Migraines and Menopause: Two Case Studies

By Jillian Finker, ND

Explore how naturopathic approaches effectively address hormonal migraines in menopausal women through real-life patient case studies.

Summary: This article explores two case studies of women suffering from migraines during menopause. It details their symptoms, treatment plans, and how naturopathic medicine provides lasting relief by addressing hormonal imbalances and other root causes.

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 (HRT). 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

“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”—specifically 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 also 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 Topamax, Imitrex, and Inderal, along with IV medication (Reglan, etc.) during several hospitalizations. 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 lived 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
• Flaxseed Oil: Taken with each meal to normalize estrogen levels
• Blackcurrant Seed Oil: To balance estrogen levels

Inflammatory Support

• Fish Oil: To decrease inflammation and help mitigate migraines

Nutritional Support

• Magnesium Citrate: Taken before bed to help with constipation and migraines, dosed to bowel tolerance

Dietary Changes

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

Second Visit (3 Weeks Later)

Jennifer was feeling slightly better. Her headaches were less severe, presenting as an 8 out of 10 pain with a shorter duration lasting only two days. She was also happy that she hadn’t reacted negatively to the supplements I had given her. The patient still refused further testing. Since she felt the headaches clearly started with the cessation of her menses, and alongside the positive feedback from taking the flax and blackcurrant seed oils, I further addressed her hormones with targeted supplements and lifestyle changes.

Hormone Support

• Calcium D-Glucarate: Helps safely optimize estrogen metabolism

Dietary Changes

• Avoid dairy to improve her GI symptoms and to completely eliminate dietary xenoestrogens
• Eat only organic red meat to avoid beef injected with estrogenic hormones

Lifestyle Modifications

• Daily relaxation practices to modulate her cortisol levels and support her progesterone levels
• Avoid environmental xenoestrogens by staying away from plastics and handling paper receipts

I also increased her dosages for the magnesium, fish oil, flaxseed oil, and blackcurrant seed oil she was currently taking.

Third Visit (1 Month Later)

The patient is thrilled and doing so much better. Jennifer only had one migraine that was short and entirely tolerable. I gave her a natural anti-inflammatory formula containing feverfew, rosemary, and curcumin to take acutely if she felt any headaches developing in the future. At the same time, we continued to work on deep-level healing.

Delighted with her progress, the patient now readily agrees to future testing and requests. My patient has been looking vibrant and younger for almost twenty years now, and she noted that she “feels better now at 60 than she did at 40.” I always love reviewing this case because it is a beautiful reminder that simple, natural therapeutics can truly 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, but became severe in her 30s. When the patient was in her 40s, she managed her migraines well with a whole food-focused diet and exercise. Then, the migraines returned in her 50s and became much worse. The migraines were currently severe three to four times a month, typically lasting a full day. They were worsened by weather changes, stress, and distinct smells. Lorna described the pain as a 10 out of 10 throbbing over her entire head, accompanied by sound sensitivity, mild nausea, and photophobia (light sensitivity). The patient found temporary relief with Nurtec 75mg disintegrating tablets and strict rest.

The patient had a history of menopause for one month, with many severe menopausal symptoms lasting about one year in duration. These ranged from hot flashes, night sweats, and vaginal dryness to insomnia (waking three times a night), joint pain, absent libido, weight gain, low blood pressure, dry skin, dry eyes, anxiety, and trouble concentrating.

A gynecologist in Lorna’s 20s had told her that her migraines were hormone-related, which aligned with her current gynecologist’s thoughts; however, her current doctor refused to order blood work or run any targeted functional tests. This patient was open and willing to run labs and take recommended supplements. I provided her with an extensive blood work panel to run with an MD colleague whom I refer to, alongside a comprehensive urine female hormone panel and a comprehensive 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 direct hormone replacement therapy, including bioidenticals. She was already taking a collection of her own supplements from good quality brands that had helped over the years (Vitamin C, Vitamin D, Vitamin K, a B-complex, collagen, and an electrolyte powder). I kept her on all of those and simply added a Vitamin E suppository to resolve the vaginal dryness. The patient did not want to remove coffee from her daily routine, so I successfully switched her to an organic, mold-free coffee option.

Second Visit (1 Month Later)

Her blood work results were unremarkable, with standard markers resting at optimal levels. However, her comprehensive urine hormone panel revealed several notable imbalances:

• Low baseline estrogen, with difficulty metabolizing harmful downstream estrogen byproducts
• Very low progesterone, DHEA, and testosterone, including their corresponding metabolites
• Very low baseline cortisol and low overall adrenal reserves
• An explicit functional need for targeted B vitamins and electrolyte replenishment

The comprehensive stool analysis showed alarming results, including:

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

The Vitamin E suppositories had successfully relieved her vaginal dryness, and the patient eagerly continued using them. To comprehensively address her hormonal imbalances, gut health, and systemic symptoms, I implemented the following strategy:

Hormonal Support

• Hops and Norway Spruce: Taken at bedtime to support low estrogen levels and calm vasomotor menopausal symptoms
• Calcium D-Glucarate: Lowers high beta-glucuronidase and assists with protective estrogen metabolism
• Garum Armoricum: Taken in the morning to stabilize her anxiety and support adrenal gland function
• Botanical Blend: A combination of dandelion, wild yam, chaste tree, black cohosh, ashwagandha, motherwort, red clover, dong quai, and licorice at breakfast to support adrenal reserves, help regulate female hormones, and naturally normalize her low blood pressure

Gut Health

• A high-quality, multi-strain probiotic taken before breakfast
• Time-released Butyrate to directly improve short-chain fatty acids (SCFAs) and fuel the colonocytes

Nutritional Support

• Combined her separate Vitamin D and K supplements into a single, optimized combination formula
• Upgraded her B-complex to a high-delivery version featuring sublingual B12 and active sublingual folate
• Continued her Vitamin C and electrolyte powder, and successfully initiated a comprehensive magnesium complex

Dietary Changes

• Southern Mediterranean Diet: Strict elimination of gluten, GMO foods, chocolate, caffeine, and dairy—focusing heavily on anti-inflammatory foods and reduced grain intake

Lifestyle Modifications

• Castor oil packs applied topically, alternating between the liver and lower abdomen every few days

Third Visit (1.5 Months Later)

The patient reports feeling healthier than she has felt in years. All of her primary menopausal symptoms are almost totally resolved, including the bulk of her migraines. She still reports occasional milder migraines, some lingering anxiety, and slight insomnia; however, everything else—from the vaginal dryness to the bloating—is completely better.

I switched her magnesium intake to an advanced complex featuring dimagnesium malate, magnesium citrate, Albion® minerals, and magnesium lysinate glycinate chelate before bed (to also be taken as needed if she felt a headache approaching). I also added a proprietary calming blend of inositol, L-theanine, magnesium L-threonate, sunflower lecithin, and glycine to take before dinner and bedtime.

Final Visit (2 Months Later)

The patient feels like her old self again. She is regularly exercising, sleeping better than ever, and is overall immensely happy with her outcomes. Lorna is completely headache-free, calm, and returned to her balanced, pre-menopausal self.

I always enjoy determining the underlying hormonal issues that contribute to migraines in the majority of my patients and treating them accordingly. I’ve observed hundreds of similar success stories over my twenty years in practice; these are merely two examples. Sometimes, the hardest part of my job is simply convincing patients that their chronic migraines can truly heal—even with minimal, natural intervention.

References

1. Peikert A, Wilimzig C, Köhne-Volland R. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia 1996; 16:257.
2. Wider B, Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database Syst Rev 2015; 4:CD002286.
3. Sun-Edelstein C, Mauskop A. Foods and supplements in the management of migraine headaches. Clin J Pain. 2009 Jun;25(5):446-52. doi: 10.1097/AJP.0b013e31819a6f65. PMID: 19454881.
4. Kargozar R, Azizi H, Salari R. A review of effective herbal medicines in controlling menopausal symptoms. Electron Physician. 2017 Nov 25;9(11):5826-5833. doi: 10.19082/5826. PMID: 29403626; PMCID: PMC5783135.
5. Abdi F, Mobedi H, Roozbeh N. Hops for Menopausal Vasomotor Symptoms: Mechanisms of Action. J Menopausal Med. 2016 Aug;22(2):62-4. doi: 10.6118/jmm.2016.22.2.62. Epub 2016 Aug 30. PMID: 27617238; PMCID: PMC5016504.
6. Fuhrman BJ, Pfeiffer RM, Wu AH, Xu X, Keefer LK, Veenstra TD, Ziegler RG. Green tea intake is associated with urinary estrogen profiles in Japanese-American women. Nutr J. 2013 Feb 15;12:25. doi: 10.1186/1475-2891-12-25. PMID: 23413779; PMCID: PMC3584908.
7. Nowak W, Jeziorek M. The Role of Flaxseed in Improving Human Health. Healthcare (Basel). 2023 Jan 30;11(3):395. doi: 10.3390/healthcare11030395. PMID: 36766971; PMCID: PMC9914786.
8. Nanashima N, Horie K, Maeda H. Phytoestrogenic Activity of Blackcurrant Anthocyanins Is Partially Mediated through Estrogen Receptor Beta. Molecules. 2017 Dec 29;23(1):74. doi: 10.3390/molecules23010074. PMID: 29286333; PMCID: PMC6017224.
9. Ramsden CE, Zamora D, Faurot KR, et al. Dietary alteration of n-3 and n-6 fatty acids for headache reduction in adults with migraine: randomized controlled trial. BMJ. 2021;374:n1448.
10. von Luckner A, Riederer F. Magnesium in Migraine Prophylaxis-Is There an Evidence-Based Rationale? A Systematic Review. Headache. 2018 Feb;58(2):199-209. doi: 10.1111/head.13217. Epub 2017 Nov 13. PMID: 29131326.

Author: mod.joshuaclark@gmail.com