[00:00]
What if the migraines that suddenly feel more frequent, more intense, and less predictable
[00:05]
are not random at all, but your brain responding to one of the most hormonally turbulent transitions
[00:15]
Welcome to Migraine Heroes, a podcast for people living with chronic migraines with
[00:19]
years of pain, misunderstanding, and lack of answers.
[00:24]
I'm Diane Ducarme.
[00:25]
I've helped more than a thousand people reduce the burden of migraines and feel more in control.
[00:31]
My mission in life?
[00:32]
To help a million people.
[00:35]
Each episode brings you grounded insight into what your body might be asking for and what
[00:42]
Just to keep you fully supported, this podcast is educational.
[00:47]
For diagnosis or medication, always work with your doctor.
[00:52]
Now take a breath and let's dive in.
[00:56]
In this episode, you will learn why hormonal instability matters more than simply having
[01:01]
low hormones and why the ups and downs of estrogen may make your migraine brain much
[01:09]
Why symptoms such as poor sleep, hot flashes, anxiety, irregular periods, and migraine can
[01:15]
become tangled together, creating what can feel a vicious cycle.
[01:19]
A simple strategy you can start at home today to identify your personal rhythm and make
[01:24]
this phase of life a little less unpredictable.
[01:27]
Stay with me till the end because at the end of this episode, you will have a simple way
[01:31]
to start separating what you cannot control, your hormonal transition, from several things
[01:36]
you may actually be able to influence.
[01:39]
So if you're in your 40s or early 50s and thinking, what is happening to me?
[01:45]
My migraines used to make sense or that word was estranged to me before and now they are
[01:51]
taking over my life.
[01:52]
And I want to acknowledge how unsettling that can feel.
[01:56]
So perhaps you had migraines once or twice a month and suddenly they're appearing every
[02:00]
week or even worse, every single day.
[02:04]
Perhaps your medication and other coping mechanisms do not seem to work anymore in the same way.
[02:09]
Perhaps your period comes after 24 days one month, 38 days the next, and then disappear
[02:16]
You may sort of sleep badly.
[02:18]
You may wake up hot, 3 a.m. sharp in the morning, eyes wide open.
[02:23]
You may feel more irritable or more emotionally sensitive, really on edge.
[02:28]
And on top of all of that comes a migraine.
[02:31]
It can feel as though your body has changed the rules without telling you.
[02:35]
Your body and brain were completely betraying you.
[02:38]
And this all comes at a time when your children are leaving the nest but still fundamentally
[02:44]
need you, at a time when your partner is also going through their head changes, at
[02:48]
a time when your parents need you the most, or when you have the highest responsibilities
[02:52]
at work, at a time when you're contributing to your community, and it can feel completely
[02:58]
It's like you've lost your superpowers and you're kind of losing yourself.
[03:02]
I remember this woman, when we met, she said to me, you know, it's not that I'm suicidal
[03:08]
I have a husband, I have children, grandchildren.
[03:11]
In many ways, these are golden years.
[03:14]
But when I go to bed, I really think to myself, if I don't wake up tomorrow, really, it doesn't
[03:21]
It's just so hard.
[03:22]
And so there is a biological reason why the spirit can be particularly difficult for someone
[03:28]
So I want to talk today about perimenopause and first going to very briefly define it.
[03:33]
So perimenopause is the natural biological transition leading up to menopause, when the
[03:38]
body gradually produces less estrogen and menstrual cycles begin to change.
[03:44]
So it's often identified by persistent difference of seven days or more in cycle length and
[03:49]
maybe accompanied by symptoms such as hot flashes, sleep disruption, or mood changes.
[03:55]
Perimenopause is defined primarily by changes in the menstrual cycles rather than a single
[03:59]
blood test and continues until one year after the final menstruation period, in which case
[04:05]
we enter menopause.
[04:08]
During this transition, estrogen does not simply move gently downward in a straight
[04:13]
It can rise, it can fall, it can surge and fall again.
[04:18]
And that distinction matters enormously for migraine.
[04:21]
Because for migraine brains, the problem appears to be less about one specific estrogen level
[04:26]
and more about rapid hormonal changes.
[04:30]
So in the journal called Maturitas, researchers describe perimenopause as a period associated
[04:35]
with increased migraine, so particularly menstrual migraine, and highlighted unpredictable
[04:41]
estrogen fluctuations as an important contributor.
[04:44]
So this was in 2020.
[04:46]
So more recent reviews have reached sort of similar conclusion.
[04:49]
In 2026, there was a review in Headache, and it was saying that unstable estrogen and progesterone
[04:55]
during perimenopause were described as factors that can worsen both the frequency and predictability
[05:01]
of migraine attacks.
[05:03]
So when someone tells you your hormones are normal, they may not tell you the entire story.
[05:08]
A blood test, for example, is a single photograph, while perimenopause is a changing landscape
[05:15]
and migraine may be reacting to the shifts happening between pictures.
[05:20]
So there's a huge estrogen withdrawal hypothesis in all of that.
[05:25]
So one of the famous explanations for hormonally associated migraine during perimenopause is
[05:30]
called the estrogen withdrawal hypothesis.
[05:33]
So one of the famous explanations for hormonally associated migraine is called the estrogen
[05:38]
withdrawal hypothesis.
[05:40]
And so the idea is that sufficiently rapid decline in estrogen can lower the threshold
[05:46]
at which the nervous system generates a migraine attack.
[05:49]
This is one reason migraine attacks often cluster around menstruation.
[05:53]
But there's an important scientific nuance here.
[05:56]
Although estrogen withdrawal is widely accepted as a plausible trigger, it has not been conclusively
[06:02]
proven to explain every menstrual or perimenopausal migraine.
[06:05]
And I would completely agree with that.
[06:07]
The nuance is important.
[06:09]
We do not need to replace one oversimplification with another.
[06:13]
It's not like estrogen goes down, therefore migraine happens.
[06:16]
So your brain is not separate from your hormones.
[06:19]
So estrogen receptors are found in areas involved in pain processing and reproductive hormones
[06:25]
and interact with the trigeminovascular system, the network of nerves and blood vessels deeply
[06:30]
involved in migraine biology.
[06:32]
Researchers have also become increasingly interested in the relationship between estrogen
[06:36]
and other signaling molecules involved in migraine.
[06:39]
So think of your migraine threshold almost like a glass.
[06:42]
So your genetic predisposition is going to make the glass in the first place.
[06:46]
Then hormonal fluctuations will add some water, and then poor sleep will add, and stress will
[06:53]
Skipping lunch adds some, dehydration adds some, hot flashes add some, and then one day
[07:00]
the glass spills over.
[07:01]
And so the migraine may appear to have been triggered by one thing, but biologically,
[07:06]
it may have been the sum of several pressures arriving at the same time.
[07:10]
And so this brings us to something extremely important about perimenopause, is that the
[07:14]
hormone change is only part of the story, because perimenopause can affect so much more
[07:19]
than menstruation.
[07:21]
Sleep fragments, night sweats can wake you repeatedly, mood and anxiety symptoms may
[07:26]
change, your body temperature regulation changes, menstrual bleeding may become heavier, energy
[07:32]
can fluctuate, and each of these can potentially interact with migraine vulnerability.
[07:36]
That is why treating perimenopausal migraine as simply a headache problem can completely
[07:41]
miss the big picture.
[07:43]
So there was a 2026 review by Friedman, Korn and Bernstein that emphasized this interaction,
[07:49]
noting that sleep disturbance, vasomotor symptoms, mood disorders, and metabolic changes
[07:55]
can complicate migraine management during midlife.
[07:58]
So imagine someone who already has a sensitive migraine nervous system.
[08:03]
She begins sleeping five fragmented hours instead of seven, she wakes sweating several
[08:08]
times each night, her menstrual cycle becomes unpredictable, she's exhausted, so she skips
[08:14]
breakfast, she increases caffeine just to function, her stress tolerance falls, and
[08:19]
then she experiences more migraine attacks.
[08:21]
So was it oestrogen?
[08:22]
Yes, perhaps, partly.
[08:29]
Was it all those systems interacting?
[08:31]
Well, very possibly.
[08:33]
That's why I prefer to think of perimenopause creating a period of reduced neurological margin
[08:38]
Your nervous system may simply have less room to absorb disruption.
[08:42]
So how big is this effect?
[08:44]
Are you alone in this?
[08:46]
So the increase is large enough to be measurable at a population level.
[08:49]
There was a study of 3,664 women with migraine, which was published in Headache in 2016, and
[08:56]
8% of premenopausal women experienced high frequency headaches, so defined as 10 or more
[09:03]
headaches days per month.
[09:04]
And during perimenopause, that rose to 12.2%.
[09:08]
So put in another way, the proportion of women experiencing frequent headaches was
[09:12]
about 50% higher during perimenopause.
[09:16]
It's a massive increase.
[09:18]
So even after researchers accounted for factors such as age, depression, body mass index,
[09:23]
preventative medication use, and medication overuse, women in perimenopause still had
[09:27]
42% higher odds of high frequency headache than premenopausal women.
[09:33]
So this is not simply anecdotal.
[09:35]
Perimenopause is a recognized period of increased migraine vulnerability.
[09:40]
It does not mean that every woman's migraine will worsen, but for a meaningful subgroup,
[09:45]
the transition can push migraine from an occasional problem toward a much more frequent one.
[09:51]
So I want to talk about why menstrual migraine can become especially difficult.
[09:56]
So if you already experienced migraine around your period before perimenopause, this transition
[10:02]
it may become particularly challenging.
[10:05]
During a predictable reproductive cycle, you might at least have known my period is coming
[10:10]
Tuesday and my migraine usually starts on Monday or even maybe on Sunday.
[10:14]
But perimenopause can move that predictability.
[10:18]
Ovulation becomes less consistent, cycle length changes, and hormonal peaks and declines become
[10:26]
And so migraine attacks can appear to move around the calendar.
[10:30]
So a 2026 narrative review of perimenopausal migraine described early perimenopause as
[10:35]
a phase in which high and fluctuating estrogen, shorter cycles, and more frequent anovulatory
[10:41]
cycles may contribute to increased migraine severity and more perimenstrual attacks.
[10:47]
So if your old migraine calendar suddenly seems useless, there may be a reason.
[10:53]
The rhythm itself is changing.
[10:55]
Now what about menopause?
[10:56]
Does it ever get better?
[10:58]
And so there's some encouraging news.
[10:59]
So for many women, particularly those with migraine without aura, migraine tends to improve
[11:06]
after natural menopause, once the hormonal turbulence finally settles.
[11:11]
And notice the word settles.
[11:13]
Again, stability may matter.
[11:15]
During perimenopause, the hormones fluctuate dramatically.
[11:19]
After menopause, estrogen remains much lower, but generally becomes more stable.
[11:24]
Migraine does not disappear in everyone, and people with chronic migraine may continue
[11:28]
having substantial symptoms, but several reviews describe improvement after spontaneous menopause
[11:34]
for a significant proportion of women.
[11:36]
So in other words, perimenopause can sometimes be the storm before calmer hormonal weather.
[11:42]
So I'm reminded of a woman I met in New Zealand.
[11:45]
It was around 2019, maybe 2020 maximum, and she had been told that her migraines would
[11:50]
improve when she reached menopause.
[11:53]
And she was so desperate for relief that she underwent artificial menopause.
[11:57]
So she underwent surgery to remove her uterus and her ovaries in the hope of decreasing
[12:05]
And then we worked together and we achieved that.
[12:08]
That case stayed with me because it showed me how far people are willing to go to escape
[12:12]
migraine and how desperate and vulnerable they are.
[12:16]
And so I always add a word of caution when we talk about averages and statistics, which
[12:22]
You're not a statistic, you know, you are a hundred percent of yourself.
[12:26]
And so being told to simply wait for the storm to pass can be incredibly painful when that
[12:31]
promise never comes.
[12:32]
What about menopausal hormone therapy?
[12:35]
So this is where individualized medical care becomes extremely important and really professional
[12:41]
There's no universal rule saying menopausal hormone therapy cures migraine or causes migraine.
[12:46]
Its effects vary, quite honestly.
[12:49]
Delivery methods matters.
[12:51]
Whether hormones are continuous or cyclical matters.
[12:54]
And whether you are having migraine with or without matters.
[12:57]
Your cardiovascular risk factors matter.
[13:01]
And the reason you are considering hormone treatment matters.
[13:04]
Current reviews generally suggest that when menopausal hormone therapy is appropriate,
[13:09]
maintaining more stable hormone exposure may be better tolerated by some people with migraine
[13:14]
than producing repeated hormonal peaks and troughs.
[13:18]
Transdermal estrogen, therefore estrogen delivered through the skin, is often discussed
[13:22]
a bit more because it can provide a steadier hormone level than some oral regimens.
[13:27]
But this is absolutely an area to discuss with a clinician who understands both menopause
[13:32]
and migraine, particularly if you experience migraine with aura or have cardiovascular
[13:38]
Migraine with aura carries additional vascular considerations, so hormonal decisions should
[13:43]
never be based just on a podcast or what worked for a friend.
[13:48]
Migraine is complex, it's not random, but you are unique.
[13:51]
And look, I've seen hormone therapy do wonders for some women, sometimes completely changing
[13:55]
their quality of life, but also sometimes creating much, much damage.
[14:00]
And so, so much depends on finding the right type and the right dose for you.
[14:05]
And also, remember what worked beautifully a couple of years ago may need a solid adjustment
[14:11]
So try to keep the dialogue open with your clinician and report anything that feels wrong.
[14:15]
Also, please consult with people who really know what they're talking about hormone-wise.
[14:20]
This is not a standard training for all doctors, so try to find people who are really specialized
[14:26]
Now, as you listen, I am well aware that for some of you, even getting one appointment
[14:32]
That can feel frustrating and infuriating and unfair.
[14:36]
So that will be the object of another podcast.
[14:38]
I'm really conscious.
[14:39]
It can be really problematic.
[14:41]
Now let's turn east.
[14:42]
Traditional Chinese medicine is going to look at this period of life through a very different lens.
[14:46]
And I want to make a distinction clearly before we explore it.
[14:49]
So concepts such as qi and yin, yang, liver energy and kidney essence, which we're going
[14:53]
to talk about, belong to a traditional Chinese medicine and medical framework.
[14:57]
They're not anatomical structures or measurable physiological mechanisms in the Western biomedical
[15:05]
They're also just translation of two languages that are very different from one to the other.
[15:10]
But traditional frameworks can still offer very useful ways of thinking about patterns,
[15:15]
rhythms, depletion and adaptation.
[15:17]
And it's very pragmatic too.
[15:19]
Perimenopause is above all a period of transition.
[15:22]
And traditional Chinese medicine has never viewed menopause simply as something going wrong.
[15:27]
It sees it as a change, a change of season.
[15:30]
There's an old Chinese philosophical idea that nature does not move in straight lines.
[15:35]
Day becomes night, summer becomes autumn, activity becomes rest, expansion becomes contraction.
[15:42]
And health comes partly from our ability to move with those transitions rather than demanding
[15:48]
that the body remain permanently in summer.
[15:51]
Now you might go, oh wow, this is autumn before winter, which is old age, that is so sad.
[15:57]
Well, that's not quite how TCM views it.
[16:00]
They see perimenopause as what they call a second spring.
[16:04]
And I'm not saying that lightly.
[16:06]
Spring is not necessarily calm.
[16:08]
The weather changes quickly and temperatures rise and fall.
[16:11]
Storms appear unexpectedly and everything is reorganizing beneath the surface.
[16:17]
Perimenopause can feel much the same.
[16:18]
Hormones fluctuate, cycles become less predictable, and the body can temporarily feel more sensitive
[16:25]
But in Chinese medicine, this transition is not viewed simply as something being lost.
[16:30]
It is also a redirection of energy.
[16:33]
As the body gradually moves away from menstruation and reproduction, the resources once invested
[16:40]
there can begin to turn inward.
[16:42]
So perhaps perimenopause is not autumn after all.
[16:45]
It's the unsettled weather of a second spring, a different season of growth, of strength,
[16:51]
of wisdom, and of renewal.
[16:53]
It's interesting because I've just worked on the podcast of Patricia.
[16:57]
And people tell us they love podcasts with actual migrant heroes.
[17:01]
And this is one of them.
[17:02]
And Patricia explains that renewal beautifully as she looks forward to her new and regained
[17:08]
life with much fewer migrants, regained independence, and self-confidence, and self-trust, and how
[17:14]
she wonders how she's going to be when she turns 80.
[17:17]
There's a beautiful illustration of this new spring.
[17:21]
These are not just words.
[17:22]
You'll hear it from her.
[17:23]
The next decade can be gorgeous and a prolific one.
[17:27]
And you will see she wants you to give hope, and I want that for you too.
[17:31]
She's a great example to follow, a great leader in her own right.
[17:35]
Now, in traditional Chinese medicine, the reproductive development and aging are closely
[17:40]
associated with what is called the kidney system.
[17:42]
And again, this does not mean your physical kidneys are failing.
[17:45]
It refers to a broader traditional concept which is associated with development, with
[17:50]
reproduction, resilience, and constitutional energy.
[17:54]
And as women move toward menopause, traditional practitioners often describe a gradual decline
[17:59]
in kidney yin, or kidney essence.
[18:02]
And in simple language, you could think of yin as representing the body's cooling, nourishing,
[18:07]
moistening, and grounding qualities.
[18:09]
So what happens when that cooling and grounding capacity becomes relatively weaker?
[18:15]
Traditional Chinese medicine would expect more signs of internal heat or internal instability.
[18:21]
Hot flashes, night sweats, restlessness, poor sleep, dryness, a feeling of being tired but
[18:28]
somehow unable to settle, and sometimes headache.
[18:32]
From a Western perspective, we would describe vasomotor symptoms, neuroendocrine changes,
[18:37]
and sleep disruption.
[18:39]
Traditional Chinese medicine uses a different language.
[18:41]
Less cooling, more apparent heat, different map, some overlapping territory.
[18:46]
Now, why migraine may feel more explosive?
[18:49]
So in traditional Chinese medicine, perinopause involves a second system, the liver system.
[18:54]
It talks about liver yang rising and liver qi stagnation.
[18:57]
And again, neither refers to liver disease.
[19:00]
The traditional liver system is associated with keeping things moving smoothly, including
[19:05]
qi, emotions, and the body's response to change.
[19:08]
And so with prolonged stress, or poor sleep, emotional strain, hormonal fluctuations, or
[19:13]
depletion, that movement may become less free.
[19:17]
DCM describes this as liver qi stagnation, a kind of internal constraint, a kind of internal
[19:24]
Instead of the energy circulating smoothly, it begins to feel held, compressed, or stuck.
[19:29]
This can show up as neck and shoulder tension, irritability, a sense of pressure, sighing,
[19:34]
digestive disruption, or headaches that build with stress.
[19:38]
And when that constraint energy combines with deeper depletion, particularly declining yin,
[19:43]
another pattern may appear, which is called the liver yang rising pattern.
[19:47]
And the system has less anchoring and less capacity to regulate upward movement, so pressure
[19:52]
and activity rise more easily toward the head.
[19:54]
The traditional description can sound remarkably familiar, throbbing headache, pressure behind
[20:00]
the eyes, dizziness, neck tension, irritability, sensitivity to stimulation, and the sensation
[20:05]
of heat or pressure rising upward.
[20:08]
I don't know if you relate to some of these symptoms, I hope you do.
[20:11]
Now there's a Chinese image that captures this beautifully.
[20:14]
When the root is weak, the branches shake.
[20:17]
And so perimenopause can therefore be understood in TCM terms as involving both less smooth
[20:22]
movement below, and more uncontrolled movement above.
[20:27]
Liver qi may become more constrained, while depleted yin provides less anchoring for yang.
[20:33]
Western medicine might describe hormonal instability and disrupted sleep, stress physiology, and
[20:39]
a lower migraine threshold.
[20:41]
Traditional Chinese medicine uses a different language, but both are trying to describe
[20:45]
a system that has become less stable, less adaptable, and more easily pushed into an
[20:51]
Now there's something super interesting in Western science that is not linked to perimenopause
[20:55]
on paper, that happens in parallel at the same time and mirrors what traditional medicine
[21:00]
is saying beautifully.
[21:01]
And the science does not prove the connection, but the parallel is almost impossible to ignore.
[21:06]
So from a Western physiological perspective, the liver organ undergoes measurable structural
[21:12]
and functional changes with aging.
[21:15]
A review published in the World Journal of Gastroenterology in 2015 reported that liver
[21:21]
volume and hepatic blood flow gradually declined with age, with some estimates suggesting a
[21:26]
reduction in liver volume of approximately 1% per year from around 40, eventually contributing
[21:32]
to substantially lower liver volume in older adults.
[21:36]
Interestingly, the age at which this decline becomes more apparent broadly coincides with
[21:40]
the years in which many women enter perimenopause, and by age 80, so much later when we're well
[21:46]
into menopause, this could amount to roughly a 30-35% reduction in liver volume compared
[21:54]
And so current scientific evidence does not establish that perimenopause causes the reduction
[22:00]
For now, these should be understood as two biological processes that occur during an
[22:05]
overlapping period of life, with their precise relationship still requiring further investigation.
[22:10]
So you see, when traditional Chinese medicine talks about liver G-stagnation, therefore
[22:14]
sometimes liver Yang rising, it's not just metaphorical, it's one of those beautiful
[22:19]
spaces where we start to see overlap.
[22:21]
And so here, traditional Chinese medicine is going to take the change holistically,
[22:25]
and not say this is perimenopause and this is not, this is aging, and start to see the
[22:29]
blend and how both need to be addressed to help support that beautiful second spring.
[22:35]
And this is really important when it comes to migraine care.
[22:38]
Now the lesson is not to fight harder.
[22:41]
And this is where I think the Eastern perspective offers something particularly valuable.
[22:45]
Western culture often responds to midlife symptoms by saying keep going and push through,
[22:50]
sleep later, work harder, drink more coffee, do everything you were doing at 35 while your
[22:55]
physiology is reorganizing itself underneath you.
[22:59]
Traditional Chinese philosophy would probably question that approach.
[23:01]
Here is a saying attributed to classical Chinese thought, a tree that cannot bend eventually
[23:09]
Perimenopause may require more flexibility, your body may need greater consistency around
[23:14]
sleep, more recovery after periods of intense activity, more regular nourishment, more respect
[23:19]
for heat, fatigue, and sensory overload, not because you are becoming weaker, but because
[23:24]
your physiology is changing its operating conditions.
[23:28]
And rhythm matters.
[23:30]
Traditional Chinese medicine places tremendous value on rhythm, eating regularly, sleeping
[23:35]
at regular hours, matching activity with recovery, observing the seasons, noticing menstrual
[23:41]
patterns, watching what happens before symptoms rather than only reacting after they appear.
[23:47]
And this overlaps surprisingly well with modern migraine management.
[23:51]
Migraine brain often dislikes abrupt change, irregular sleep, sudden fasting, large changes
[23:57]
in caffeine, dehydration, rapid changes in stress, and perhaps in hormonally sensitive
[24:03]
people, rapid endocrine change.
[24:06]
So whether we speak in the Western language of migraine thresholds and nervous system
[24:10]
homeostasis, or the Eastern language of balance and harmonious flow, we arrive at a similar
[24:15]
practical principle, reduce unnecessary volatility where you can.
[24:21]
And this is something I personally relate to.
[24:23]
I'm 43 now, and while my cycles are still quote-unquote normal, I can feel that my body
[24:28]
My digestion is not quite as forgiving as it used to be, and I have become a bit more
[24:32]
mindful of when I eat and the rhythms I keep.
[24:36]
Holidays are actually a good example.
[24:37]
When the usual routines disappear and meals become lighter, heavier, or simply less predictable,
[24:42]
I really feel disruption in my body.
[24:44]
I enjoy the holidays, of course, but I also find myself generally looking forward to back-to-school
[24:49]
time when life becomes more settled again, and I can return to a more natural flow, regularity
[24:56]
And for me, that has been one of the clearest reminders that this stage of life is not necessarily
[25:00]
about something being wrong, but about realizing that my body may need a little more consistency
[25:05]
and attention than it once did.
[25:07]
It's subtle, but it's there.
[25:08]
I can't ignore it, and I long for it.
[25:10]
Now, what can you do today at home?
[25:13]
So here's your exercise for today.
[25:15]
Create what I call a migraine transition map.
[25:18]
For the next few weeks, instead of tracking only whether you had a migraine, write down
[25:23]
five things each day.
[25:25]
Migraine symptoms, menstrual bleeding, sleep quality, hot flashes or night sweats, and
[25:31]
You can also note unusual stress or medication use.
[25:34]
Do not obsess over perfection.
[25:36]
The goal is simply to look for clusters.
[25:39]
Maybe attacks repeatedly follow two poor nights of sleep.
[25:42]
Maybe they appear around bleeding.
[25:44]
Maybe hot flash nights and migraine days travel together.
[25:47]
This information can turn my migraine or completely random into more insights that you can make
[25:53]
And while your hormones may not be controllable from day to day, give your nervous system
[25:58]
as much predictability as you reasonably can.
[26:01]
Eat regularly, stay hydrated, protect your sleep schedule, avoid dramatic swings in caffeine,
[26:07]
and build short periods of recovery into your day.
[26:10]
If your migraine pattern has changed significantly, attacks have become much more frequent and
[26:15]
you're considering hormonal treatment, bring that diary to a clinician who understands
[26:19]
migraine and menopause.
[26:22]
And of course, you can do all of that in the Migraine Heroes app.
[26:26]
That's all for today.
[26:27]
I hope this episode added another piece to your migraine puzzle.
[26:31]
If you'd like to apply what we've discussed to your own life, you can find us by searching
[26:36]
Migraine Heroes in the App Store or Google Play.
[26:40]
Look for the green icon with the love heart in the brain.
[26:43]
Migraine is complex, but it's not random.
[26:46]
And every step forward brings us closer to lasting relief.
[26:50]
Your body has a story to tell.
[26:51]
Let's keep listening.
[26:52]
I will be back with you soon.
