Migraines and Menopause: Two Case Studies – Jillian Finker, ND

Migraines and Menopause: Two Case Studies

Jillian Finker, ND  

Introduction

After two decades of practicing naturopathic medicine, I have observed that advancements in allopathic migraine treatment remain limited. While a few newer medications may be effective for specific individuals, the majority of migraine sufferers continue to struggle without finding long-lasting relief. Conventional treatment often relies on suppressive medications, which may temporarily reduce pain but fail to address the root causes of the situation. This approach can have devastating consequences for patients. Over the years, I have encountered rare but serious outcomes, such as brain bleeds, strokes, and other life-altering conditions that remain undiagnosed in chronic migraine patients. However, more commonly, subtle underlying factors like hormonal imbalances, nutritional deficiencies, or musculoskeletal tension–are to blame. Though these issues may seem less severe, failing to address them appropriately can still significantly impact a patient’s quality of life. 

It is crucial to address the root cause of migraines, and in many cases, balancing hormones is an essential step in achieving true healing. Two significant patient cases I have seen stand out in my mind. The first case we’ll discuss involved one of my earliest patients, who visited me in 2004. To this day, she remains one of my strongest supporters and a key factor in my ability to help hundreds of migraine sufferers. This patient only wanted minimal intervention and no testing. So, this case is a pleasant reminder that basic naturopathic medicine can sometimes work wonders. The second patient is more current, but like in the initial case, she also didn’t want to use bioidentical hormone replacement therapy. Since we still cannot use this therapy in most states; I like to educate the public on a more natural means of healing. 

Case Studies: Real-Life Success Stories

Case One: Jennifer’s Journey to Migraine Relief First Visit

First Visit: 

“Jennifer,” a 45-year-old female, came to see me with severe debilitating migraines when she was 44 years old. The pain she described was a 10 out of 10 sharp, stabbing pain over her entire head that lasted for three days, followed by relief for a few weeks. She would lie on the floor, often crying in debilitating pain. The migraines were worse after drinking red wine, crying (which she couldn’t stop), and taking “too many vitamins,” a prescription multivitamin, which had also given her a rash. She hesitated to try any remedy, including natural therapies and opposed HRT because of her mother’s experience with melasma while using it. The patient had a sensitive stomach with many GI complaints, including bloating, constipation, and irritation from foods.  

Jennifer felt her migraines were hormonal. Prioritizing patient perspectives is crucial; their intimate knowledge often reveals the underlying issue through intuition or reason. With no menses for over a year, the patient’s medical history included fibroids, polyps, and ovarian cysts. Despite visiting multiple gynecologists in the past year, none agreed to test her hormones and dismissed any hormonal connection to her migraines.  

The patient had tried “many medications,” including Topomax, Imitrex, and Inderal, along with IV medication (Reglan, etc.), during several hospitalizations, and per the patient, nothing medical was helping at all. She had gone to the chiropractor regularly, had gotten massages, practiced yoga, and changed her diet. This helped slightly, but not nearly enough. She came to the office with her extended family, who also had no hope since nothing had helped thus far, and they were anxious about vitamins since she had issues with the prescription multiple.   

Jennifer was in excellent shape, with an optimal BMI. Before the migraines, she had little to no health complaints. She actively took part in local community affairs and owned a nearby gym. I strongly desired to assist this patient because she advocated for health and wellness in my town.

Since Jennifer was a patient in an unlicensed state, I deferred her physical exams and diagnosis to her primary care doctor and gynecologist. The only diagnosis she had received was menopause and migraines. Based on her extensive history and the onset of migraines with menopause, I concluded her migraines were most likely because of hormonal imbalances.

The patient and her extended family declined further testing, and she was hesitant to take anything.

To address her hormonal imbalances, probable inflammation, and nutritional deficiencies, I convinced her to take the following:

Hormonal Support:

• Green Tea 1 cup before breakfast and 1 cup before lunch to modulate estrogen metabolism
• Flax seed oil taken with each meal to normalize estrogen levels 
• Black currant seed oil to balance estrogen levels

Inflammatory Support:

• Fish Oil to decrease inflammation and help with migraines

Nutritional Support:

• Magnesium citrate before bed to help with constipation and migraines before bed dosed to bowel tolerance

Dietary Changes:

• Avoid processed foods, seed oil, and gluten to bring down inflammation
• Increase vegetable intake to bring down inflammation and increase her micronutrient levels

Second Visit (3 weeks later):

Jennifer was feeling slightly better. Her headaches were less severe, with 8/10 pain, shorter duration lasting only two days. She also was happy that she hadn’t reacted to theo supplements I had given her. The patient still refused further testing. Since she felt the headaches had started with the cessation of her menses and along with the positive feedback from her taking the flax and black current seed oil, I further addressed her hormones with supplements and lifestyle changes.

Hormone Support:

• Calcium D-Glucarate helps with estrogen metabolism

Dietary Changes:

• avoid dairy to help with her GI symptoms and to avoid xenoestrogens
• eat only organic red meat to avoid estrogenic hormone injected beef

Lifestyle Modifications:

• daily relaxation to modulate her cortisol levels and increase her progesterone levels
• Avoid xenoestrogens by staying away from plastics and to stop touching receipts

I also increase her magnesium and the fish, flax and black currant seed oils she was currently taking.

Third Visit (1 month later):

The patient is thrilled. She is doing so much better. Jennifer only had one migraine that was short and tolerable. I gave her a natural anti-inflammatory containing fever few, rosemary and curcumin to take acutely if she had any headaches in the future. At the same time, we continued to work on healing her body. The patient, delighted, readily agreed to future testing and requests. My patient has been looking younger for almost twenty years now, and she “feels better now at 60 than she did at 40.”

I always love reviewing this case because it’s such a pleasant reminder that simple, natural therapeutics can really transform a person’s life. 

Case Two: Lorna’s Path to Recovery

First Visit: 

 “Lorna,” a 54-year-old female, came to see me with a history of migraines in her 20s that were manageable and became severe in her 30s. When the patient was in her 40s, she managed the migraines with a whole food-focused diet and exercise. Then, the migraines started again in her 50s and became much worse. Migraines are severe three to four times a month, lasting one day. They are worse with weather changes, stress, and smells. The pain is severe over her entire head, 10/10 throbbing pain, noises bother her, mild nausea, and lights make it worse. The patient feels better with Nurtec 75mg disintegrating tablet and rest.  

The patient has a history of menopause for one month with many severe symptoms for about one year in duration ranging from: hot flashes, night sweats, vaginal dryness, insomnia with waking three times a night, joint pain, no libido, weight gain, low blood pressure, dry skin, dry eyes, anxiety, and trouble concentrating.  

A gynecologist in Lorna’s 20s told her that her migraines were hormone-related, along with her current gynecologist, but he refused to order blood work or run any other tests. 

This patient was open and willing to run tests and take supplements. I gave her an extensive blood work panel to run with an MD that I refer to, along with a comprehensive urine female hormone panel and a stool panel. The patient has a family history of female cancers, including a distant relative with breast cancer, and made it clear she didn’t want to use any type of hormone therapy, including bio-identicals. She was on a lot of her own supplements that have helped over the years and were good brands. She was currently taking Vitamin C, D, Vitamin K, a B complex, collagen, and an electrolyte powder. I kept her on all of those supplements and just added in a Vitamin E suppository to help with the vaginal dryness. The patient didn’t want to remove coffee from her daily routine, so I switched her to an organic and mold-free coffee.

Second Visit (1 month later)

Her blood work results were unremarkable, with everything at optimal levels. However, a comprehensive urine hormone panel revealed several imbalances:

• Low estrogen, with difficulty metabolizing harmful estrogen byproducts
• Very low progesterone, DHEA, and testosterone, including their metabolites.
• Very low cortisol and low adrenal reserves
• There is a need for b vitamins and low electrolytes.

The comprehensive stool analysis showed  alarming results, including:

• Extremely high beta-glucuronidase, raising concerns due to her family history of female and colon cancers
•  Severe dysbiosis, low short-chain fatty acids (SCFAs), and overall low probiotics. 

Vitamin E suppositories successfully relieved vaginal dryness; the patient continued using them.  

To address her hormonal imbalances, gut health, and overall symptoms, I implemented the following plan:

Hormonal Support: 

• Hops and Norway spruce at bedtime for low estrogen and menopausal symptoms
• Calcium D-glucarate lowers the beta-glucuronidase and helps with estrogen metabolism. 
• Garum Armoricum in the morning to help with her anxiety and adrenal gland function. 
• A blend of dandelion, wild yam, chaste tree, black cohosh, ashwagandha, motherwort, red clover, dong quai, and licorice at breakfast to support adrenal function, regulate female hormones, and normalize her low blood pressure. 

Gut health:

• A high-quality probiotic before breakfast.
• Butyrate (time-released) to improve SCFAs

Nutritional Support:

• Combined her separate Vitamin D and K into a single supplement combo
• A better B complex with sublingual B12 and folate sublingual 
• She continued taking Vitamin C and electrolyte powder and started on a magnesium complex already.    

Dietary Changes:

• A Southern Mediterranean diet:  no gluten, GMO foods, chocolate, caffeine, or dairy, focusing on anti-inflammatory foods and fewer grains. 

Lifestyle Modifications:

• Castor oil packs applied alternately over the liver and lower abdomen every few days.  

Third Visit (1.5 months later)

The patient feels healthier than she has felt for years. All of her menopausal symptoms are almost totally better, including the migraines. She is still having occasional migraines, some anxiety, and slight insomnia. However, everything listed above, from vaginal dryness to bloating, etc. is all completely better. I switched her magnesium to a better complex with dimagnesium malate, citrate, albion minerals, and lysinate glysinate chelate before bed and to take as needed if she felt a headache coming on. I also added in a proprietary blend of inositol, l-theanine, magnesium l-threonate, sunflower lecithin, and glycine to take before dinner and bed.  

Final Visit (2 months later)

The patient feels like her old self again. She is exercising, sleeping better than ever, feels amazing and is overall so happy with everything. Lorna is headache-free, calm, and back to her pre-menopausal self.  
I always enjoy determining the underlying hormonal issues that contribute to most of my patients who experience migraines and treating them accordingly. I’ve observed hundreds of similar cases over twenty years; these are merely two examples. I find it hardest to convince patients that their migraines can heal, sometimes even with minimal intervention. 

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