If you are a woman experiencing migraines it is almost certain that like me, you have noticed some sort of correlation between your cycle and your migraines.   Although chronic migraine may make it difficult to identify estrogen cycle fluctuations as your trigger due to migraine frequency.  So what about our cycles makes us susceptible to migraines at specific times versus others?  There have been numerous studies suggesting a connection to estrogen.

If we take a look specifically at estrogen during a female cycle, this is what happens:
1. Menstruation: estrogen typically measures at a low of <50 pg/ml (first 7 days of graph)
2. Follicular development: estrogen increases during follicular development and peaks at about 200 pg/ml (peak pictured in graph)
3. Ovulation: estrogen drops briefly during ovulation (around day 16 pictured in graph)
4. Luteal phase: estrogen rises again for a second peak (roughly days 20-24 pictured in graph)
5. End of Luteal phase: estrogen level drop to their menstrual levels (assuming we aren't pregnant)

For me personally I tend to "struggle" around (1.) menstruation and (3.) ovulation.  These are both times in the female cycle where estrogen is dropping.  Estrogen related migraines usually are due to a drop in circulating estrogen after exposure to higher levels of estrogen for a few days (this is referred to as estrogen priming).  This "priming" happens naturally at the beginning of menstruation or immediately after giving birth (and lucky me, after delivering both of my beautiful children I had a tremendous migraine).

Other instances that can cause a change in estrogen levels include:
1.  A purposeful withdrawal from an estrogen containing product (birth control) during the hormone-free week or interruptions in estrogen therapy.
2. Unintentional withdrawal from estrogen by missing doses of pills or as a result of drug interactions that may reduce estrogen availability.

This made me wonder exactly how and why does this drop in estrogen trigger a migraine? 
While investigating I came across a connection between estrogen and serotonin.  Estrogen may also impact migraines by affecting other chemical mediators like nitric oxide, magnesium, and prostaglandins which help keep balance between
excitatory and inhibitory neurotransmission.  However I find the estrogen-serotonin connection particularly interesting.  If you are familiar with migraine medications then you know that one of the most effective abortive medications for migraine are a class of drugs called triptans.  These drugs are serotonin receptor agonists (meaning they bind to the specific receptors in the brain that bind to serotonin).  They work because once they bind that receptor on cranial vessels they cause vasoconstriction (shrinking of the vessels) as well as a decrease the release of a neuropeptide that causes inflammation.  Estrogen impacts the central nervous systems in a number of ways.  When estrogen levels drop, serotonin levels fall and there is also an increase in the rate of serotonin elimination.  With the drop in serotonin two things happen that could impact a migraine: a release of calcitonin gene-related peptide (which is a potent vasodilator or vessel expander that is produced in both peripheral and central neurons) and a release of substance P (which is associated with pain and inflammation) from trigeminal nerves.  To sum it all up, this drop in estrogen has begun a process that leads to vasodilation of cranial blood vessels and pain and inflammation via the trigeminal nerve.

**My graph of the female hormones during cycle was made available thanks to Wikipedia
 

If you are looking for a vegetarian migraine-friendly recipe...this may be what you need.  My 5 year old daughter loves these artichokes, which is evidence that an adult palette is not required for this meal.

Artichokes
2 whole artichokes
Minced garlic
black pepper
salt

I prepared the quinoa per the package instructions... making enough to yield 3 cooked cups of quinoa.  Basically I brought it to a boil and then let it sit there.

To prep the artichokes I cut off the pointed end with a serrated knife and placed them in a pan to boil.  I made sure they cooked at a boil for 15 minutes.  At the same time I preheated the oven to 400 degrees (I will put the artichokes in the oven once they are seasoned later in recipe).

I chopped up the produce:
1. Sliced the green onion thin
2. Diced the green and red bell pepper
3. Chopped the pear into bite size or smaller pieces
4. Diced the celery into thin pieces

I added all of these wonderful things into the cooked quinoa.  Then I added the 1/2 cup of sunflower seeds, 1/2 tsp. crushed red pepper flakes, 3 tsp. agave nectar, and 1 tsp. of salt (I usually add more salt) and mixed it all together.  This quinoa pilaf is ready to eat!

Back to the Artichokes:
Once the artichokes are finished boiling, I removed them from the water and placed them on a cutting board. I cut them in half with a serrated knife.  Then I put them on sheet pan with their hearts exposed.   While exposed I misted them with olive oil with my "Misto" then I seasoned them by sprinkling minced garlic, fresh ground black pepper, and sea salt on them (If you don't have a "Misto" just brush them in olive oil).  Then I placed them in the preheated oven (400 degrees) for 15 minutes.  I left my oven light on to make sure they didn't get too crispy.

If you thought I was done grooming this four little "chokes" you were wrong.  I removed them from the oven and then gave them all a cute little hair cut.  If you have never prepared or eaten an artichoke this is how I do it.  I take a regular spoon from my cutlery drawer and spoon out/off all of their hair being very careful not to take a piece of their sweet little hearts off with their hair.  Then I remove all the "crispier" leaves leaving only the yummy ones with a little heart on them (pictured). 

If you have never eaten an artichoke prepared this way, you pull each leaf off and eat the tender white heart off each leaf (as in the one pictured) one at a time until you have no leaves left.  At this time it will be just you and the heart--the best
part.  You can eat all the heart you want.  It's a very sad ending for the artichoke but a wonderful experience for the eater.  And to quote my now seven year old son, who was 3 at the time of the quote, "Lehman's aren't quitters, we are eaters"! 

I served these artichokes on top of the pilaf for a vegetarian and migraine-friendly dinner. 

**This pilaf goes great with both fish and meats as well.