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HRT and migraine headaches

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  • For some time now, I have been interested in the possibllity that TG MtF folk might suffer a higher incidence of migraine headaches than most XY-chromosomal persons, similar to the incidence in XX-chromosomal persons. If so, it could have indicated a "brain sex" link between TG MtF and XX-chromosomal females. This article does not directly address this issue. However, it is of some importance to those of you undergoing hormonal treatment. It indicates that the presence of estrogen may be directly linked to increased incidence of migraine headaches, rather than the fluctuations of estrogen in XX-chromosomal females. The following is an excerpt from the article:

    MIGRAINE AND THE SEXES - by Amy Norton
    (read the entire article on MSNBC) at:
    http://managingmigraines.[...]?aid=10

    "Examining the hormonal link
    Yet it may not be only a matter of hormonal fluctuations, per se, according to Dr. Tamara Pringsheim of the University of Toronto.

    Pringsheim recently completed a study of men who underwent sex-change surgery and were taking estrogens to enhance breast development and other female physical characteristics, along with anti-androgens to suppress male sex hormones.

    She and her colleagues found that 26 percent of these genetic males had the symptoms of migraine — much closer to the number of migraine cases that would be expected among genetic females than among genetic males.

    Because the patients were on steady levels of hormones, Pringsheim says the finding suggests it's not only fluctuations in estrogen that are involved in generating migraine.

    She and her colleagues speculate that estrogen's effects on nitric oxide, a natural chemical in the body that dilates blood vessels, help explain the hormone's role in migraine. It's believed that inflammation of the cerebral blood vessels, in response to a trigger, is part of the complex process that leads to head pain and other migraine symptoms.

    Nitric oxide is a known migraine trigger, and because of estrogen, women have higher levels of the chemical than men do, according to Pringsheim.

    However, she says, "I can't say from my study that these transsexual patients are having migraines because of nitric oxide."

    Yet the study, as a "natural experiment" of sorts, gives further evidence of the role of hormones in women's migraines, according to Pringsheim."


    IF... you start suffering from a new, intense, often one-sided headache, sound and/or light sensitivity, nausea, dizzyness... you may be experiencing migraines. There are medications that you can take on a daily basis (relatively cheap) and at the time of an attack (expensive, but you won't care during a migraine). Most medical insurance will cover at least the first type, but I wouldn't mention to anyone but your doctor that it is from the HRT or they may weasel out of paying). Of course if the headaches had started BEFORE the HRT and you finally had enough of them, well then you should be covered.

    I cannot recommend one form of treatment to anyone where it is illegal, but inhaled smoke of cannibus sativa, a primitive herbal remedy, often referred to as "pot" or "marijuana" is purported to be very effective in controlling the intense nausea that comes with migraines. There are also teas that include this substance (you have to make your own or know a friendly and reliable herbal remedist) but the rapid onset of nausea and it's persitent violence makes oral medications almost useless unless taken at the first sign of a migraine, which can last for an average of three days. Injectible Imitrex runs about $75 a shot for autoinjectors and you WILL be willing to pay it.

    By the way, this is one of those reasons for doing HRT under medical supervision. You will only need one migraine attack to go running to a doctor for help. Hopefully this article will make sure you know to do so after the first attack. Since hormonal fluctuatons MAY trigger migraines, I do not recommend suddenly stopping your HRT without consulting a physician.

    Lucky me, I got my mother's migraines as part of my feminine inheritence. :-D


    "A live lived in fear is a life half-lived." - Native American proverb. "Inside every man is a woman who was drowned in testosterone before birth". - Wendy Jeanette Larsen "It is better to be hated for what you are than loved for what you're not." - Andre Gide (French writer)
      February 9, 2005 11:16 PM GMT
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  • Wendy,

    Interesting article, from both sides of the fence as both I and my GF suffer from migraines. I get them very rarely but when I do I'm out of it for a day at least and it feels like a pick axe has been driven through my temple. Leave me to sleep in a very dark room with no noise and I'm fine. Now I am not on any medication at all except strong painkillers for my back and i have no idea what triggers them for me.

    My GF gets them roughly every 3-5 weeks and we think they are triggered by stress and after reading that article I think there is a hormonal input as well. Since she changed birth control pills a few months ago they have become more regular (every 4 weeks) and less debilitating (no vomiting) but she dies like me for a day until I open a can of Irn-Bru and she perks up.

    Worst thing is they always happen at the weekend for both of us, just wish there was someway we could shift them to a Monday morning!!

    I can recommend 2x Ibuprofen 400mg taken with a cup of warm milk; helps me sleep, dulls the pounding in my skull and makes me forget about my back for 12 hours!!
    My GF takes Prontalgine, which is a French painkiller and is Paracetemol based (I think) which works for her.

    Only problem with regularly taking any medication for headaches and migraines is your body builds up a tolerance for them and they stop working, something I'm finding with my back now.

    Does anyone have any experience of accupuncture or other alternative treatments for migraine or other debilatating pain? If so I'd like to hear.

    Alex
    xxxx
    Life's Too Short Not To..... Living on Dreams and Custard Creams...... You're Only Young Once...But You Can Stay Immature Indefinitely.....
      February 10, 2005 8:20 AM GMT
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  • Alex,
    You probably have a migraine sufferer among your recent ancestors. It is generally gentic although head injuries seem to also cause them. Women have them more frequently and they are more intense in general. Mom requires morphine injections at times. Birth control pills have been known to diminish and regulate the headaches as well as menstrual cramps.

    It is possible that the weekend occurance is caused by removal of stress, not having to work, which also can set them off. I used to regularly fight them all day and get hit just as I left work, vomiting out the door of the car on the way home. Imitrex (sumatriptan) tablets can be very effective if taken at the first sign of a possible migraine. At $15 each, they are expensive, but nobody who has migraines of any severity minds much at the time. If you wait until the migraine sets in, they are less effective, though they seem, for me, to diminish the symptoms intensity and duration, but may require repeated doses during the attack. The self-injectors cost about $75 each.

    Accupuncture is supposed to be very effective, but many people can't get to the accupuncturist durng an attack. Also, botox injections, same problem. Howerver, women migraine sufferers on cosmetic botox injections reported diminished or complete absence of migraines. This requires botox injections by a medical specialist every 3-6 months, prophylactic treatment. There may be legal issues for non-cosmetic treatment in some areas. I have found accupressure points in the neck to relieve the sypmtoms at times and also work for toothache and other pains when pressure is applied to the appropriate spot with the proper amount of pressure.

    Causes and treatment vary dramatically from one individual to another. Chocolate causes migraines in my mother but relieves them someowhat for me....if i can keep it down. Cafregot, helps some migraine sufferers but makes some vomit.(ergotamine). I use to use a chemical cocktail that included antihistamines/motion sickness pills (the nausea is from the brain's motion sickness area, not the stomach) caffeine (tablets or cola), chocolate, codeine, ibuprofen. Daily Atenolol (beta blocker) signifigantly reduced my frequency and intensity of migraines. I can also speak to the effectiveness of some herbal treatments....however, some of them contain drugs that could cause problems in high doses or with prescription medications or certain medical conditions, though I have not personally heard of any.

    The idea that HRT could increase my migraines again would be a major factor for me to consider, since the pain levels can actually lead to active suicidal ideation. For someone who never had them before, the first one could be terrifying.
    "A live lived in fear is a life half-lived." - Native American proverb. "Inside every man is a woman who was drowned in testosterone before birth". - Wendy Jeanette Larsen "It is better to be hated for what you are than loved for what you're not." - Andre Gide (French writer)
      February 10, 2005 7:07 PM GMT
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