Migraines and Menopause

It is estimated that about one in four women experience migraines before the age of 40, usually starting sometime in their teens or twenties. Migraines are often linked to fluctuating hormone levels in the body and about half of the women who experience migraines feel that their menstrual cycle directly affects them. Some research studies have indeed suggested a link between migraine attacks and fluctuating oestrogen levels which are found during perimenopause or menopause.  

Perimenopause Migraines

During the perimenopause phase – women’s ovaries start producing less oestrogen and such changes in hormone levels can trigger migraines (attacks happen more frequently or become more severe). Studies show that menopause makes migraines worse for up to 45% of women, 30-45% do not notice a difference and 15% actually notice an improvement – this possibly shows the variation in individual sensitivity to the hormones.  

As some oestrogen (fluctuating levels) continues to be produced by the ovaries for a few years while the menopausal transition is complete, women may experience migraines due to these hormonal changes in the body despite not having a period for quite some time. Although for most women, symptoms related to menopausal transition usually settle within 2 to 5 years after the onset of menopause, some women may continue to experience them longer.

Help with menopause related migraines

Migraines can cause additional hardship to women already suffering from debilitating menopausal symptoms such as hot flushes, mood changes, tiredness or night sweats, and the irregularity of periods can make it harder to prepare for a migraine. Many women find it useful to maintain a diary for 2-3 months to see if there is any correlation between the menstrual cycle and migraines. General measures to prevent or reduce the severity of migraines include staying well hydrated, avoiding known triggers (foods, smells, noise etc.), stress management e.g. practicing yoga or mindfulness, maintaining healthy diet, regular physical activity, and avoiding smoking or drinking too much alcohol.

Treatment for menopause related migraines

If your quality of life is significantly affected by migraines, you must talk to your GP or a specialist about medications which can prevent or stop an attack. Migraines which are triggered by hormone fluctuations often respond to hormone replacement therapy (HRT). Clonidine, a blood pressure lowering agent, often prescribed to help with hot flushes to women who cannot take HRT can have a limited positive effect on migraines. It’s important to persist with any medication for at least 3 months to see if the treatment is working. Occasionally, some HRT preparations might worsen migraines for few women – switching to an alternative type especially transdermal hormones (patches/gel) may help alleviate the symptoms.

Can I take HRT for migraines

There are several different types of HRT preparations so it’s worth trying a few to find the one that works for you. At Menopause Clinic London, we will aim to find the option that works best for you based on your individual sensitivity and preference. We prescribe transdermal body-identical hormone patches or gels as the first line, compared to the oral tablets as this route of administration of oestrogen is associated with fewer risks. We understand that each women’s experience of menopause is unique, and we remain dedicated to tailoring the treatment to suit your individual needs.