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Hi Iris Pleased you have found this link with Hormones. I cannot tolerate Oestrogen and my headaches are directly linked to fluctuating levels of hormones. I have been doing quite a lot of research on this recently particularly in the link between hormones and calcium channels (given Verapamil helps a number of people) and Vitamin D. My history: worse during perimenopause cycle lined up with menstruation and hormone fluctuations, every month, starting mid luteal phase and lasting two weeks from age 15 (now 53 and post meno) improvement during pregnancy improvement with progesterone or Depo‑Provera flares with oestrogen spikes What I have found so far: oestrogen increases intracellular calcium progesterone reduces neuronal excitability vitamin D stabilizes calcium regulation the hypothalamus is hormone sensitive TACs are disorders of trigeminal autonomic circuits these circuits are heavily influenced by calcium signalling When hormones fluctuate (perimenopause, cycles, postpartum), TACs often flare. When hormones stabilize (pregnancy, Depo‑Provera, post‑menopause with support), TACs often calm. Even though men don’t have the same oestrogen–progesterone cycles as women, the same biological theory still applies to males with hemicrania continua, cluster headache, or paroxysmal hemicrania. The inputs are different, but the mechanisms are the same. All trigeminal autonomic cephalalgias (TACs), including hemicrania continua, paroxysmal hemicrania and cluster headache involve: trigeminal hyperexcitability hypothalamic dysregulation Men don’t have progesterone cycles, but they do have hormones that affect neuronal excitability and calcium signalling. Testosterone has several effects that parallel progesterone's calming influence: supports GABAergic (calming) pathways reduces inflammation stabilizes calcium‑channel activity Low testosterone, which is extremely common after age 40, can make pain circuits more reactive. This is why some men with cluster headache or hemicrania continua improve dramatically with testosterone replacement. Men also produce oestrogen (via aromatization of testosterone). It’s lower than in women, but still biologically active. Oestradiol in men: modulates calcium channels influences hypothalamic function affects trigeminal sensitivity If testosterone is low, oestradiol can become relatively high, which may increase neuronal excitability. Vitamin D is a major regulator of: calcium movement neuronal firing inflammation hormone synthesis (including testosterone) Low vitamin D in men is strongly linked to: lower testosterone higher inflammation more reactive pain pathways worse TAC symptoms I still have a lot of research to do to confirm this theory, and I am finding it very interesting. My specialist (menopause) is also supporting trials I am doing on myself with various combinations of hormone replacement to find the right balance. She also has trialled me on H1 blockers and whilst these did not help with headaches, my allergy symptoms improved, always a bonus. I am about to start a trial of H2 blockers alongside 200mg daily of progesterone. Hope you remain pain free!