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.