The Migraine - Menopause Connection

Both men and women suffer from migraines, but women are somewhat more likely to be afflicted. And in women it appears that there is sometimes a link between the menstrual cycle and migraine incidence. In these cases there is probably a hormonal connection.  Moreover, there also seems to be a link between menopause and migraine further strengthening the hormone connection in some cases.

Menopause is a natural part of a woman’s aging process during which women undergo a lot of physical changes, some of which may not be very welcomed. One of the possible effects of perimenopause (transition phase) is the exacerbation of migraine headaches. Studies have confirmed that migraine attacks seem to get worse in the years before and during menopause.

The Hormonal Link

There is a lot of scientific evidence that supports the link between migraine and menstrual cycles. It is believed that a change in the hormone levels during menstruation is responsible for the onset of headache and symptoms of migraine. Typically, the lower level of estrogen that is seen towards the end of the menstrual cycle appears to be directly linked to migraine occurring.

During menopause the hormone levels in the woman’s body change and the eggs that are released by the ovaries reduce in number. The periods become irregular and ultimately they stop. Once the periods completely stop, it is known as menopause as opposed to the transition or perimenopause. The average woman goes through menopause between the ages of 50 to 55 years, though this can vary.

One of the reasons why the perimenopausal and menopausal period is associated with migraine is because these times coincide with very low estrogen  levels in the blood stream. As the perimenopausal period begins to approach menopause, the levels of estrogen  become lower and lower and this can result in more and more severe attacks of migraine.

Interestingly, in patients who have completed menopause, migraine attacks can sometimes continue. It is possible that this is linked to ongoing changes in the hormone levels in the blood even after menopause has concluded. Of course, hormonal fluctuations are not the only causes of migraine attacks. In addition, other triggers such as stress, anxiety, and food triggers can contribute to migraines in menopausal women. All of the normal preventative measures like avoiding stress, getting good rest, etc. still apply to menopausal migraines.

Hormone Replacement Therapy or HRT for worsening migraine during perimenopause

If the increased migraine attacks are linked to approaching menopause, then your doctor may consider hormone replacement therapy. Lower doses of estrogen improve the intensity as well as frequency of headaches. The goal of estrogen therapy or HRT is to stabilize estrogen levels in the body. There are different types of HRT – pills, patches, gels, etc. Each type works differently and has different effects on menopausal migraines. In other words, you and your doctor may need to experiment to find which type works for you, if you choose to use HRT.

However, it is important to note that for some women, headaches can actually get worse with hormone replacement therapy.  HRT is not suitable for everybody. Don’t be afraid to discuss your migraines with your doctor and push them to help you find a solution that works for you.

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