Migraine pain and symptoms affect 29.5 million women in the US; about one-fifth of those suffer migraines aggravated by hormonal shifts. They also most commonly suffer migraines between the ages of 20 and 45. Almost half report experiencing a migraine before their reproductive years end. 

In other words, many women have migraines during their prime child-bearing age and some are sensitive to hormonal shifts. Since fertility treatment often means messing with a woman’s hormones, it follows that those women might find that they suffer more migraines while under assisted reproductive care.

Yes, fertility treatment can be linked to an increase in migraine frequency. Women with a history of migraines reported an increase in frequency compared to women without a history of migraines. 

If you undergo fertility treatment and you are a migraineur, coordinate between your fertility specialist, primary care physician, and headache doctor to monitor your migraines during treatment, pregnancy, and post-partum. 

There is good news — there is nothing to suggest migraines cause infertility, although the desire for sexual intercourse may be low due to head pain. The stress of infertility can reduce libido, too. 

Hormones and Migraines

Fluctuating estradiol levels during menstruation can affect the frequency of your migraine attacks. Also, drops in estrogen triggers migraines in up to 60% of women. Stable hormone levels reduce migraine severity and frequency.

Estradiol, estrogen, and progesterone are all hormones present during ovulation and pregnancy. Fertility treatments often introduce higher than normal amounts to ready your body for ovulating multiple eggs and your uterus for implanting a zygote. 

An Overview of Fertility Treatment

Fertility treatment typically begins with the least invasive procedures, however, once those fail, your specialist may ask you to consider IVF.

IVF stands for in vitro fertilization. A particular course of treatment encourages your ovaries to produce more than one egg at a time. Once several eggs are “mature” another course of treatment readies them for release so the doctor can retrieve them.

Your eggs are then introduced to the sperm in a petri dish (sorry, no test tubes) and allowed to fertilize and expand into a multi-celled zygote. You receive yet more medication to make your uterus ready to receive the zygote and increase the chances of implantation and one or two zygotes are introduced into your uterus. 

You may continue to receive additional hormones to ensure a zygote implants. 

Throughout the entire procedure you receive various amounts of pregnancy hormones, often in higher amounts than your body typically produces. If you are one of the women who suffer migraines most often when you ovulate, you can see why these treatments can be challenging.

Don’t Give Up - You Have Options

One of the biggest perks of IVF is that you know exactly when ovulation and implantation occurs. Everything is timed down to within a couple of days once you begin treatment. Having a set schedule allows you to continue acute medications as needed or for your headache specialist to put you on a short-term preventative up until implantation.

If you take triptans, ditans, or gepants, you will be required to stop after implantation or when your doctor recommends it. Unfortunately, you might need to avoid NSAIDs because they can interfere with implantation. Make a plan with your fertility and headache doctors to reduce your migraine pain while you are prevented from taking medication. Always discuss any medication changes with your doctor first.

Post-Partum

After the baby is born, about 30% to 40% of new mothers report a headache during the first week after delivery, including women who have never suffered migraines.

Post-partum depression (PPD) is a bigger risk with migraineur Moms than those who don’t suffer migraines. You may be more prone to anxiety and other mental health issues, too, particularly if you suffer migraine with aura.

PPD can occur up to a year after you give birth, although you usually notice it within the first month. It’s more than the “baby blues.” Migraineurs have a higher chance of suffering depression than the general population and that fact remains true here.

Symptoms of PPD include:

• Feeling restless or agitated
• Feelings of sadness or anxiety
• Trouble caring for yourself or the baby
• Fatigue 
• Lack of appetite
• Trouble sleeping
• Rapid weight changes
• Feelings of guilt or worthlessness
• Not bonding with the baby
• Thoughts of harming yourself or the baby

If you experience these feelings, get in touch with your healthcare provider immediately since depression worsens without treatment. Ask your support system to help watch for these symptoms since you may not realize the extent of the problem.

As a new Mom, you might neglect other self-care activities simply because you are preoccupied with the baby. Sometimes women become dehydrated (especially if breastfeeding), don’t eat well, and don’t get enough sleep.

For some women, bottle feeding helps with migraine occurrence more than breastfeeding because your hormone levels stabilize as your milk dries up. Also, breastfeeding prevents estrogen levels from dropping so quickly after birth and the increased hormone can be a factor in migraine attacks.

However, if you choose to breastfeed, you also need to know which medications you can’t take because they could be passed through breast milk. Talk to your doctors to determine the best course of medication for you.

In Summary

Many women who suffer migraines notice increased frequency and severity while they are ovulating. The same hormones that trigger their migraines are used in higher amounts during fertility treatments, creating the conditions for migraine attacks during IVF proceedings. 

However, you know exactly when implantation takes place, so you and your doctors can determine the best acute or short-term medication to use until that day. If you decide to breastfeed, be aware that the higher estrogen levels might trigger more migraines than if you bottle feed and check with your doctors about safe medications than won’t be passed through breast milk.

If you have any questions or need migraine treatment support during your fertility treatment, contact the Migraine Relief Center.