Most people who suffer from hormonal migraines will experience an intensely painful headache . However, lots of people who menstruate regularly experience migraine-related symptoms, without ever getting a headache . This type of migraine is sometimes called a ‘silent migraine’. The symptoms include :
- increased sensitivity to odours, light or sound
- nausea or vomiting
- poor concentration
- poor temperature control or sweating
- abdominal (stomach) pain
- fatigue and/ or persistent yawning 
As with more typical migraines, these symptoms can sometimes be ‘triggered’ by certain foods or drinks, or behaviours e.g. alcohol (especially red wine) , caffeine , lack of regular meals (i.e. an empty stomach) , working on a computer , too much or too little sleep , or stress .
Migraine researchers are not really sure why some people become highly sensitive to light, sound, or smells . It is likely to be a mixture of factors; complex hormonal and neurological processes, and behavioural, dietary or genetic differences that make some people more sensitive to hormonal changes than others .
Note: If your symptoms are caused by your hormonal medication, we suggest that you discuss your options with a doctor. These steps may reduce symptom severity, but are unlikely to be able to stop them completely whilst you remain on the same medication.
Managing sensitivity to light, noise, or odours:
TOP TIP! Sleeping in a quiet, dark room, away from strong odours can help to alleviate symptoms. If you feel slightly better when you wake up, try to eat a small meal, to prevent your stomach being empty.
Try a hormone-balancing diet– As outlined in this blog, a vegetable-based ‘anti-inflammatory’ diet can significantly improve all hormone-related symptoms. We highlight a few of the key steps that are especially relevant for those suffering from sensitivity to light, noise, or odours, below;
Try nutritional supplements– Magnesium– Studies have shown that people have low brain magnesium during migraine attacks  and magnesium deficiency may play a particularly important role in menstrual migraine . It is thought that a relatively high dose of Magnesium (400- 600 mg daily) is best to prevent migraines- but if you begin to develop diarrhoea, reduce the amount you are taking .
Vitamin B2– riboflavin- (200-400 mg daily) can reduce the frequency of migraines and hormone headaches . In the only study involving riboflavin alone, 59% of the participants who took 400 mg/day riboflavin for 3 months experienced at least 50% reduction in migraine attacks compared with 15% for placebo.
Co-enzyme Q10– In one study, 61.3% of the patients treated with Co-enzyme Q10 had a greater than 50% reduction in number of days with migraine headache. The reduction in migraine frequency after 1 month of treatment was 13% and this improved to 55% by the end of 3 months of therapy . The data presented in this trial suggest that CoQ10 starts to work within 4 weeks but usually takes 5 to 12 weeks to yield a significant reduction in days with migraine . In another study migraine attack frequency after 4 months of treatment was reduced at least 50% in 48% of patients as compared to 14% for placebo .
Feverfew– Seventeen migraine patients who already used feverfew daily as migraine prophylaxis enrolled in a controlled trial in which 8 patients continued to receive feverfew while 9 stopped taking it and received placebo treatment instead . Those who received placebo had a significant increase in the frequency and severity of headache (an average of 3.13 headaches every 6 months when taking placebo vs. only 1.69 headaches every 6 months when taking feverfew), nausea, and vomiting, whereas there was no change in the group receiving feverfew . In a larger study of 72 patients, feverfew was associated with a 24% reduction in the mean number and severity of attacks although the duration of the individual attacks was unaltered .
Avoid alcohol and caffeine– alcohol is a potential trigger for migraines (especially red wine) so if this is the case for you (track your symptoms/ diet to find out) it may be best to reduce your consumption, or avoid it completely , and eliminating caffeine is known to improve the efficacy (i.e. the effectiveness) of migraine medication .
Eat regular meals– Fasting or skipping meals are well-known migraine triggers, try to eat little and often .
Although some peoples’ experience is that exercise triggers a migraine attack, research suggests that moderate regular exercise can be an effective way to reduce the frequency of attacks .
If you have found that exercise has triggered a migraine, it could be due to the following reasons :
- You start exercising suddenly with no prior planning which means that your body has a sudden demand for oxygen.
- You have not eaten properly before exercising so that your blood sugar level falls as you become very hungry.
- You have not taken sufficient fluids before and during exercising so your body becomes dehydrated.
- You start a strenuous ‘keep fit’ programme at the same time as ‘healthy’ new diet . If not managed properly, these changes to your lifestyle can act as an additional trigger.
- You undertake strenuous infrequent exercise which causes stiff, aching muscles which can then act as a trigger.
Previous studies have suggested that mild regular aerobic exercise offers the most benefits to those with migraine . Remember, it is important to choose an exercise activity that you enjoy. It could be jogging; swimming, dancing, cycling, or brisk walking…
Reduce stress hormone levels– Hormonal migraines and stress are strongly linked. Indeed, anxiety, excitement and any form of tension or shock can all lead to a migraine .
This suggests that it may be (rapidly) changing levels of stress hormones that act as a trigger for migraines. This certainly makes sense in relation to menstrual migraines, since these are (by definition) triggered by rapidly changing levels of sex hormones, known to directly interact with the HPA (Hypothalamic Pituitary Adrenal) stress axis . So, as always with hormone-related symptoms, it is important for migraneurs to reduce anxiety and stress, perhaps through improved self-esteem, or by incorporating relaxation techniques into daily activities. In fact, therapeutic massage (body or head) has been found to be as effective as migraine medication in some trials .
Top tip! Both too much or too little sleep can trigger a migraine . So, try to keep to a sleep routine, going to bed and getting up at roughly the same time each day can make a huge difference…
If you have tried the suggested tips and tricks for at least 3 months, and your symptoms do not improve, please consult your doctor.
If you have any suggestions, or tips, for managing silent migraines- please let us know– we can share them with others!
- NHS information on migraine without headache; http://www.nhs.uk/Conditions/Migraine/Pages/Introduction.aspx
- WebMD information on ‘silent migraines’- http://www.webmd.com/migraines-headaches/what-are-silent-migraines#1
Page last reviewed and updated: June 2018
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