Hormones are one of the four pillars because estrogen, progesterone, testosterone and stress hormones all influence the migraine brain ^1,2,3.

Why test?

Symptoms alone do not tell the whole story. Two people with menstrual migraine might have very different hormone patterns: one with a steep estrogen drop, another with stress hormones out of rhythm, another with differences in how estrogen is broken down. Testing helps make treatment specific.

What testing can include

Depending on your history, Dr. Harcourt may recommend a hormone profile that looks at:

• Sex hormones: estrogen, progesterone, testosterone and DHEA
• Estrogen metabolism: how the body breaks down and clears estrogen
• Stress hormones: cortisol and its daily rhythm, reflecting the HPA axis ⁴

Harcourt Brain Center confirms whether you are currently taking any hormones before testing, since that affects results.

What support can look like

• Lifestyle: stress management, sleep regularity and blood sugar balance, all of which affect hormone signaling ^4,3
• Nutrition and targeted supplements based on results
• Cycle-based planning for menstrual migraine, such as vitamin E around the period ⁵ and treatment timed with your prescriber
• Coordination with your physician for any hormonal medications, contraception or hormone therapy ^6,7

Life stages

Needs change through puberty, pregnancy, perimenopause and menopause ^8,9. See Pregnancy, perimenopause and menopause.

Men too

Hormone evaluation is not just for women. See Hormones in men with migraine.

Research cited on this page

1. Borsook D, Erpelding N, Lebel A, et al. Sex and the migraine brain. Neurobiol Dis. 2014;68:200-14. PubMed 24662368 · DOI
2. Chai NC, Peterlin BL, Calhoun AH. Migraine and estrogen. Curr Opin Neurol. 2014;27(3):315-24. PubMed 24792340 · DOI
3. Li W, Diao X, Chen C, et al. Changes in hormones of the hypothalamic-pituitary-gonadal axis in migraine patients. J Clin Neurosci. 2018;50:165-171. PubMed 29366620 · DOI
4. Guilliams TG. The Role of Stress and the HPA Axis in Chronic Disease Management. Point Institute. 2015. Source
5. Shaik MM, Gan SH. Vitamin supplementation as possible prophylactic treatment against migraine with aura and menstrual migraine. Biomed Res Int. 2015;2015:469529. PubMed 25815319 · DOI
6. Sacco S, Merki-Feld GS, Ægidius KL, et al. Effect of exogenous estrogens and progestogens on the course of migraine during reproductive age: a consensus statement by the European Headache Federation (EHF) and the European Society of Contraception and Reproductive Health (ESCRH). J Headache Pain. 2018;19(1):76. PubMed 30171365 · DOI
7. MacGregor EA. Migraine, menopause and hormone replacement therapy. Post Reprod Health. 2018;24(1):11-18. PubMed 28994639 · DOI
8. Faubion SS, Batur P, Calhoun AH. Migraine Throughout the Female Reproductive Life Cycle. Mayo Clin Proc. 2018;93(5):639-645. PubMed 29728203 · DOI
9. Ripa P, Ornello R, Degan D, et al. Migraine in menopausal women: a systematic review. Int J Womens Health. 2015;7:773-82. PubMed 26316824 · DOI