By Fabian Goguta
Researcher and Academic Writer, Montreal, Canada
Photo credit: Unsplash
Migraines are a common problem for both females and males of all ages. While during childhood and old age, a similar percentage of females and males are affected by migraines, during reproductive years women are two times more likely to suffer from them.
According to research, an estimated 18% of women suffer from migraines and the peak morbidity occurs during their most productive years (Warhurst et al., 2017).
Treating chronic migraines can be challenging, as treatment often means taking anti-inflammatory and analgesic medication to levels that can negatively impact other parts of the body (e.g. kidney, liver).
Oriental herbal products have been used for centuries for the treatment of headaches and migraines. One of the most well-known herbal products is ginger, also known as Zingiber Officinale Roscoe.
Ginger has been the focus several scientific studies, showing that it works on several levels in the treatment of migraine. It is powerfully anti-inflammatory, anti-nociceptive (pain reliever), anti-emetic (nausea) and it suppresses the release of many chemicals involved in the body’s immune system response to migraine triggers.
Recent studies also show that it suppresses the release of CGRP a key peptide in the pain of a migraine.
Another potential therapeutic effect of ginger on migraine can be explained in part by the role ginger plays in enhancing estrogen levels.
Several factors explain the differences in the prevalence of migraine between women and men during a woman’s reproductive years. For instance, studies show differences in headache characteristics and the anatomy of the central nervous system.
A significant amount of research suggests that hormones are one of the leading factors that make women more susceptible to migraines. More specifically, studies show that migraines are significantly influenced by estrogen concentrations, with lower estrogen levels leading to a higher risk for migraines.
Estrogen plays an important role in many psychological processes (for both genders), including memory and pain processing (Chai, Peterlin & Calhoun, 2014).
Estrogen also plays a role in many key physiological processes, including cardiovascular protection, bone mass maintenance, and brain protection. When estrogen levels decrease to a significant level (typically during menopause), many women experience joint pain, cardiovascular problems, and vaginal dryness, among others. There is also commonly a reduction in migraines after menopause.
Many women associate hormonal birth control pills with an increase in headache and migraine frequency. Scientific data suggests that hormonal birth control pills can indeed increase the frequency of headaches and migraines in some circumstances while decreasing them in others.
The three most relevant estrogens are estradiol, estrone, and estriol. In the brain, estrogen acts on estrogen receptors. These are specific molecules that communicate with other parts of the body in order to produce the effects associated with the substances that attach to them.
Hormonal contraceptive pills can cause a decrease in estradiol that is significant enough to trigger an estrogen withdrawal migraine (Chai, Peterlin & Calhoun, 2014). For this reason, some women are more likely to experience migraines when they are using hormonal contraceptives.
The relationship between estrogen levels and migraines may also explain why women tend to experience more migraines during menstruation, as estrogen levels decrease during this phase of the menstrual cycle (Chai, Peterlin & Calhoun, 2014).
While birth control pills can cause migraines by decreasing estrogen levels, in some cases the opposite occurs.
Research shows that migraines caused by hormonal contraceptive pills that increase estrogen levels occur during the periods that women stop taking the pills, as many women in this situation experience estrogen withdrawal symptoms.
It is important to note that whether birth control pills will increase or decrease someone’s estrogen levels will depend on the individual.
In most cases, women of reproductive age with optimal estrogen levels will experience a decrease in their estrogen level when taking birth control pills, including those containing estrogen.
Conversely women that no longer produce enough estrogen may experience an increase in their estrogen level by taking birth control pills which contain it.
Chronic migraine sufferers can use anti-inflammatories and analgesic medication to excess and thereby suffer medication overuse side-effects. A common side-effect of medication overuse is migraine and headache.
Another drawback of many medications is that they do not treat the underlying cause or causes of migraine.
Ginger-based treatment can however act directly upon one of the triggers of migraines by rectifying a hormonal imbalance by increasing estrogen levels.
One way of demonstrating whether ginger has an effect on estrogen levels is by analyzing the effects of ginger extracts on estrogen receptors.
With this in mind, Kim, Kang, Kim Choung & Zee (2008) used yeast cells that were modified to carry the human estrogen receptor (hER gene). The researchers applied extracts of 94 medicinal plants on the yeast cells and measured the responses of the human estrogen receptor.
Of the 94 plants, only 14 showed significant effects on the human estrogen receptor. One of those plants was ginger. More specifically, it was found that ginger concentrations between 0.1 and 2.8 mg/ml are sufficient for producing estrogenic responses of different magnitudes.
These results suggest that low concentrations of ginger influence estrogen levels in the brain and the degree of influence increases as the level of ginger concentration increases.
This raises the question as to just how and why estrogen levels affect migraines, and research suggests that it relates to estrogen’s effect on glutamate.
Allais, G., Gabellari, I. C., De Lorenzo, C., Mana, O., & Benedetto, C. (2009). Oral contraceptives in migraine. Expert review of neurotherapeutics, 9(3), 381-393.
Chai, N. C., Peterlin, B. L., & Calhoun, A. H. (2014). Migraine and estrogen. Current opinion in neurology, 27(3), 315.
Kim, I. G., Kang, S. C., Kim, K. C., Choung, E. S., & Zee, O. P. (2008). Screening of estrogenic and antiestrogenic activities from medicinal plants. Environmental toxicology and pharmacology, 25(1), 75-82.
Tomlinson, S. E. (2017). Effectiveness of the progestin-only pill for migraine treatment in women: A systematic review and meta-analysis. Cephalalgia, 0333102417710636.