10 Nov 2020

Migraines in perimenopause and menopause

Migraines can be a debilitating symptom that some women experience during perimenopause and menopause writes Dr Stephanie Goodwin.

What is a migraine?

I am a migraine sufferer – it’s an unpleasant and sometimes very debilitating condition.

The headaches can be very severe and are usually on one side of the head. You may feel nauseous and be more sensitive to light or sound.

Occasionally the headache may be preceded by an aura – usually described as zig-zag lines in the peripheral vision.

RELATED: How does menopause affect the brain?

What is the link between migraines and a woman's menstrual cycle?

About 50% of women who suffer from migraine believe these are linked to their periods.

Referred to as “menstrual migraines” they are most likely to occur either in the two days leading up to a period or during that period’s first three days.  Believed to be caused by a drop in oestrogen levels, these migraines are typically more difficult to treat than other types of migraine.

As your periods become less regular during the perimenopause, you may, unfortunately, find that your migraines are more severe, longer or occur more frequently.

This coincides with the shift in your hormones during perimenopause and menopause.

That means that even women who have not previously experienced headaches may start to get these regularly.

The irregularity of your periods will obviously make the onset of migraines less predictable, and a combination of night sweats/less sleep/more stress can also increase the likelihood of you having a migraine.

How can I reduce migraines in perimenopause and menopause?

HRT can be very helpful for migraine sufferers as it levels out the hormones and prevents the dips.

I normally recommend using an oestrogen patch along with progesterone.

The patch works really well because the dose of oestrogen remains very constant day and night. You can also use oestrogen gel or a spray.

Other treatments include anti-inflammatory drugs, triptans (prescription-only drugs), low-dose antidepressants and beta blockers.

RELATED: Can your diet have an effect on menopausal migraines?

Will my migraines ever disappear?

When menstruation ends and the menopause begins, 67% of sufferers find that migraines improve or go away entirely.

According to the Migraine Research Foundation, after the age of 60, only 5% of women continue to suffer migraines.

My advice is to keep a diary for three months in order to get a handle on any pattern and then discuss managing your migraine and menopause with your GP or a menopause specialist.

Photo by Marcus Aurelius from Pexels
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