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Migraines and Menopause

By: Ian Murnaghan BSc (hons), MSc - Updated: 21 Oct 2020 | comments*Discuss
Headaches Menopause Hrt Hormone

Menopause is a natural part of a woman's aging process. During menopause a woman's ovaries produce lower levels of the hormones estrogen and progesterone and she is no longer able to become pregnant.

The changes leading up to menopause can occur over many years, with the average age for menopause being around age 52. Changes can, however, begin to occur in the early 40's or to the late 50's. Perimenopause refers to the several years before menopause when a woman experiences the initial signs of menopause.

How Does Menopause Affect Migraines?

For women whose headaches have been triggered by menstrual cycles, the lack of periods following menopause can result in a noticeable improvement in headaches. Aging can be associated with headaches becoming less severe and in fact, some women may find that their headache pain is less severe during and after menopause. Unfortunately, not all women will discover that menopause improves their headaches. For some women, migraine frequency and intensity may increase, particularly during perimenopause.

Causes of Migraine During Menopause

Migraine headaches may become more severe just prior to menopause and this is related to hormone fluctuations. During menopause, the levels of 'female' hormones decline and migraine headaches frequently decrease. It is thought that these changing levels of hormones trigger migraines for some women.

Treatments For Menopause Headache

Hormone Replacement Therapy
For women who already suffer from migraines, they may find that previous treatments, drug or otherwise, are no longer effective. This can be particularly stressful during a time when women are adjusting to various hormonal and emotional changes.

Due to the major role of hormones in menstrual migraine, one treatment method is through the use of hormone replacement therapy (HRT). HRT may be prescribed during perimenopause and then continued through the entire menopausal transition. The key therapeutic aim of HRT is to treat the uncomfortable symptoms of menopause, such as hot flashes, depression and anxiety. The benefit of migraine reduction from HRT is therefore in addition to the other common aims of HRT.

Women who decide to use hormones might also wish to consider a consistent dose regiment to help them to avoid migraines resulting from a cyclical pattern of use. There has been some controversy in recent years surrounding the safety of HRT and it may not be appropriate for all women. It is recommended that you discuss any benefits and concerns about HRT with your healthcare provider.

Phytoestrogens are plant compounds similar to estrogen. There are various ways to ingest these compounds such as through food sources which include soy or herbs such as black cohosh. Supplement products containing isoflavones, a component of soy, are widely available and can be purchased as capsules or shakes.

One study suggested that a combination of soy compounds, dong quai, and black cohosh was associated with a lower risk for migraines but other studies have found no link. In fact, some studies have found that phytoestrogens may even exacerbate migraines and as such, it can be very confusing for women to choose a migraine treatment during menopause.

Ultimately, women may best be advised to keep their hormone levels as steady as possible during menopause. The process of relieving migraine headaches during menopause is similar to general migraine treatment advice: find what works best for you. It may require trial and error to identify triggers and find a dose regimen with HRT or supplement with phytoestrogens, if at all, that works.

Less time worrying about migraines means that you can focus more on the enjoyable aspects of the 'middle years' of life.

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I suffered horrid migraines in my teenage years, which re-appeared when I was 40.... now 54 and having developed all symptoms of menopause from 50, the worst symptoms for me, are my migraines. They happen with each period, and can last x 3 days. Have taken sumatriptan for years, which I hate & make your muscles ache. The pain sometimes is unbearable (can’t tell you how painful) Now that my periods can be every 2 weeks, enough is enough, I have spoken with the doctor, and am going to try HRT (something I always didn’t want to do) Anyways, that’s my story (on the headache side) Love & hugs to all, take care & be happy, Julia
Julia - 21-Oct-20 @ 3:58 PM
I started with headaches from about March this year all down in the back of my neck and across the front of my head. I’ve had one period in 18 month the headaches were driving me mad I can work but the pain down my neck was only helped with a cold pack.i ring doctors but no face to face appointments and she said cos I’m 49 it probably is the menopause and they don’t do blood tests now at my age.Im really glad I can read this as Ithought that I may have something wrong with me but reading all these comments makes me feel much better. I feel dizzy too and light headed one times a bit like I’m in a cloud. Haven’t been back it touch with doctor but reading these comments is helping. Paracetamol and ibuprofen helps but don’t like taking them too much. Thanks.
Jojo - 17-Sep-20 @ 8:46 PM
Hello I am going through early menopause I’m only 38 and have been feeling unwell for six months doctor has put me on HRT but I have been getting really bad tingling feeling in my face and head is this normal
Rach - 4-Aug-20 @ 8:21 PM
I've been suffering with headaches for 8 months now. My last period was march this year. The headaches are as follows tightness around the front of my head. Pulsating on my left hand side more so when I bend down when lying down I can hear my the pulse in my head and sometimes my heart flutters or misses a beat .I seem to be squinting too as some times the headaches get worse at night .actual migraines only ever experienced 3or 4 .blurred vision on the right side eases after taking 2 paracetamol and 400 ibuprofenhope to see a menopause nurse soon as doctors not to helpfull at the present time
Delph - 7-Jul-20 @ 10:50 PM
Im really grateful to have found this page. A few months back I had a thunderclap headache and was rushed to ED for all the usual tests.Nothing was found though neurologically it looked like a haemorrhage. Im nearly 49 and post menopausal.Im now suffering from debilitating headaches.I wake with them and have been told at work that I am not myself (no kidding!) Im muddled, miserable and tired. Who knew hormones could do this? I have been feeling like Im going mad.I am in the military so you can imagine how difficult that can be.Awaiting a neurology appt but I just dont feel like anyone takes menopause seriously.To be fair, I never did until I reached it, but this is getting me down.
Rache - 30-Jan-20 @ 8:31 PM
I am 54 and have been having severe headaches for the last few months.My last. Period was 6 months ago so I’m assuming I have entered the menopause.. I don’t really have many other symptoms..although I have had palpitations and feelings of panic occasionally. Very often I am woken in the night with severe head pain or I wake in the morning with a headache which then has an affect on my sleep patterns. I have been having to take co-codamol to get through the next day as paracetamol has no affect I am wondering if HRT will have any affect and if anyone else has these type of headaches.
Robo - 6-Jun-19 @ 9:10 PM
I am 49 and went down with chronic daily migraine 2 years ago. My neurologist said it may be hormonal but this is the first site I have seen that explains it so clearly. It gives me hope that I will come out the other side.
Karen1969 - 13-May-19 @ 9:12 AM
Wow, I am so glad I found this page. About 3 years ago whilst at work, I felt a pop in my head followed by a whooshing sensation. The vision in my right eye went kaleidoscopic. This lasted for less than a minute but afterwards i felt nauseated and had a very horrible pulsing sensation deep in my head. PANIC, i thought i was having a stroke or a bleed on my brain. I called 111 and was advised to see my GP asap. The GP diagnosed ocular migraine and gave me medication. This didn't work and the pain and pulsing sensation lasted several weeks. I had numbness and could only relieve the pulsing by laying with my head on a cold cushion. I had a further 4 'episodes' all lasting around 6/7 weeks with a break of about 3/4 months in between. After having mri scans and seeing a consultant neurologist, I was advised that the symptoms were atypical of migraines and was given medication. A wonderful lady GP read my letter from the consultant and read my history and suggested it could be linked to the menopause. Fast forward to now and I am taking HRT and antidepressants. When my HRT is at the right level I don't get migraines. Looking back I was 40 when i started getting feelings of pressure in my head leading up to the pop when i was 45. I also had severe night sweats and feelings of panic. I am now a lot more chilled but still get night sweats and am hoping it all ends soon. I am a completely different person..
Bertsgirl - 5-Apr-19 @ 11:21 AM
@CarryWarry - Oh wow - thanks for this. I have had a continual headache since menopause, having never suffered previously in my life.
Hil - 2-Jul-18 @ 3:42 PM
I am hoping to be at the end of a horrific 2.5 year period of hell with headaches which came out of the blue.My story started with me asking for HRT and the doctor said 'No let's sort your headaches first'.Here's my history in brief, after seriously wondering if I had a brain tumour in the beginning....and trying everything, (spent £4000 privately altogether) to suss the problem.I never had been a headache lady until I hit 51 and boy was it ghastly.After antibiotics for chronic sinusitis (which is wasn't) here's what happened... 1)CT scan showed nothing 2)MRI scan showed nothing 3)MRI scan with contrast showed nothing Neurologist explained that I was a 'mystery'.Suggested I had chronic daily headaches.I personally disagreed as I wasn't at all stressed and have a fab life style with no worries, very happy etc.Saw a 2nd neurologist who examined all scans and said that there was nothing on them. 4)Saw ENT specialist - prescribed medication for cough headache.It didn't work. 5)Doctor prescribed various anti-depressant (Triptans and SSRIs) which didn't touch the headache. 6)Went to HRT specialist 18 months ago....and have been trying to get there ever since, headaches are much improved but here's the story.... Had blood tests showing my oestrogen was extremely low.Having started on Evorel 25 then 50, finally ended up on 100.Decided headaches were a bit better but hated patches so went to my GP who put me on Divina which made me have a very very heavy bleed.Returned to HRT specialist who put me on Angeliq because it's a 'kinder progesterone'.Felt great for about 3 months, hardly any headaches except enormous pressure whenever I coughed or sneezed.Then started light period daily for 8 weeks.Just been back to HRT specialist who has insisted that my body hates progesterone going through it and I need the Mirena coil (which I had for 17 years and it was great for me).She said I need progesterone to go straight to my womb and nowhere else and I need separate tablets or patches, gel for the oestrogen and to balance things.I am praying that the mirena will conquer the headaches once and for all and can only pray.In the beginning I couldn't even bend down to pick up the post, but I have moved on since those terrible days....I used to go to bed in the afternoons to escape the pain.Every day.Now I have a mild headache and tinnitus which I hope to get rid of soon.Oh to be myself again.Good luck all and hope this might help you in some way. Caroline
CarryWarry - 2-Jul-18 @ 11:11 AM
Hello, I am Janet and going49 yrs. old this year. I just read all the comments and I can totally relate because I am exactly in the same situation. I am having headaches( bad ones! ) for the last few months now and my gp says it is chronic tension headaches which I have no idea as I never had this kind of headaches before. I go to bed with them and wake up the same way if not worse and yes it can be dibilatating as most times I can not function well anymore. Went back this morning to my gp as it is getting worse, slight movements like looking sideways and bowing or tilting my head is very painful lately and I am getting really frustrated. He mentioned thatthis may also be due to my age and the prospect of menopause as my period has stopfor the last few months now. ( i think the last one was January this year and had been erratic since) I have looked into the symptoms of menopause but so far, missingmy cycle and headaches are all I have. I have been takingpain killers( Ibuprofen and paracetamol) but trying to decrease it and only take them when the pain is unbearable. I have an appt. for the physio next week and my gp prescribe Amytriptyline to help me sleep at nights as this has become a problem as well hoping these would help and break the cycle. If not, we are looking for a neuro in the future:( I have lived a healthy , happy sociable life beforebut this headaches have change me into a confuse, tired, restless and unhappy person. Please help... Any info is very much appreciated:)
Jane - 5-Sep-14 @ 8:52 PM
I was 51 this year, and just before I turned 51 in April, I started with the most horrendous headaches, which seemed to come from nowhere, having never been prone to headaches before. I have been backwards and forwards to my GP, who says she feels that they are "chronic tension headaches", as I have them at least 70% of the time. I've tried food intolerance testing, cutting down on sugars, trying to manage stress where possible (easier said than done), &, as they have been ongoing for about 6 months now, my GP is referring me for a CT scan, to be on the safe side. She has offered to prescribe amitriptyline, which may help to prevent the headaches. I am otherwise trying to manage without taking pain meds such as paracetamol or ibuprofen all the time, however, I sometimes need to. Feels like I have been in a black hole for most of this year, wondering if this is part of the perimenopause, as my periods are starting to be less regular, having been extremely regular all my life? Anyone else out there who knows how it feels, has any ideas, wondering if I'm going mad (or even madder)? Thanks
MrsC - 4-Sep-14 @ 3:26 PM
I am going through the menopause, I have a lot of the symptoms( forgetfulness, sleepless nights, hot flushes) the headaches get me down the most though. They are very strange and leave me feeling quite tired.It starts with a tingling sensation (like pins and needles) from my legs up wards. I get palpitations and thenthe pins and needles in my head then quite a sever pain that can last from just seconds up to a minute.which is quite debilitating. Does anyboby else get headaches like these? they don't happen often but like I said they are the most troublesome and the most worrying
jasin5 - 11-May-14 @ 1:40 PM
I finally relented and acknowledged I have begun to go through the menopausal stage. Iam missing my cycle already, it made me feel flushed out and clean, ready for another month's worth of life. I hope they haven't left me completely, I would like say goodbye. I have always strived to have reached the peak of my wisdom by this time of life. Although my vanity has enabled me to maintain a certain degree of youthfulness and pride, I want to earn the respect of this "Old Hag Stage.". Aaah, The Old Hag. The wise woman, the third stage of the Feminine. .
aedelpryd - 26-Nov-13 @ 8:22 PM
Hi my name is tracy. I am 48yrs old , not surw weather i am in early stages of the change I was sterilized about 25yrs ago thon found out i had endometriosis so had the marina coil fitted,i was pain and period free for many yrs,however over the past year i have noticed bleeding efter intercourse,bloating, mood swings, insomnia, hot flushes,sweating,headachs, aching and abdominal discomfort and feeling very very tierd and lythargic i also have a very low sex drive. Would be very helpfull of anybodys thoughts or avice as seem to be getting no where . Thankyou
tray - 13-Oct-13 @ 3:54 PM
Hi, I can relate to your migrane problem. How are you now? as I see your post was 2011. I am 43 and had a hysterectomy when I was 38 and been on Everol HRT patch 25 mg since, but this week due to bouts of depression and feeling unwell all the time, have come off it. I have had a migrane for 2 days now, which is a regular occurance, will prob last another day. I have just ordered some black cohosh and feverfew.Did it help you? Hope you are better.
tinabee - 7-Jun-13 @ 12:11 PM
i suffer with migraine myself which makes me feeling very down and weepy, when i was younger i used to get sometimes headches with my monthly periods which weren't migraine just normal headaches. When my periods stopped at 53 years old these horrible migraine like headaches came on and my doctor said they were hormonal migraines caused by the menopause. That was about 10 years ago now the migraines have got less but recently i had a bad dose of it and i have just got rid of the pain etc today really. I went to bed for a few hours it stopped but next day it was back again i take pain killers but they don't always work really the worse symptom is the buzzing sound in my ears and head and i feel very dizzy sometimes and sick. and i am going mad, I haven't had a bad migraine for months and had to go to bed but this one laid me low sorry to say. Perhaps the fact that i get sleepless nights and feel stressed because of that doesn't help really. I was taking feverfew tablets but stopped taking them because the migraine was much better but i think i will return to them and see if they get rid of the problem altogether, i try to keep positive as much as i can which isn't always easy. A friend has said drinking water often helps the migraines so i will give that a try too. Anyone who suffers migraine i can relate too, when people say it is a headache who don't suffer it that is not true its more than that ask some migraine sufferers.
Jocasta - 5-Aug-11 @ 11:03 AM
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