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How To Treat Menopause Migraines

An Introduction To Headaches And Menopause

Perimenopausal migraines: Why they happen and how you can stop them!

Some women entering the menopause experience headache for the first time in their life. This can be disturbing and sometimes debilitating. However, menopausal headaches are most common among women who have suffered from headaches before, particularly around their menstrual period, or among those who are taking hormonal contraceptives.

There are several types of headaches that the menopause can trigger:

  • Migraines these are the most intense type of headache. The pain grows generally on one side of the head or behind the eyes and begins to pulsate or throb. This is sometimes accompanied by aura, or flashing lights and nausea
  • Tension headaches these may be associated with stress and tend to be less severe than migraines. They are characterised by a feeling of tightness or moderate pain across the forehead and back of the head and neck
  • Sinus headaches the sinuses are small air-filled cavities behind the forehead and cheekbones. If the lining of these sinuses becomes inflamed, you may feel congested and experience facial pain.

What You Need To Know For Successful Menopause Headache Treatment

Hormone Replacement Therapy is often used to successfully treat the symptoms of menopause. There is not a lot of research linking HRT with migraine headaches. It might be trial and error to see what your body needs for balance.

You can also consider natural or traditional hormone treatments. Either way, trying to balance your hormones may come with risks.

Consult with your physician, if you feel the need for hormone replacement. Health history and family health history need to be taken into consideration before starting hormone therapy.

A rather large study with over 22,000 doctors, who also had migraines found the risks leaned more towards stroke than heart attacks.

I covered this thoroughly in reducing migraine stroke risks. The study followed the doctors over years, so the findings feel reliable to me.

Once you and your doc both decide it is the right path to take, it is very important to take the hormones long enough to give your body the time it needs to adjust to the meds. Unless you have side effects, of course.

Try different delivery methods for taking the hormones in order to find the best course of treatment for you. Here are some options:

  • capsules, sublingual lozenges, patches, gel, topical creams and suppositories.

Note: oral capsules or tablets have to pass through your digestion process so their effectiveness may be compromised. Creams, suppositories and sublingual troches are forms of transdermal absorption, all of which bypass the digestive system.

What About Vaginal Estrogen

Vaginal estrogen is useful to help control local symptoms of pain and dryness in women who have no problems with hot flushes or sweats, or who still get vaginal symptoms despite using HRT. Vaginal estrogens can cause a temporary increase in migraine during the first couple of weeks but this quickly settles and there is no evidence that vaginal estrogens are a trigger for migraine with long-term use.

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What About Those Who Worsen After Menopause

This is another area with little published data. While there is no good time to have debilitating migraine, Im sure its especially frustrating when we are usually told things get better in the menopause years.

It seems that there are a few factors that influence whether or not migraine tends to improve. Being clinically depressed is associated with worsening migraine. Having high-frequency episodic migraine or chronic migraine is also less associated with improvement. Taking pain-relief medications during perimenopause and menopause for the aches and pains of aging and getting into rebound may lead to worsening migraine. Also, those who seem to be less likely to improve after menopause are women who have their ovaries removed or induced menopause.

HRT seems to be less successful and less appropriate for women after menopause but it may be an option for you. While the 4 doctors did not lay-out a different approach for those women not helped by having lower and more steady estrogen levels, they were still very encouraging about available treatments. They were emphatic about being more aggressive about lifestyle and medical approaches to minimize attacks. If you arent getting better you must advocate for yourself and find a better approach.

What Blood Tests Tell Us

Menopause Headaches: What You Need To Know

Its important to understand that overwhelmingly, those of us that experience hormonal migraine whether its menstrual migraine or from perimenopause, have normal hormone levels. Its our migraine brain that is hyper-responsive and thinks something is wrong. In a person who is not genetically predisposed to migraine, they have the same normal hormonal fluctuations and do not have headache and migraine symptoms.

Blood tests are not typically ordered by doctors as hormone levels vary by the hour, day and month. Hormones are often pulsed into the bloodsteam. The lab information doesnt usually tell them much. Doctors typically make the determination of perimenopause and menopause by what we report.

All 4 of the specialists in the Migraine World Summit interviews were emphatic about the importance of keeping track of your menstrual cycle and symptoms of migraine as well as the usual perimenopause symptoms like night-sweats, hot flashes and altered mood. This info is very important to get the right help managing migraine and menopause.

This is the tracking form that Dr. MacGregor uses with her patients.

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What Does Sleep Have To Do With It

Interrupted sleep, insufficient sleep or sleeping late might increase the frequency of headaches. Menopausal women often suffer with one or more of these sleep disturbances. Up your sleep hygiene game by avoiding caffeine and sugar before bed, limiting screen time before sleep, practicing mindfulness while falling asleep and gaining control of hot flashes and night sweats.

What Are The Symptoms Of A Menstrual Migraine

The symptoms of a menstrual migraine are the same as the symptoms for other types of migraines:

  • Headache pain that ranges from dull to a severe throb.
  • Feeling very warm or cold .
  • Sensitivity to light, noise and smells.
  • Tender scalp.
  • Nausea and vomiting, stomach upset, abdominal pain.
  • Diarrhea or fever .

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Migraines May Worsen Before Menopause

By Kathryn Doyle, Reuters Health

4 Min Read

– High-frequency migraine headaches, which occur at least 10 days a month, are more common in women during the transition to menopause, according to a new study.

For years women have been telling me as a headache doctor that their headaches worsen in perimenopause, but it hadnt been directly studied, said lead author Dr. Vincent T. Martin of the University of Cincinnati College of Medicine and co-director of the Headache and Facial Pain Program at the UC Neuroscience Institute.

Symptoms like hot flashes, irritability, insomnia and depression may start during the hormonal changes of perimenopause, when periods become irregular, but menopause does not officially begin until periods have stopped for one year.

Since the average age of menopause is 51 to 52, and the average transition is five to 10 years, women may see a worsening of their migraines as early as 42 to 47 years old if they are going to have an average-age menopause, said North American Menopause Society executive director Dr. JoAnn V. Pinkerton. The variability for normal menopause is 45 to 55, so women could see an intensification before or after that time.

Changes in brain chemicals may cause blood vessels to swell or dilate, putting pressure on nearby nerves and structures and causing a migraine, Pinkerton told Reuters Health by email.

Risk of headache was highest during late perimenopause, before periods stopped completely, when estrogen levels are low.

Can You Use The Mirena Coil As Well As Hrt

How to Treat Menstrual Migraine–LIFE CHANGING

The Mirena intrauterine system can be used for contraception, to control heavy/painful periods, and to act as the progestogen component of HRT. One advantage is that it acts directly on the womb, with very little hormone reaching the rest of the body. This means that side effects are generally very few. Another advantage is that if a woman has a Mirena, it is easy to adjust the dose of oestrogen to suit her needs. Also, many women find that their periods become very light, or stop completely while they are using a Mirena. If migraine was linked to troublesome periods, this in itself can make migraine less likely to occur.

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Could Hrt Be The Best Treatment For Menopause Headaches

    Theres a sharp, persistent throb on the side of your head, a pulse of pain that seems to quicken even while it slows down time. You have trouble concentrating, become acutely sensitive to noise and lights, feel nauseous, and maybe even experience vomiting. Its a migraine. And if you are undergoing menopause, it could be the result of your changing hormones.

    It is well known that migraines often increase in both frequency and severity during the menopausal transition, resulting in physical pain and, often, functional disruption. While these headaches arent the most famous symptoms of menopause, for many women they are among the most debilitating. If you are approaching menopause, taking steps to avoid migraines can help you feel your best through this pivotal stage of life. Now, a growing number of practitioners believe that hormone replacement therapy could be the best treatment for menopause headaches for some women.

    Signs Of Hormone Headaches

    It’s worth keeping a diary for at least 3 menstrual cycles to help you check whether your migraines are linked to your periods.

    If they’re linked, a diary can help to pinpoint at what stage in your cycle you get a migraine.

    The Migraine Trust has an online headache diary, which may be a useful tool.

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    Supplements For Migraine And Menopause

    There are 5 nutrients with enough supporting evidence in helping migraine to recommend. However, there is not enough research behind supplements for menopause for me to feel comfortable promoting its use. This study of black cohosh showed that it was helpful in reducing hot flashes but there was no control group. Given that hormonal symptoms wax and wane over weeks, its hard to draw conclusions without comparison.

    Why Does Hysterectomy Often Make Migraine Worse

    Pin on Health

    All research points to the fact that hysterectomy worsens migraine. The menstrual cycle is controlled by the brain, which sends messages to the ovaries to stimulate the production of the hormones oestrogen and progesterone. These in turn prepare the lining of the womb for a potential pregnancy. If a woman does not become pregnant, then the lining of the womb is shed at menstruation and the cycle starts over again. If the womb and ovaries are removed, the hormone cycle is disrupted and the brain hormones initially go into over-drive as they are not prepared for this early menopause. Migraine initially worsens but generally settles again over the subsequent couple of years. Replacement oestrogen can help lessen the symptoms following hysterectomy, particularly if the ovaries have been removed. Even when the ovaries are retained, the natural hormone cycle can be disrupted, so additional oestrogen may be helpful.

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    What Questions Should I Ask My Healthcare Provider About Menstrual Migraines

    • Am I experiencing a menstrual migraine or another type of migraine?
    • Should I change any of the medications Im taking?
    • What treatment do you recommend?
    • What medications should I take?

    A note from Cleveland Clinic

    A migraine is more than a bad headache. Not only can menstrual migraines get severe, but women have reported that they can be even worse than a migraine that occurs when theyre not on their period. Talk to your healthcare provider about your symptoms. There are preventative measures and treatment options. A menstrual migraine might not be something you just have to live with every month.

    Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.


    Can Hrt Help Migraine

    HRT should not be used as a treatment for migraine. However, many women notice that migraine is more likely to occur when they have bad hot flushes and night sweats. Since HRT is very effective at controlling these menopause symptoms, it can help reduce the likelihood of migraine. However, some forms of HRT can create more hormone fluctuations, triggering migraine. This is more likely to occur with tablets of HRT. We generally recommend that women with migraine who need HRT should use oestrogen patches or gel, as these maintain stable hormone levels with few fluctuations. The best dose of oestrogen is the lowest dose necessary to control flushes and sweats. This may be as little as 25mcg of oestrogen patches, or 1 pump of oestrogen gel. Try this for 6 weeks, and if flushes persist, increase to 50mcg patches, or 2 pumps of gel. Bear in mind that it can take 3 months before full benefit is achieved, so dont increase the dose too quickly. Some women do need higher doses, up to 100mcg patches or 4 pumps of gel, but this can usually be reduced once the symptoms settle. Unless a woman has had a hysterectomy, she will also need progestogens to protect the lining of the womb from thickening in response to oestrogen. If this goes unchecked, it can lead to potentially cancerous many years later. Women with migraine, best tolerate progestogens when combined with oestrogen in patches, or as the Mirena intrauterine system.

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    Diet Lifestyle And Home Remedies For Headaches

    Some people find that certain foods trigger headaches, particularly migraines. If you work out that particular things such as chocolate, caffeine or red wine are intensifying your problem it will be worth limiting or eliminating these foods from your diet.

    Try to avoid stress because this can often result in headaches. While it is easy to say stop stressing, it is not so easy to do. If you feel that stress is at the root of your headaches, our stress and menopause page may help.

    You should try to eat regularly. If your blood sugar level drops too much in between meals this can often result in headaches. You should eat small and healthy snacks such as dried fruit and nuts to keep your blood sugar levels up.

    Some people have found that upping their intake of magnesium and calcium has helped their headaches. Magnesium and calcium can be found in foods such as dark green vegetables, dried fruit, nuts, and wholegrains. However, most people will struggle to absorb enough magnesium purely through their diet, and so may need to take a food supplement. An excess of magnesium and calcium may cause headaches, however, so it is important to take the correct dosage.

    Are There Herbal Remedies To Help Me

    Menopause Headaches And How To Cope

    As hormonal imbalances are often at the root of menopausal headaches, start with using a soy based supplement to help settle the hormones at this time of your life. The best extracts are derived from fermented soy because the active ingredients are better absorbed by the body.

    “This has worked for me I was always very active and suddenly found myself tired and a lot of aches this has now gone I also take the sage tablets and they are excellent.”Changes in your hormonal levels can make you less able to cope with stress which in turn, lowers your threshold for stress-related headaches. Helping your mind and body cope better with stress can be the best approach if this is your situation.

    Eileen’s TOP TIP: Valerian is one of our most popular herbs to calm both mind and body. Like many ‘stress-herbs’ it works well in combination with others with the same action. A.Vogel Stress Relief contains both valerian and hops and as a tincture, works quickly to calm you down.

    Tension in the muscles of the neck, skull and scalp can creep into your life without being noticed and can lead to tension headaches, even when you are not feeling under stress. This is the reason why a head massage is so relaxing.

    Eileen’s TOP TIP:: Massage essential oils based on eucalyptus and peppermint into your temples and the nape of your neck to help you relax. Better still, get your partner to do it for you.

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    Common Strategies For Preventing Or Treating Menopause Headaches

    The exact relationship between migraines and menopause is still under investigation and may be more fully clarified by future research. However, we do know that there are meaningful steps you can take to minimize the occurrence of menopause headaches and alleviate your discomfort when they do happen.

    What Can I Do To Help Relieve The Symptoms Of A Menstrual Migraine

    Do your best to figure out what makes your hormone headaches better or worse. For example, if light causes pain and you feel overheated, stay in a cool, dark room. Additional tips include:

    • Keep your blood sugar levels up by eating small, frequent snacks. Never miss a meal.
    • Learn relaxation techniques.
    • Avoid too little or too much sleep, and keep a regular sleep pattern.
    • Change your diet, if needed.
    • Avoid stress when you can, and learn how to manage it when you cant.

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    The Relationship Between Hormones And Headaches

    Many within the medical community used to believe that headaches increased during perimenopause but decreased in menopause. However, a 2018 paper published in Current Treatment Options in Neurology, explored the link between headaches and hormones and found that the relationship is far more complexand deeply individual. While headaches improved for about 25% of menopausal women, they were actually worse for 35.7%. Overall, up to 30% of women report higher incidence of migraines during perimenopause or menopause than before. Another 2018 study found that among women with a history of migraines, 60% experience a change in their migraine patterns and for 60% of those women, the change is for the worse.


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