Migraines and Menopause

We know that headaches, migraine and menopause are linked. Women are generally three times more likely to get migraines than men are. Additionally, women experience more intense headaches just before their period when the estrogen levels are the lowest in their cycle.

This group of women have less intense headaches during a pregnancy when estrogen levels are high and once post-menopausal, they may see a reduction or a resolution of their frequent headaches.

The struggle is the peri-menopausal stage, when a woman can experience extreme fluctuations in her hormonal level and her cycles become more irregular. During this stage there is no predictability when and for how long she can have headaches, and this can have a profound debilitating effect in her life. From missing days at work to reduced physical activity and ultimately low mood as a result.

Treating menopause migraines

• Lifestyle changes
• Reduce stress, using relaxation methods such as yoga, massage and exercises with deep breathing
• Maintain good hydration
• Eat at regular times and avoid food that are known to trigger migraine e.g red wine, artificial sweeteners, chocolate and aged cheese
• Get enough sleep
• Balancing hormones

Hormone replacement therapy (HRT) which is the treatment taken by many women just before or after their menopause to help with symptoms such as hot flushes and night sweats can help reduce or treat ‘hormonal’ migraines very effectively.

As always this is a very individualised treatment option which should be started and continued after a detailed risk assessment by a specialist. Sometimes a very mild dosage of estrogen plus a bio-identical (biologically identical) progesterone can help reduce the intensity and frequency of headaches effectively. Although not yet proven but in some individuals an addition of a small dose of testosterone to the HRT treatment can improve/resolve migraines.

If you have been diagnosed with migraines in the past or recently or you are experiencing a higher frequency or intensity of your migraines, it’s definitely worth speaking with a menopause/hormone specialist and to have your hormonal blood levels checked. Re-balancing your female hormones or gently replacing those hormones which have reduced can have a significant positive effect in your migraine management and quality of life.

It’s good to mention that there are many medicines which are either given to prevent migraines such as beta blockers and those which are given at an onset of migraine to relieve the pain and shorten the duration like Triptans, Ibuprofen and Aspirin.