilize drivers, and build a prevention‑focused plan that actually works in real life.
Estrogen fluctuations sensitize the trigemino‑vascular system and alter pain thresholds. Poor sleep, vasomotor surges, dehydration, skipped meals, and caffeine swings amplify attacks. Stabilizing hormones and routines reduces the brain’s “over‑react” signal.
We distinguish migraine (± aura) from tension‑type or cervicogenic headache. Your plan is built around the true pattern, not generic advice.
For eligible women, continuous transdermal estradiol (with progesterone if uterus present) can reduce perimenopausal migraine swings. We avoid oral estrogen in women with aura and tailor risk‑benefit to your history.
We screen for new neurological deficits, thunderclap onset, fever/neck stiffness, and other urgent signs—coordinating imaging or referral when warranted.
We chart frequency, duration, triggers, aura, meds, and sleep to identify patterns. A simple 2‑week log often reveals actionable levers.
Right‑sized acute meds, prevention strategy, sleep/vasomotor control, hydration and nutrition steps, and posture/neck care as needed.
Follow‑ups refine dosing, timing, and routines until attacks are rare and recovery is fast.
We avoid oral estrogen in migraine with aura due to clot/stroke risk considerations. Transdermal estradiol uses lower, steadier doses and is often preferred if HRT is indicated. We individualize to your risks.
Magnesium (often 200–400 mg glycinate at night), riboflavin (400 mg/day), and CoQ10 (100–300 mg/day) have supportive evidence for prevention. We tailor dosing and check interactions.
A newer class of migraine medicines (CGRP receptor antagonists) used for acute treatment and, in some cases, prevention. They don’t cause medication‑overuse headache and are useful when triptans aren’t tolerated.
Thunderclap headaches, new neurological symptoms (weakness, vision or speech changes), fever with neck stiffness, or a dramatic change in your pattern need urgent evaluation.
Educational content only; not a substitute for personal medical advice. For thunderclap headache, new weakness/numbness, high fever, or confusion, seek emergency care.
