Over the years, I’ve come to understand that headaches
are my body’s way of telling me something’s out of balance. In understanding this
dynamic I now know my daily choices play an active role in preventing my headaches.
This means I can act first, not just react after I get a headache.
When I do my best at practicing what I preach — optimizing my diet, taking my core
supplements consistently, drinking enough water, trying to sleep at least 8 hours
a night, and exercising regularly — my headaches are almost nonexistent, even during
Having a healthy lifestyle that places a premium on nutrition and supports natural
hormonal balance is the first step in any drug-free approach to preventing and treating
frequent headaches. Most headaches have multifactorial roots, however, which means
relieving them may require multiple strategies.
The story of your headache
There are many separate types of headaches, with a wide variation in triggers and
differing components of the headaches themselves. What causes a headache depends
on a woman’s individual situation — her nutrition, unique stress factors, body mechanics
— and her medical history. But one thing is certain: in many cases, a headache is
a symptom of something deeper going on in her life.
As a headache sufferer myself, I understand well the need to treat the pain in that
moment. But to truly resolve your chronic headaches, you may need to figure out
what stressors lie at the root. Once you familiarize yourself with any pattern,
you can often treat and — ultimately prevent — them from recurring.
To be fair, I think it’s important to note that there is a component of genetic
propensity, particularly with migraine headaches. Although there are lots of strategies
a woman can employ to attempt to minimize her headaches, in some cases genetics
reign, and she may get that headache no matter what. While I always recommend doing
what you can to reduce the likelihood of getting headaches, I don’t want you to
start blaming yourself for them, especially when you are trying to do “everything
That said, there are many helpful options to try. Let’s look at the most common
types of headaches and then discuss strategies for prevention.
Different types of headaches — a brief overview
The two major categories into which most chronic headaches fall are tension headaches
and migraine headaches. Let’s take each major type separately, and also touch on
cluster and rebound headaches and the less common but serious form of headache known
as temporal arteritis. There are many other subtypes — from caffeine withdrawal
headaches to menstrual headaches,
and the lines between many of these can be blurry. If you are unsure what type of
headache you suffer from, it may be helpful to see your healthcare practitioner
for a diagnosis.
Please note that we are talking about most moderate headaches — if your headaches
deviate from their normal presentation, change or worsen in any way that seems alarming,
seek medical attention immediately.
Tension headaches may be the most common type of headache women experience. They
are typically described as a band-like vise that creates pressure and pain uniformly
around the head, and may involve the neck as well. Tension headaches can occur episodically
or chronically, depending on the individual and aggravating factors. They can even
progress to include migraine-like sensitivity to light or sound, and even become
a trigger for true migraines in some cases.
There are many stressors that can make a woman prone to tension headaches and that
may explain their prevalence. These include are poor head and neck alignment and
other posture issues, prolonged computer work, more serious prior cervical spine
strain (such as whiplash), poor jaw alignment and other dental issues like nocturnal
teeth grinding (bruxism), need for eyeglasses, weather changes, stress
at home or at work —the list is almost endless!
Fortunately, these headaches often respond remarkably well to natural prevention
techniques and occasional treatment when needed. When these interventions don’t
work, there are medications that a neurologist can prescribe to alleviate these
kinds of headaches. It is so important to remember you have a range of options when
trying to find relief. When you’re partnering with a neurologist, you will want
to first discuss all the benefits and risks of drug therapy.
Migraine headaches are characterized by a series of four phases that occur with
some regularity but which vary widely among sufferers: prodrome, aura, headache
The prodrome phase may take place anywhere from a few hours to days before
onset of a migraine headache, with symptoms that can include mood changes, fatigue,
and cravings for certain foods that may themselves be migraine triggers.
Some migraine sufferers also experience an aura, with sensations of flashing
lights, numbness and tingling, or altered vision before or during onset of the severe
head pain. This aura experience is generally short-lived (usually about 20 minutes)
and considered part of the classic migraine sequence, but the majority
of migraine sufferers do not experience an aura. The aura phase can occur on its
own, with no subsequent headache pain, which is known as optical migraine or acephalalgic
migraine. But most migraines occur without any aura, and are known simply
as common migraine.
Pain during the headache phase is generally described as severe throbbing
or a pulsating sensation that occurs on one side of the head or temple. Migraines
can last anywhere from two hours to several days. This type of headache is usually
associated with sensitivity to light (photophobia), sound (phonophobia),
or smells (osmophobia) and is frequently accompanied by lightheadedness,
nausea, gastric upset and vomiting. It is important to remember that pain is not
necessary to define a headache as a migraine, and the severity of the pain accompanying
the headache isn’t migraine specific either. Instead a migraine is defined by the
features that go along with it: nausea, throbbing, photophobia, phonophobia, and
photopsias (flashes of light).
By the postdrome phase, the pain has usually subsided, but sufferers are
typically left feeling tired and worn out. Some also report experiencing negative
psychological effects such as slower thinking or feeling “flat” after a migraine,
and in some cases these after-effects can last several days.
Women may also experience migraines at the onset of their monthly cycle, with these
hormone-related headaches often referred to as menstrual migraines. Approximately
70% of migraine sufferers are women, and there’s no doubt that chronic migraines
can have a significant impact on a woman’s quality of life. The higher incidence
of migraines in women may be related to our hormonal fluctuations, or the way we
respond to stress in our lives — but as we know, these two are interlaced.
Historically, many experts considered migraines to be a vascular disorder caused
by constriction, then sudden dilation of the blood vessels to the neck, brain and
scalp. Then the throbbing pain of migraine was thought to be brought on by an abnormal
release of the neurotransmitter serotonin, bringing about additional constriction
of the arteries supplying blood to the brain. This theory has been debunked by modern
neurology, and we now understand more about migraines thanks to improved imaging
of the brain.
The new migraine theory proposes that migraines start with electrical “hyperexcitability”
in an area of the brain, meaning migraine sufferers may simply have a hypersensitive
nervous system that makes them prone to these headaches. A lifestyle or environmental
trigger such as hormonal fluctuation or exposure to a certain food or chemical can
provoke an attack.
In any event, migraine pain is best prevented and treated — both conventionally
and naturally — at its onset. While debate continues about the biochemical basis
of migraine headache, it’s important to recognize that with a little detective work
you can learn to recognize your personal triggers, and, in many cases, abort a migraine
before it turns painful. The key part of treating an active migraine is doing it
quickly. If you wait too long to intervene, it is often too late to achieve quick
This type of headache seems to affect men more than women. Patients describe the
pain of a cluster headache as severe, usually one-sided, and often associated with
symptoms such as nasal congestion, a bloodshot or tearing eye, or facial perspiration.
The pain of a cluster headache is intense, often prompting restless, pacing behavior.
It often begins during sleep, and may be present for several days in a row, but
a series of cluster headaches can also recur months or years apart. People often
mistake the name “cluster” to mean multiple headaches in a short time period. But
actually, “cluster” refers to the tendency of the headaches to cluster around the
same time of year. They can then spontaneously resolve until the next year or for
Some people have chronic cluster headaches which do not remit spontaneously. Others
can have a “cluster-migraine” variant which involves symptoms of both headache types
and doesn’t fit neatly into one definition or the other. Oxygen therapy with deep
breathing can be an effective abortive therapy for cluster headaches. Also, some
of the medications which are used to abort migraine headaches often work with cluster
headaches as well.
Another common type of headache is the rebound headache, often referred
to as medication overuse headaches. Many people don’t realize that regular
overuse of prescription and non-prescription headache medications is a very common
cause of chronic daily headaches. The brain becomes dependent on the substance that
once helped relieve the headaches. Weaning off the overused product is the only
way to break the cycle, though this process can be difficult because the sufferer
is stuck with headache pain and must slowly taper off the meds. If you do not detoxify
from your daily analgesic regimen, then all other interventions, both natural and/or
prescribed, will not work!
There are, of course, alternative measures that can help alleviate symptoms of withdrawal
from these meds, such as acupuncture. I encourage anyone with rebound headaches
to see a headache specialist or neurologist for consultation. Working together from
here, you can develop a plan to really support your body through the withdrawal
and stabilization periods.
One rare type of headache that you should be aware of is temporal arteritis. Temporal
arteritis, also known as giant cell arteritis, is an inflammatory condition
affecting the medium-sized blood vessels that supply the head, eyes and optic nerves.
It is an uncommon affliction, but women are approximately four times more likely
to suffer from temporal arteritis than men, and it occurs most often after the age
of 60. It should be ruled out in women over 60 who experience unusual headaches
with localized temple or scalp tenderness and affected vision in one eye (eventually
Temporal arteritis can include other associated symptoms, including fever, nausea
or jaw discomfort. There is a risk of permanent vision loss if left unidentified
and untreated with corticosteroids in the acute stages. If you experience an unusual
headache or a headache with symptoms matching these, seek medical evaluation promptly
from a specialist or an emergency room physician. A simple blood test can often
confirm or rule out this condition.
Headache treatments: the conventional approach
As a headache sufferer, woman, and healthcare practitioner, I am a big believer
in pain relief. While my colleagues and I want to prevent headaches as effectively
and naturally as possible, we also accept the reality that once a headache has taken
hold, a woman may need help with the pain. Women need to work and be able to function
for themselves and their families, so turning to the medicine cabinet once in a
while may be their best recourse.
There are plenty of headache medications, or “rescue treatments,” available. But
just as important is recognizing that headaches are your body’s way of getting your
attention and highlighting an imbalance that needs to be addressed. Simply treating
the pain without addressing the underlying imbalance will leave you vulnerable to
further headaches and can lead to other, more substantial issues over time. And
while there are effective natural headache remedies, the best place to begin is
with natural prevention.
Natural prevention — start with a headache diary
Most chronic tension headaches can be relieved by dietary and lifestyle changes.
Migraine headaches are somewhat different as they may stem from other issues, but
they also usually respond well to natural measures.
A headache diary is one of the most useful tools available for this purpose. Over
time, tracking your headaches, their quality, quantity and duration, allows you
to spot your personal triggers. You can keep a daily record of your eating, sleeping,
drinking, and exercise habits, along with the time and place you begin to feel a
headache coming on. You can also mark down where you are in your menstrual cycle,
if and when you take medication or HRT, and how these factors may relate to your
headaches. When in doubt, write notes on behavior and events. All of this information
can reveal surprising patterns when recorded consistently for two to three weeks.
Premenopausal women should log a headache diary through at least one menstrual cycle,
Some of my patients who began headache diaries found that their headaches were directly
related to previously undiagnosed food or environmental sensitivities, underlying
muscle tension, teeth grinding (a major culprit in TMJ headaches) — even sleeping
on a bad mattress! One of my friends consistently developed a migraine the day after
visiting her mother-in-law — a trigger she was unaware of until she began keeping
a record of her daily activities.
Assessing the support you give yourself in relation to the demands and difficulties
in your life is absolutely the first step in determining how to help yourself.
Once you have a broad idea of your habits and the kind of headaches you suffer from,
you can choose to adopt a few or all of the following natural measures. You may
want to consider trying our programs.
Either way, you are treating your headaches from the ground up, not just at the
surface and it may take a little time. But if you’re prepared to stick with it and
tune in to the elements creating your core imbalance, these measures can often provide
full relief from chronic headaches.
Ten ways to eliminate headaches naturally
1. Focus on diet and optimal nutrition.
Headache sufferers should take a close look at their diets. For many people, sugar
and alcohol are headache triggers. While it may not be possible for you to eliminate
them from your diet, gradually reducing your intake may decrease the frequency of
your headaches. Ensuring that your body has all the essential vitamins and minerals
it needs to work efficiently will also help reduce headache frequency and intensity.
A balanced diet rich in all the food groups that focuses on whole, natural foods
forms a solid base. We recommend women take a top quality daily multivitamin that
includes calcium, magnesium and essential fatty acids in addition to a healthy diet.
A note about caffeine: Caffeine itself isn’t really a headache trigger. It’s the
caffeine withdrawal that triggers a headache. Caffeine can actually be
effective in aborting migraines and so quitting caffeine may need to be done gradually
to avoid headaches.
2. Consider testing for food and environmental allergies and
Many women get a lot of information from blood testing for food and environmental
allergies and sensitivities. Headache-aggravating foods worth investigating include
alcohol (wine especially), dairy, aged and fermented foods, and highly processed
food products. Substances in foods of greatest concern to headache sufferers include
tyramine, nitrites, chocolate, MSG, sulfites, histamines, tannins, prostaglandins,
artificial colorants, preservatives, and sweeteners such as aspartame (NutraSweet).
Since, depending on your unique physiology, a headache could be triggered by just
about any substance, get a handle on what’s affecting you by being tested. And don’t
forget examining your environment: mold, scented candles, air fresheners, cosmetics,
cleaning products — even soap — are all suspect. Some find NAET (Nambudripad’s Allergy Elimination Techniques)
successful at diagnosing and clearing both food and environmental issues.
3. Reduce inflammation with regular detoxification.
Much of the inflammation in your system fans out from inflammation of the gut. Good
digestion and regular daily bowel movements are signs of efficient detoxification.
One of the first signs of sensitivity to a toxin is a headache, and chronic headaches
may indicate that your body is trying to process a heavier toxic load. Magnesium
at bedtime and a daily dose of probiotics can really help. Consider a biannual detox
and colon cleanse if you have any issues with IBS or constipation.
4. Adopt stress management and relaxation techniques.
Once people start tracking their headaches, they may conclude that mild to moderate
headache sufferers always feel better when they’re on vacation. Why? The answer
is simple — stress reduction. An interesting phenomenon often seen in migraines
is the concept of the “let-down” headache. This phenomenon has been well studied
in the medical literature and it seems that many migraine sufferers will develop
a migraine after a stressor. For example, the headache often comes on the weekend,
on vacation or after a big exam or presentation at work. Sort of the opposite of
what you might think when linking stress to headaches.
We cannot escape stress, but we can develop
better coping strategies for daily challenges — at home, where we actually
tend to feel the most stress, and at work. This takes attention, self-care, and
awareness. Begin with the small steps you’re most sure about to ease your stress,
or manage individual stressors. These will help you build momentum toward a greater
Sometimes a therapist, behavioral counselor or life coach can help you explore your
emotional roots so you can get past any behaviors that no longer serve you. Don’t
forget the possible triggers of physical stress — poor ergonomics at work, staring
at a screen or too much driving — even carrying a heavy purse or wearing an ill-fitting
bra can cause muscle tension that leads to headache.
Many women use yoga, meditation and deep breathing exercises to reduce tension.
Others prefer more active antidotes to stress like running or swimming. And still
others find peace from a new hobby or artistic technique. With a little experimentation
and an open mind, you can find what soothes and relaxes you and then do it more
consistently. Try building “mini-vacations” into each day — little respites for
breathing deeply, enjoying nature or just unwinding and being still. Counselors,
doctors, books, and classes are good places to start — I often recommend the book
The Relaxation Response by Herbert Benson.
5. Get enough sleep.
Sleeping soundly for a good amount of time can help headache sufferers in many ways.
Most of us thrive on seven to nine hours per night, with less in summer, more in
winter for some. If you have trouble falling asleep or wake in the night, take a
look at what you do before going to bed.
Set the stage for a better night’s rest by making a few simple adjustments. Some
women need a small bedtime snack to keep their blood sugar stable. Other women do
well with extra adrenal or serotonin support that can shift their physiology into
a deeper, more restful sleep cycle. You might consider a short-term course of phosphorylated
serine or 5-HTP for these purposes. Additionally, some women benefit from taking
melatonin to help normalize their sleep cycles. If hormonal fluctuations are contributing
to restless sleep, these may be influencing your headaches as well.
Most women find that calm, relaxing activities during the two hours before bedtime
translate to more peaceful sleep. No More Sleepless Nights is a good
resource that details successful sleep hygiene techniques and has proven to help
my patients sleep.
6. Stay well hydrated.
Many of my patients’ headaches experience dramatic relief once they focus on drinking
more water daily. Most have no idea they are dehydrated! Increase water consumption
slowly, working up to 8–10 glasses a day by increasing one cup per day every three
days. Sipping throughout the day is better for you than guzzling large quantities
of water in one sitting, but we encourage you to experiment and do whatever works
best for you and maintains good results. Many people are convinced they don’t need
so much hydration, but if you suffer chronic headaches, nothing is easier than drinking
7. Evaluate body mechanics and alignment.
Posture and head and neck alignment are huge factors in nearly all types of headaches.
Many of us are unaware how significantly our body architecture affects our joints
until we have pain. Chronic headaches may be your body’s telltale sign that something
is misaligned and not working for you.
It is critical to make sure your desk and overall work environment are ergonomically
correct for your body’s dimensions and activities — especially with repetitive or
computer tasks. Consider strength and alignment training with a certified yoga or
Pilates trainer and pay attention to how you move through life every day. Are you
sleeping in a healthy position? Cradling the phone between your head and shoulder?
Driving and gripping the wheel? Carrying your purse? All of these activities can
add up to major physical stress and lead to head and neck pain over time.
Talk with your dentist about your bite and whether or not you grind your teeth.
Ask if you might benefit from an occlusal adjustment — a process that realigns the
way the surfaces of your teeth strike each other when you bite down.
8. Get regular exercise and stretch daily.
We all need exercise for its many benefits — to the heart, circulation, muscle tone,
and stress reduction. Most tension headache sufferers find immense relief with the
addition of exercise — and there is the added advantage of deeper breathing and
better oxygenation. Just remember to pace yourself if you are beginning a new routine,
and to support your workout with good nutrition and plenty of water.
9. Explore alternative therapies like massage and acupuncture.
Many headache sufferers respond well to massage therapy and acupuncture. In fact,
many forms of bodywork or physical therapy can help reduce stress and may release
endorphins into the blood that help relieve pain. If you pursue Traditional Chinese
Medicine and acupuncture, find a licensed practitioner. If these methods work to
alleviate your headaches, I would try to integrate them into your monthly routines.
You may want to explore biofeedback as well, which has been shown in some studies
to decrease headache frequency by 50%.
10. Support with supplements.
In addition to a full-spectrum multivitamin that includes adequate daily vitamin
D, we recommend some specific supplements to reduce headaches. Research — and our
own medical experience — indicates that
and newer discoveries like quercetin and green tea leaf extract can all be helpful.
Regular use of herbal products containing standardized, purified extracts of butterbur
(Petasites hybridus) and feverfew (Tanacetum parthenium) can help
A custom homeopathic or flower essence formula is also worth consideration, as both
are very safe and yield good results — especially in combination with the above
measures — in our natural approach to headache relief for women. Most women can
definitely find the headache relief they need, and in the process, they’ll find
other benefits as well.
Abraham, G., & Lubran, M. 1981. Serum and red cell magnesium levels in patients
with premenstrual tension. Am. J. Clin. Nutr., 34 (11), 2364–2366.
Bianchi, A., et al. 2004. Role of magnesium, coenzyme Q10, riboflavin, and vitamin
B12 in migraine prophylaxis. Vitam. Horm., 69, 297–312.
Boehnke, C. et al. 2004. High-dose riboflavin treatment is efficacious in migraine
prophylaxis: An open study in a tertiary care centre. Eur. J. Neurol. 11(7), 475–477.
Breen, C., et al. 2003. High-dose riboflavin for prophylaxis of migraine. Can. Fam.
Physician, 49, 1291–1293.
Burke, B., et al. 2002. Randomized, controlled trial of phytoestrogen in the prophylactic
treatment of menstrual migraine. Biomed. Pharmacother., 56, 283–288.
Davis, J. 2004. High-dose riboflavin for the prevention of migraine: Can we afford
to ignore it? Intern. Med. J., 34 (6), 372–373.
Diener H., et al. 2004. The first placebo-controlled trial of a special butterbur
root extract for the prevention of migraine: Reanalysis of efficacy criteria. Eur.
Neurol., 51 (2), 89–97.
Glueck, C., et al. 1986. Amelioration of severe migraine with omega–3 fatty acids:
A double-blind, placebo controlled clinical trial. Am. J. Clin. Nutr., 43, 710.
Grossman, W., & Schmidramsl, H. 2001. An extract of Petasites hybridus is effective
in the prophylaxis of migraine. Altern. Med. Rev., 6 (3), 303–310.
Johnson, E., et al. 1985. Efficacy of feverfew as a prophylactic treatment of migraine.
Brit. Med. J., 291, 569–573.
Lipton, R., et al. 2004. Petasites hybridus root (butterbur) is an effective preventive
treatment for migraine. Neurology, 63 (12), 2240–2244.
Maizels, M., et al. 2004. A combination of riboflavin, magnesium, and feverfew for
migraine prophylaxis: A randomized trial. Headache, 44 (9), 885–890.
Mauskop, A., et al. 2000. Petasites hybridus (butterbur root) extract is effective
in the prophylaxis of migraines: Results of a randomized, double-blind trial. Headache:
J. Head & Face Pain, 40 (5), 420.
Peikert, A., et al. 1996. Prophylaxis of migraine with oral magnesium: Results from
a prospective, multi-center, placebo-controlled and double-blind randomized study.
Cephalgia, 16 (4), 257–63.
Pothman, R., & Danesch, U. 2005. Migraine prevention in children and adolescents:
Results of an open study with a special butterbur root extract. Headache, 45 (3)
Rios, J., & Passe, M. 2004. Evidence–based used of botanicals, minerals, and vitamins
in the prophylactic treatment of migraines. J. Am. Acad. Nurse Pract., 16 (6), 251–256.
Silberstein, S., & Merriam, G. 1999. Sex hormones and headache. Neurology, 53, S3–S13.
Silbertstein, S., 1992. The role of sex hormones in headache. Neurology, 42 (Suppl.
Smith, S., et al. 1987. Progesterone alters GABA and glutamate responsiveness: A
possible mechanism for its anxiolytic action. Brain Res., 400 (2), 353-359.
Hauri, P., & Linde, S. 2006. No More Sleepless Nights. NY: John Wiley & Sons, Inc.
Davis, M., et al. 2000.The Relaxation and Stress Reduction Workbook. Oakland, CA:
New Harbinger Publications.
Enhance memory now -
take care of your brain for the future