Menopause and Migraine
Migraine Ireland
Removing the trigger of Migraines closely linked to menstruation can have a possitive but not total effect. In contrast to physiologic menopause, surgical menopause results in worsening of migraine in two thirds of cases.
Removing the trigger of Migraines closely linked to menstruation can have a possitive but not total effect. In contrast to physiologic menopause, surgical menopause results in worsening of migraine in two thirds of cases.
It has been found that many women experience an improvement in their migraine symptoms once peri-menopause has settled, their periods have stopped and menopause has begun. This is usually at roughly aged 50-52. Some women continue experience symptoms for a time after their periods have stopped before eventually settling. Some women can find after menopause that triggers that are not connected to their periods become more noticeable. Menopause is a different experience for everyone, and lots of things can affect a person’s life and condition at this time.
In all cases, it is important that you have the support of your doctor to best navigate the condition of migraine.
Hormone Replacement Therapy
HRT is licensed for the control of menopausal symptoms and the prevention of osteoporosis and has a variable effect on migraine frequency. Research as shown that it is almost a likely to worsen migraine than improve it. It remains virtually impossible to predict what a given woman will experience.
In general:
Subcutaneous routes of oestrogen administration are more likely to improve migraine than oral routes.
Lower doses are recommended for migraine, although there may well be some trade off with other menopausal symptoms. Continuous oestrogen replacement therapy may be preferable to cyclical dosing For optimal results, oestrogen levels should be kept stable to avoid triggering an attack. The patch forms of oestrogen supplementation release more smoothly than the oral versions.
Note that migraine is not a risk factor for stroke in post-menopausal women and therefore, HRT is not contraindicated for this reason.
Some women may improve when progesterone is eliminated entirely. However, additional progestogen is necessary to prevent endometrial cancer in unhysterectomised women using oestrogen replacement. This may lead to an increase in migraine, especially if administered cyclically, rather than continuously. A transdermal route of administration can help minimise this effect.