Migraines and Mental Health: Hormonal Change Across the Lifespan
The connection between migraines and mental health is often overlooked, even though migraines are shaped by many interconnected factors, including hormones, stress responses, trauma histories, and other health conditions. Understanding these systems can help individuals and clinicians approach migraine care more holistically.
In Fall 2025, clinicians from Council for Relationships attended HER: The Health Empowerment Revolution, a women’s health conference focused on migraines. The conference emphasized how migraines intersect with hormonal, neurological, and psychological factors. This blog builds on those insights to explore the relationship between migraines and mental health and why a whole-person approach to care matters.
Migraine patterns linked to menstruation, hormonal shifts, perimenopause, or menopause are common in women’s health care, but they can also affect people of different genders.
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Understanding the Connection Between Migraines and Mental Health
Our bodies are not a collection of isolated parts, but rather complex, interconnected systems. Brain health, gut health, hormones, and the nervous system continuously influence one another. When one system is impacted by illness, injury, or stress, the effects are often felt throughout the body. Migraines are a clear example of this interconnectedness.
While migraines are often described as a “throbbing, one-sided headache,” they frequently involve much more than head pain. Nausea, vision changes, extreme fatigue, sensory sensitivity, and significant shifts in mood commonly accompany migraines. For many people, physical activity, bright lights, loud noises, or strong odors can intensify symptoms—often making daily functioning extremely difficult.
Migraines are also frequently comorbid, meaning they occur alongside other conditions such as gastrointestinal disorders, cardiovascular concerns, posttraumatic stress disorder (PTSD), anxiety, depression, and ADHD. Notably, migraines are one of the leading causes of disability worldwide, particularly among women ages 15–49. Beyond their physical effects, migraines carry emotional and social consequences, including stigma, dismissal, and misunderstanding—particularly for women and people facing gendered or racial bias in healthcare.
One helpful way to conceptualize treatment is to imagine a cup divided into three sections: genetics, lifestyle, and hormones. While genetics cannot be changed, lifestyle factors and hormonal supports may be adjusted over time. There is no single or easy solution, but that does not mean there are no solutions or that anyone should feel alone. For those who feel dismissed or limited to one type of care, it is important to know that providers who take a whole-person, trauma-informed approach do exist, even amid real challenges related to access and health inequities.
Hormonal Changes That Influence Migraines and Mental Health
Migraines are not one-size-fits-all. They affect individuals differently across life stages, particularly as hormones fluctuate. Changes in estrogen levels can significantly influence both the frequency and severity of migraines.
Menstrual Migraines and Emotional Wellbeing
Menstrual migraines affect approximately 20–25% of people with migraines who menstruate and are clinically distinct due to their connection to estrogen withdrawal and prostaglandin release. These migraines often occur without aura and are most severe at the start of menstruation. For individuals with Premenstrual Dysphoric Disorder (PMDD), menstrual migraines may be especially intense and challenging to manage.
Because of ongoing hormonal fluctuations, menstrual migraines are often difficult to treat—but “difficult” should never mean dismissed. These migraines can contribute to anxiety and depression, and stigma surrounding menstruation can compound emotional distress, particularly for adolescents navigating puberty.
Perimenopause, Menopause, and Migraines
Migraines are also common during perimenopause and the early years of menopause, when hormone levels shift dramatically. Some individuals benefit from hormone replacement therapy to reduce the severity of estrogen drops, though responses vary. While migraines may improve for some during menopause, this is not universal.
For those whose migraines are closely tied to menstruation, perimenopause, or menopause, seeking medical providers with expertise in hormonal, reproductive, menopause, or gender-affirming care can be an important step toward comprehensive care.
Trauma, Stress, and the Relationship Between Migraines and Mental Health
For individuals with complex trauma histories, migraines often occur more frequently and with greater severity. A study from the Harvard T.H. Chan School of Public Health found that experiencing at least one traumatic event in childhood increased the risk of developing an adult headache disorder by 48%. In that study, 26% of adults diagnosed with a headache disorder reported childhood trauma, compared to 12% of those without such a history. that experiencing at least one traumatic event in childhood increased the risk of developing an adult headache disorder by 48%. In that study, 26% of adults diagnosed with a headache disorder reported childhood trauma, compared to 12% of those without such a history.
This connection is partly explained by the hypothalamic-pituitary-adrenal (HPA) axis, a system that regulates the body’s stress response. Repeated trauma can alter how this system functions over time.
When the HPA axis is activated, stress responses can manifest throughout the body—changes in appetite, nausea, temperature fluctuations, and heightened sensitivity. Hormonal shifts during the menstrual cycle can also activate this system, which may help explain why migraines and PMDD occur at higher rates among individuals with trauma histories.
How the Nervous System Links Migraines and Mental Health
The autonomic nervous system is responsible for survival-based, automatic bodily responses. It connects the brain to internal organs and illustrates the deep interconnection between mental and physical health. This system includes the sympathetic nervous system (fight-or-flight) and the parasympathetic nervous system (rest-and-digest).
These reactions can feel overwhelming, especially when there is no clear external threat. While the rational part of the brain may recognize that “nothing bad is happening,” the body may still respond as though it needs protection.
Have you ever seen a dog hear an unfamiliar sound and tense up? Once the dog realizes the sound is a creaking door, they do a full-body shake. You can see the dog’s muscles relax. We, as humans, are not often encouraged in social settings to do full-body shakes. But that technique is essentially a way to activate the parasympathetic nervous system. To mimic this, some people may find movement, grounding, or other body-based calming strategies can help support their nervous system regulation.
Calming Techniques That Support the Nervous System
If a full, golden retriever-like shake doesn’t feel right for you or wouldn’t be appropriate, there are other calming techniques.
Mindfulness practices involve focusing one’s attention nonjudgmentally. There are many ways to engage in mindfulness activities. Progressive muscle relaxation is an accessible starting point. The idea is to start at your toes and focus your attention and breath on each part of your body as you move upward. You can also try it from the top of your head to your toes. There is no right or wrong way.
Boxed breathing, a technique in which you inhale for four counts, hold for four counts, exhale for four counts, and pause for four counts before beginning again, also works for some people. Something as simple as holding an ice cube or running cold water across your hands when you’re feeling anxiety or panic in your body can be effective. Weighted blankets work for some folks, but they’re not for everyone. No one technique will work all the time or for everybody.
Support and Treatment for Migraines and Mental Health
Effective migraine treatment requires a collaborative, trauma-informed approach. The high rates of developmental trauma among individuals with migraines—and the compounding effects of anxiety, depression, and ADHD—underscore the need for integrated care.
For individuals with trauma histories, Eye Movement Desensitization and Reprocessing (EMDR) can be a powerful therapeutic option. EMDR recognizes how trauma impacts the nervous system and uses structured bilateral stimulation to help reprocess distressing experiences. While EMDR can significantly improve quality of life, healing unfolds at an individual pace. A trauma-informed clinician will prioritize safety, consent, and readiness throughout the process.
Migraines also affect relationships. They can influence how partners communicate, ask for help, and offer support. Couples therapy can provide a space to build understanding, strengthen connection, and navigate these challenges with care and nuance.
Moving Forward With Support for Migraines and Mental Health
Migraines are not simply “bad headaches.” They are complex, life-altering conditions with profound physical, emotional, and relational impacts. Substantial evidence highlights the interplay between migraines, trauma histories, and mental health conditions, as well as the ways migraines shift across the lifespan due to hormonal and lifestyle changes.
Finding supportive providers and a sense of community can reduce isolation and foster resilience. Miles for Migraine is a nonprofit organization dedicated to advocacy and education. Therapists and psychiatrists at Council for Relationships provide specialized therapy for women and nonbinary people across the lifespan—and for the partners and families who love and support them.
Learn More About Migraines, Mental Health, and Support at CFR
Council for Relationships supports women’s mental health through its Women’s Psychological Health Services.
Betsy Roy is a Clinical Intern in CFR’s Clinical Internship Program.
About the Author
Betsy Roy is a Clinical Intern at Council for Relationships who works with individuals navigating chronic pain and life transitions. She is part of CFR’s Clinical Internship Program, where emerging therapists provide low-cost therapy for those facing financial barriers to care. Get matched with a CFR Clinical Intern today.
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