Migraine and hormones
Migraine and hormones are closely linked. We look at how changes in your hormone levels may have an impact on your migraine.
How hormones affect migraine
Migraine is often linked to changes (fluctuations) in hormone levels, particularly oestrogen. It’s one of the main reasons why migraine is so much more common in women than men. Why changes in oestrogen may impact migraine is not completely understood. But oestrogen seems to have a direct effect on pain pathways in your nervous system.
Anything that affects levels of oestrogen in your body may have an impact on migraine. This includes the menstrual cycle, pregnancy and the menopause. Taking medicines containing hormones can affect your migraine too. This includes the contraceptive pill and hormone replacement therapy (HRT). It may also include fertility treatments and hormone therapy for transgender people.
Below, we give a brief overview how each of these hormonal changes can influence migraine. We then direct you to where you can find further information on our website.
Periods and the menstrual cycle
It’s very common for migraine attacks to be linked to your periods (menstruation). This is thought to affect as many as two-thirds of women with migraine. Your oestrogen levels naturally fall in the days leading up to your period. This drop in oestrogen can make a migraine attack more likely.
If you have menstrual migraine, you will usually have migraine attacks at other times of the month too. If you only have migraine attacks around the time of your periods, it’s known as ‘pure’ menstrual migraine.
Keeping a diary for at least three months can help show you whether there is a link between your migraine attacks and your menstrual cycle.
We have more information about menstrual migraine and how to manage it.
Pregnancy
Migraine often improves during pregnancy, especially in the second and third trimesters. This is because levels of oestrogen and progesterone slowly rise during pregnancy. You don’t have the big changes in hormone levels that you would normally get during menstrual cycles.
This isn’t the same for everyone though. Some people find their migraine doesn’t change during pregnancy, or that it gets worse. This is more likely if you have migraine with aura.
Your migraine will usually return after you have given birth. This can happen within days, due to the sudden drop in oestrogen levels after birth. If you breastfeed, it can take longer for migraine attacks to return.
You can find out more on our Migraine in pregnancy page.
Menopause and hormone replacement therapy
Menopause is the stage of life when you stop having periods. As you approach menopause, rapid changes in your hormone levels can trigger migraine attacks. After menopause, your hormone levels start to settle down. You may find your migraine attacks become less severe and less frequent. This may not happen immediately – it can take a few years. Some people find their migraine doesn’t improve or gets worse after menopause.
Hormone replacement therapy (HRT) can help with symptoms of menopause. Some people find that it helps with their migraine too. Others find it makes their migraine worse. There are many different types of HRT. Your doctor can advise on which types are least likely to trigger migraine attacks.
We have more information about menopause and HRT on our Migraine and menopause page.
Contraception
Contraception that contains oestrogen can impact your migraine in different ways. The type of contraception you take and how you take it can make a difference. Taking the combined pill with a seven-day break can cause a sharp drop in oestrogen levels. This can trigger migraine attacks in some people. Having fewer or shorter pill-free breaks can avoid this.
Other forms of hormonal contraception such as the vaginal ring or patch are less likely to cause large changes in oestrogen levels.
You should not take any combined hormonal contraceptive if you have migraine with aura. This is because it can cause a small but significant increase in the risk of stroke.
We have further information on our Migraine and contraception page.
We also have information on Migraine and birth control for young people.
Other types of hormone therapy
Fertility treatments such as IVF (in vitro fertilisation) involve having hormone injections. This can increase your level of oestrogen. This may trigger or worsen migraine attacks for some women.
Trans women taking oestrogen may experience an increase in migraine attacks. Some may also start experiencing migraine with aura for the first time.
If you notice a change in your migraine when taking hormone therapy, speak to your doctor for advice.
About our information
This information has been written by The Migraine Trust Information and Support Services team. It has been reviewed by our panel of expert health professionals and people affected by migraine.
Our information has been awarded the PIF TICK quality mark for trustworthy health information.
If you have feedback on our information, please get in touch at: feedback@migrainetrust.org
References for our information are available on request.
Last reviewed: May 2025 | Next review due: May 2028