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The connection between hormones and migraine headaches: understanding the link
Discover how hormones like estrogen, testosterone, and cortisol influence migraine in all genders, as well as how treatments and tracking systems can help control symptoms.

Hormones play a significant role in a wide variety of bodily functions, including how we experience pain. For people who suffer from migraines, understanding the relationship between hormones and migraine headache symptoms can be a game-changer. While hormones like estrogen, testosterone, and cortisol are often associated with specific biological sexes, fluctuations in these hormones can affect migraine risk in people of all genders. Understanding how your endocrine (hormone) system works — and what throws it off balance — can help people who suffer from migraine decrease the severity and frequency of symptoms.
Here, we'll explore how hormones can influence migraines, including how hormonal medications can affect migraines, and review both natural and medical strategies that can help balance hormones. We'll also talk about how Evidation's MigraineSmart tool can help you track your migraine symptoms, helping you to understand and avoid triggers.
How hormones influence migraine in all genders
Hormonal fluctuations are major drivers of migraines, particularly for those who experience regular hormonal changes due to menstrual cycles, pregnancy, perimenopause, menopause, or gender-affirming treatments. Hormones don't only affect women or people assigned female at birth (AFAB). Everyone produces estrogen, testosterone, and cortisol, and imbalances can trigger headaches and/or migraine in anyone. People assigned male at birth (AMAB) can also experience migraines related to testosterone dips or elevated cortisol levels, especially if they're experiencing high levels of stress or dealing with certain hormonal disorders.
Estrogen, testosterone, and cortisol: key players in the development of migraine
Even slight fluctuations in major hormones — including estrogen, testosterone, and cortisol — can trigger migraine attacks for some.
Estrogen
Estrogen's role in the development of migraine is well-studied. The hormone regulates serotonin, a neurotransmitter that plays a central role in migraine. When estrogen levels drop — such as before menstruation, during perimenopause, or after childbirth — serotonin levels also decline, increasing the likelihood of a migraine attack.
This is why many women report migraines just before getting their period. During perimenopause and menopause, estrogen levels can fluctuate unpredictably, making it difficult to pinpoint migraine triggers. Some women find that they experience relief from migraines during pregnancy due to maintaining higher levels of estrogen while pregnant, only to have them return after they give birth.
Testosterone
Testosterone has been shown to have a protective effect against migraines. It appears to reduce a brain event called cortical spreading depression that is thought to precede the onset of migraine pain. Testosterone may also support stable neurotransmitter levels. AMAB individuals with low testosterone may have higher migraine frequency, and AFAB individuals with an imbalance of testosterone and estrogen may be more likely to experience migraine.
Cortisol
Known as the "stress hormone," cortisol is linked to migraine. Chronic stress can lead to cortisol dysregulation.
Abnormally high or low levels of cortisol in both AFAB and AMAB individuals may cause:
- Disrupted sleep
- Fatigue
- Increased inflammation
- Increased nervous system sensitivity
- Increased migraine frequency or severity
Hormonal medications and their impact on headaches
Many people take medications that influence hormone levels, sometimes for birth control, hormone replacement therapy (HRT), or gender-affirming care. These medications can either alleviate or exacerbate migraine depending on their formulation and the individual's hormonal sensitivity.
Hormonal birth control
For many AFAB individuals, oral contraceptives — known as birth control or simply "the pill" — stabilize estrogen levels and reduce hormonal fluctuations, which may lead to fewer menstrual-cycle-related migraines. Others may find that the synthetic estrogen in birth control pills triggers migraines or increases their severity. Migraine with aura (neurological symptoms that can cause visual, sensory, verbal, and motor symptoms) is an especially concerning issue for those taking birth control that contains estrogen, as both migraine with aura and estrogen-containing birth control can increase the risk of stroke.
Hormone replacement therapy (HRT)
HRT can be used to treat menopause symptoms or as a part of gender-affirming treatment, but may be problematic for people who experience migraine. Some people receiving HRT may find that it alleviates the severity or frequency of their migraine symptoms, while others may find the opposite to be true.
Other medications
Corticosteroids and other hormonal treatments can also influence the frequency or severity of migraine. If you take prescription medication and experience migraine headaches, it's important to talk with your doctor about whether the two could be related and how to manage your symptoms.
Hormone testing and diagnosis
If you suspect that hormones may be to blame for your migraines, hormone testing can help.
Hormone testing can measure levels of:
- Estrogen
- Progesterone
- Cortisol
- Thyroid hormones
Testing is typically done through blood, saliva, or urine, and may be recommended by your family doctor, a neurologist, endocrinologist, or reproductive specialist. Your care provider might also ask you to track migraine episodes alongside your menstrual cycle, stress levels, or hormone therapy to look for patterns and identify potential triggers.
Natural and medical strategies to balance hormones
Addressing hormonal imbalance may reduce migraine frequency or severity. Your healthcare provider may recommend a number of strategies, including lifestyle changes, supplements, and medications tailored to your individual needs.
Natural approaches
Holistic methods your doctor may recommend to balance hormones include:
- Stress-reduction techniques: Yoga, meditation, therapy, and breathing exercises can all help your body regulate cortisol levels.
- Diet and nutrition: Eating a balanced diet with plenty of fiber, omega-3 fatty acids, and hormone-supportive nutrients like magnesium and vitamin B6 can promote balanced hormonal health.
- Sleep: Consistent, high-quality sleep supports balanced cortisol and melatonin levels.
- Exercise: Regular movement helps to improve insulin sensitivity and may help to regulate estrogen and testosterone levels.
Supplements
In addition to lifestyle changes, your care provider may recommend certain supplements, including:
- Magnesium
- Vitamin B2 (riboflavin)
- CoQ10
- Chasteberry
- Ashwagandha and other adaptogens
It's important to always check with your healthcare provider before starting new supplements, especially if you take prescription medications.
Medical treatments
If natural methods don't provide migraine relief, your doctor might recommend medical options, including hormonal therapy, migraine-specific medications (like CGRP inhibitors), antidepressants, or anti-seizure drugs.
Track, learn, and understand your triggers with Evidation's MigraineSmart tracking tool
Migraines are intricately tied to hormones, and tracking your symptoms can be vital for effective treatment. At Evidation, our MigraineSmart tracking tool utilizes data you collect from wearable fitness trackers (and other health data) to help you understand patterns and triggers, allowing you to take steps toward fewer migraine days. Whether you decide to fight back against migraine through natural lifestyle changes, hormone therapy, exploring and managing your triggers, we're here to help. Click here to learn more and get started with Evidation and MigraineSmart today.

Why Evidation Believes Everyone Can Participate in Better Health Outcomes
Evidation Members share their experiences and how they use Evidation to improve health outcomes
At Evidation, we’re passionate about helping everyone reach their individual health goals. That could be in the form of getting paid for doing health-related activities as a little extra motivation, or by providing you with easy ways to understand your personal health. We also help to connect you with ways to contribute to cutting-edge research, where you can help to improve health for everyone. We wanted to share 5 of Achievement’s values that are important in our mission of helping everyone to participate in better health outcomes.
We meet you where you’re at
We understand that everyone’s health goals and needs are not the same; that’s why we individualize your experience based on what you tell us is relevant to you. You can also choose to earn points for everything from step tracking, sleep tracking, continuous glucose monitoring, meditation and more. We are here to support your health goals, regardless of where you’re at in your personal health journey, like Sarai (a long time Achiever) explains:
“I have Fibromyalgia and chronic Myositis …. Life can become difficult and overbearing … Many, like me, are bound to a wheelchair 50% or more of the time. Can you imagine how unmotivated you can feel to get out of bed, let alone workout!? But as it stands, the best treatment for this condition, is to KEEP MOVING. Achievement provides that imaginary friend. One who will not give you unwanted advice, or invite you to things you cannot go to. It provides that gentle motivation, for you to set your own goals. Not that of your doctor, friend, or family member. But YOURS. You know your body best …. With Achievement I can keep track of my progress…” -Sarai H.
When you get started with Evidation, we encourage you to take the time to fill out your Health Survey so that we can provide you with study invitations, and other opportunities that are relevant to you.
You are in full control of your data
Evidation provides a place for you to view your data from your connected apps in one place. By centralizing this information, we can help you to better understand your health and ultimately achieve your health goals.
It’s entirely up to you to choose what you want to share and earn points for on Evidation. Whether you’re interested in steps, exercise, sleep, nutrition, meditation or something else, you can choose what activities will be shared.
This member shares how they’ve used multiple apps on Evidation to track their health:
“I’ve been a member of Evidation for a while and it has motivated me to take control of my health by syncing all of my apps into one place and then rewarding me for it. This has been vital for me recently because my health has taken a toll lately and I’ve needed to really step up my game and take control of what I can in my personal health, Evidation has made that simple.” — Isis F.
You can access and download all of your Evidation data in one place at any time, giving you more insight into your health. You can change your mind about what activities you want to track at any time. We provide you with control over what data you share with us and we do not sell your data to third parties without your clear consent. Your health data is yours.
We are transparent
We believe that it is important to always be clear and transparent with our members about how their data is used. We may use your anonymized data for our own internal research to advance the forefront of healthcare and share back insightful health trends and tips, such as whether or not air quality can affect activity patterns or how the World Series affected sleep patterns. Tristan shares why he chooses to share his data with Evidation:
“…Evidation is exciting for me as I get to send data to [them] every single day. Data gathering is fulfilling for me, especially knowing it’ll be put to good use, so that inspires me to log my activities all the time” — Tristan R.
We also give you the choice to participate in research projects related to your health interests, goals or conditions. The specific information you will be asked to share will be disclosed in the consent and/or disclosures for that particular project (each project may be different). Evidation Members have had the opportunity to participate in groundbreaking research around diabetes, mental health, and more.
We provide you the opportunity to give back to the causes you care about
It’s great to earn personal rewards for all of your health actions; however, many members also choose to use their rewards for a good cause. That’s why Evidation also provides the opportunity to donate your points to a health charity of your choice through Benevity when you reach 10,000 points. The points you earn for taking healthy actions can also go back to organizations that are working towards creating a healthier world. Elizabeth shares why she decided to donate her points:
“Evidation motivates me to exercise more since it adds points each time. It also motivates me to join support apps for my type 1 diabetes and read more research articles. When I hit 10,000 points I donated the $10 to JDRF International [Type 1 diabetes researching funding and advocacy] to help support the continuation of research to find a cure.” — Elizabeth P.
Your actions can impact many
At the individual level, we can take actions to control our health, but we believe that we can achieve and learn even more as a community. We’ve sent out offers to members with similar health conditions, allowing them to ask relevant questions they would like answered about health topics that matter to them, such as anxiety or diabetes.
You’ll also have the opportunity to qualify for and participate in cutting-edge research studies related to various conditions, for which you can earn additional points or money, and together we can contribute to and advance research that can help improve health for everyone. This Evidation Member shares how her participation in a study has helped in improving her health outcomes:
“I have been using Evidation for a few years now. I participated in the 1yr Cognitive Health Study that really helped me to know how to improve my cognitive health and protect my brain from damage due to diet and environment. It motivated me to start an exercise class for seniors … As of today we have 11 in the class…” — Janet A.
We’ve worked with a variety of research partners to conduct groundbreaking research and studies where members could participate and earn. Evidation members who participated in studies and research helped to advance research in conditions ranging from like asthma, cystic fibrosis, diabetes, mental health, migraines, rheumatoid arthritis and more. The contributions made to these studies could impact millions in the future, and help to bring new understanding about these conditions. We think Jenny, a long time Evidation Member, sums it up best:
“…[Evidation] makes me feel good knowing that maybe one day my tracking could maybe help someone. I have depression and anxiety. If that helps even one person with this data collection I stand by it 100%.” — Jenny B.

Why you might be stuck in your health goals
We’ve all been there — the “new year, new me” mindset where the first few months of the year we quickly shift our habits in order to become a better version of ourselves. However, right as the ball gets rolling, the progress suddenly stops.
We’ve all been there — the “new year, new me” mindset where the first few months of the year we quickly shift our habits in order to become a better version of ourselves. However, right as the ball gets rolling, the progress suddenly stops. Why am I not running as far? Why am I not losing any more weight? What am I doing wrong? Here are 5 key points we found that might have you stuck with your health goals (hint: it’s not your fault!)
1. The Inevitable Plateau
According to a Washington post article, once you gain the initial traction, there will be an inevitable plateau. It’s actually part of the journey. You didn’t do anything wrong, but rather you hit a milestone. Once you achieve your small goals, the journey is just beginning!
The plateau is your body’s way of telling you that you may need to switch up your fitness or eating regime to keep your body stimulated and get the most benefits from your efforts! Remember that health does not have an endpoint, it is a journey with a myriad of challenges and achievements that help sustain healthy behaviors.
2. Having grit: make a plan and stick to it!
To overcome the plateau, it’s important to analyze your goals. But first, what are they? Why do you want to achieve these goals? What steps can you take right now to achieve your goals? Having grit shows that you are resilient, able to persevere through tough situations, and keep your eye on the prize.
Remember that your journey towards better health may be nonlinear and may come with obstacles. But it’s important to create a system that works for you and make your goals attainable. According to Plunkett of the Washington Post, “the main difference between an average adult and a high-level athlete isn’t a lack of talent or willpower but rather a lack of a system.” At Achievement, we’re here to help you reach your goals no matter how big or small. Whether it is walking 5,000 steps or 25,000 steps per day, you will be rewarded for your healthy actions!
3. Have someone nudge you — accountability and buddy system
A few health experts like Dr. Arefa Cassoobhoy found that she does better when she shares her health goals with someone else. It’s important to have someone support you and be able to share wins and losses during your health journey. Having someone join you will also hold you accountable to reach your goals, and you may be helping someone else reach theirs! Win-win!
Additionally, digital health trackers are a great way to help hold you accountable to health goals and track your journey. Our in-house research team looked at thousands of individuals using digital health trackers and found a positive association between activity tracking frequency and weight loss. Just one more reason to try out a new health and wellness app for some extra accountability.
4. Rethink, don’t sink.
Perspective is key — making healthy choices shouldn’t be seen as a chore, but more of making everyday incremental investments to be a better version of yourself. Instead of having the same routine for months straight, mix it up. Try a new exercise, mix up your sleep routine, or try adding daily meditation to your day to see what works for you. This will stimulate more progression and get you out of the plateau sooner.
If you dislike running, try substituting running for something that still keeps your heart going like swimming. If you dislike eating certain foods, try substituting those foods with other ones you like that offer the same nutrition. Your health journey is not a race to the finish line — remember that this journey is about learning and creating the best version of yourself.
Cultivating confidence and finding the reasons behind your goals will help motivate you through the journey. PennState Extension Educator Lynn James stated building confidence, praise, and support are key factors in motivating you to reach your health goals. Furthermore, take time to thank your body. Akin to health expert Samantha Heller, a registered dietitian and exercise physiologist, shares that your body is working 24/7 to keep you alive; therefore, we should appreciate our body and hone in on practicing positive body image.
5. Pat yourself on the back: reward yourself.
Lastly, recognize that you are making strides and meeting milestones in your journey. For all the hard work you put in, you deserve to treat yourself! Through the Achievement app, you can connect and earn points for cash for your hard work! Woo-hoo! Our research team notes how incentives can help form habits. In this case, we want to reward you for the healthy actions you take to form healthy habits.
You can make a reward system that best suits your lifestyle, such as going to the movies or going out with your loved ones after completing your week’s workout. If you have been diligent in preparing your meals and enjoy making your own meals and drinks, use your Achievement reward to treat yourself to buying the nice blender that you wanted for your smoothies or slow cooker for your weekly meals. If you have been sticking to your exercise routine, use your rest day to spend some time hanging out with your family or friends and share your journey with them.
At Achievement, we strive to support you along your health journey and make it enjoyable. We hope that these key points and tips will give you the boost you needed to carry on and continue to progress. Was there something that we missed that made it on your motivator list? We’d love to hear your thoughts in the comments below!

Meet Our Community of Evidation Members
We recently shared a survey out to our community. The feedback and responses we’ve been receiving from our work and research brings us comfort and assurance knowing that the Evidation app has made a positive impact on your lives.
At Evidation, we're committed to putting our community first and to helping you reach your health goals no matter how big or small. We recently shared a survey out to our community. The feedback and responses we’ve been receiving from our work and research brings us comfort and assurance knowing that the Evidation app has made a positive impact on your lives. Our community of members is our driving force to create and learn new things that help you reach your health goals. Your stories have truly hit it home for us, and we love reading them.
We’re excited to continue to be part of your health journey and guide you in any step you need to keep achieving. Want to hear more about what our community of members feel? Meet the community and read their responses:

“I’ve been using Evidation for about 2 months now. I need to get back into exercising to earn more points. I like that it offers interesting articles to read and surveys. I enjoy Evidation because it will help me to reach my goals!” — (Emily D., Michigan)

“I have been using Evidation for a few years now. I participated in the 1yr Cognitive Health Study that really helped me to know how to improve my cognitive health and protect my brain from damage due to diet and environment. It motivated me to start an exercise class for seniors. This photo was last week. As of today we have 11 in the class. I am blessed!” — (Janet A., California)

“I have been using Evidation for probably close to 2 years now. I am hoping more people continue to use this so that data can be collected on activity, diet, weight, and sleep patterns and be studied to see the effects on health. This app has definitely made me track my weight closer and log my food more as well. I think this is a great app that may motivate people to make changes for a healthier lifestyle and better quality of life.” — (Ryan A., Florida)
“I was lucky enough to be chosen as one of the participants in the [cognitive health] study. It was a great experience and has made me more aware of what I need to do to keep my memory healthy. It has taught me which foods are essential for mental health and the need for exercise.” — (Carol C., PA)

“I have been using Evidation since the beginning of the year and it has been an awesome tool to quantifying my activities each day. I am a marathon runner but Evidation has been awesome for seeing all of the activities aside from running. It also just runs in the background of my daily life and will eventually earn me some money. I have been managing my own blog for my running for the past year and Evidation is changing the game for me.” — (Amanda R., South Carolina)
“I’ve been using Evidation now for about a month and a half and it’s amazing that I can earn money for being active! I challenge myself everyday to walk more and more to earn even more points then I did the day before. Cheers to being healthy! :)” — (Madison S., Indiana)

“It has been difficult to find a health routine to fit my third shift schedule. Working from midnight to 8 am sometimes forces you to eat bad food to stay awake! Fitbit and Evidation keep me accountable. I am now on a workout routine that gives me energy to put my all into work and my relationships outside of work.” — (Lauren B., Ohio)
“Evidation has been great in motivating me to get to a better place. Seeing the points I accumulate only makes me want to do more! I signed up as a means to better my health due to having high blood pressure since the age of 3. About two years ago, I decided to take up running to help do my part. Since then I have been getting faster, going farther, and feeling better than I ever have!” — (Eddy R., Pennsylvania)
“Having an app pay me to work out definitely has given me the motivation to join a gym and become a healthier happier person. I was also part of a migraine study which I hope my data is used to help someway in the future.” — (Katie N., MA)
Thanks again to all of our Evidation Members who have already shared their amazing stories. We’d love to hear from more of you! What does Evidation mean to you? What do you want to achieve? How can we help get you there? And let’s not forget, you can be a part of our Evidation community! Check out some of their awesome smiles below.
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Can sleep patterns tell us the severity of our anxiety or depression?
Depression and anxiety can have a huge impact on our daily lives and overall health. It can affect our mood, social interactions, sleep and more, but can our daily behaviors predict the severity of our anxiety and depression? Our research team sought to find out more.
We know that anxiety and depression affect many of you, with 7 out of 10 adults in the U.S. saying they experience stress or anxiety daily. Depression and anxiety can have a huge impact on our daily lives and overall health. It can affect our mood, social interactions, sleep and more, but can our daily behaviors predict the severity of our anxiety and depression? Our research team sought to find out more.
What we tested
We enrolled over 1,000 participants in a clinical study with self-reported anxiety and depression and assessed the participants’ mental health states by looking at the following for each individual:
- Anxiety and depression symptoms
- Number of hospitalizations and ER visits for anxiety/depression
- Use of anxiety and depression medications
We then looked at participants’ sleep metrics and patterns for the previous three months.
What we learned
Severe depression was significantly associated with inconsistent and disordered sleep patterns, such as spending a great amount of time in bed awake. Individuals taking medications for their anxiety and/or depression were likely to sleep more compared to those not receiving treatment, however, they also had inconsistent sleep patterns. Participants who had been previously hospitalized for anxiety and/or depression were more likely to have inconsistent sleep patterns as well.
What does this mean?
We all know that a lack of sleep can affect our daily lives, but it can also be associated with severe depression and anxiety. This means that certain sleep patterns might be able to predict the severity of an individual’s mental well-being in the future. With further research we’d like to understand if tracking sleep behavior could predict changes in the severity of an individual’s mental health condition.

Thanks to all of our members who participated in this research about how daily behaviors, like sleep, can tell help researchers to better understand anxiety and depression. If you’re interested in contributing to innovative research, we are regularly running new studies at Evidation.

3 Reasons Why Tracking Your Health Can Help You Participate in Better Health Outcomes
Here are the top three reasons why tracking your health with Evidation will help you be part of something just a little bit bigger than yourself this holiday season.
According to 2015 Pew Research, “one in three cell phone owners have used their phone to look for health information.” Four years ago, we started Evidation to help everyone understand their personal health, take control of their health journey, and help contribute to improving the health of everyone. Here are the top three reasons why tracking your health with Evidation will help you be part of something just a little bit bigger than yourself this holiday season.

1. Actively participate in your health
With the over 30+ apps that you can connect to Evidation, we’re able to look at patterns of activity levels and do a deep dive into tracking health and wellness. We’ve published research around how your social engagements can impact activity levels. Lastly, we’ve given our community a chance to learn from each other, asking communities of individuals what questions they have for one another and sharing back the results.
2. Learn about health and research through insights
With a community of over a million, we’re constantly looking for opportunities to highlight and share relevant research tailored to you. We’ve also done deep dives on seasonal trends over the last year, including a step analysis around the Pokemon Go phenomenon, the difference between men and women during Back to School, and a look across the United States at Halloween calorie count.
3. Participate in ground-breaking research to advance the health of everyone
We’re focused on building a product that makes your interactions with health unified. We believe that health is much more than a visit to the doctor. It’s a constant effort every day of how to track/monitor healthy activities — whether it be steps taken, heart rate monitored, sleep tracked, or even meditation sessions executed. Sign up for Evidation today and starting taking health-related actions, including contributing to cutting-edge clinical studies that are tailored to your specific health conditions.

Dads vs. Moms: How does the transition from summer to fall impact activity levels?
The change in seasons often brings with it a change in routine. We wanted to know how the transition from summer to fall affects our health and wellness, and we’re excited to share these insights from members.
The change in seasons often brings with it a change in routine. So we wanted to know how the transition from summer to fall affects our health and wellness, and we’re excited to share these insights from Evidation Members.
The transition to fall can be especially cumbersome for parents as they juggle back to school duties, but is one parent more impacted than the other by the changing season? We decided to take a closer look at how moms and dads health holds up during the seasonal transition. We were also curious to explore how sleep and steps between parents and non-parents compared.
Who is catching more zzzs?
We uncovered a statistically significant gender disparity between moms and dads. Moms sleep 5 minutes less in the summer than their non-mom counterparts. As the school year ramps up in late August and early September, the difference is significantly more pronounced on weekdays. Moms sleep 10 minutes less than their non-mom counterparts. Dads, on the other hand, show no consistent differences from their counterparts in summer or fall. If anything, they may sleep slightly more.
Moms are also taking a bigger hit in sleep interruption than Dads. Moms sleep 0.34% less than non-moms and 1.4% less than dads. Surprisingly though, non-dads have the most sleep interruptions, spending 8.3% of the night awake.
What time is everyone falling asleep?
Moms fall asleep 12 minutes earlier than non-moms, while dads fall asleep 24 minutes earlier than non-dads. So, while dads don’t seem to be sleeping any less if they are a parent, they appear to be shifting their sleep schedules more. Interestingly, all four groups shift their bedtimes earlier in fall, possibly due to earlier sunsets.
Who is taking more steps?
Moms take fewer steps than non-moms in general. During the summer, moms take 427 fewer steps/day on weekends and 243 fewer steps/day on weekdays. However, when the school year starts, their weekends show an even larger deficit, at 543 fewer steps/day vs non-moms. Their weekdays step counts improve markedly, though, at just 85 fewer steps/day than non-moms.
Dads show the opposite pattern. They actually take more steps than non-dads. In the summer, they have an average of 250 steps/day more than non-dads, while in the fall, they have an average of 348 steps/day more than non-dads.