Midlife and Menopause - What You Need to Know About Hormonal Migraines

Midlife, Perimenopause, and Menopause

The transition from midlife to menopause is especially difficult for the migraine sufferer. No one knows for sure why migraines start to increase in frequency and severity as one approaches midlife. Perhaps it is simply due to increased stress and responsibility. Be sure to take time for yourself and take your own medical concerns seriously (meaning treat your condition according to whatever method you feel is right for you be that a western medicine approach, alternative therapies, or wellness - or any blend of the three.)

Perimenopause

Many women start to experience the transition towards menopause in their 40's. During this time periods become very unpredictable due to the fact that your hormone levels are dropping but are still prone to unpredictable surges. This can result in periods that last longer than usual (sometimes weeks or months) or periods that are simply skipped. Likewise, the erratic hormone fluctuation can also increase migraine frequency and severity.

Treating Hormone-Related Migraines

The safest approach is to use prescription medication to prevent migraines.(See Chapter 5 for a complete explanation of migraine medications.) Some studies have shown that calcium channel blockers, beta blockers, and anticonvulsants are not as effective at treating migraines brought on by fluctuating hormones. However the advantage of these particular drugs could be their relatively low side effects.

Hormone Replacement Therapy and Migraines

If you decide to pursue hormone replacement therapy to treat the symptoms of perimenopause (including migraines) know that this method can carry certain health risks (such as a potential increased risk of breast and uterine cancer) that should be discussed by your doctor. It is also useful to know that this therapy could aggravate migraines - progesterone is sometimes a migraine aggravator (but is needed in HRT to keep a healthy hormone balance and prevent the development of caner due to treatment.) In many cases there can be a delayed reaction of a few months before there is a noticeable increase in migraine frequency or severity. For this reason, it is not always immediately obvious that the medication is a problem.

If your course of hormone replacement therapy makes your migraines worse, be sure to notify your doctor as he or she may be able to give you a different estrogen preparation (different blends, or a transdermal estrogen patch) that you could react more favorably to. Also, some women report more success using hormone replacement therapies that they take daily (meaning, you may do better taking the pill daily and skipping the seven day break) - much like oral contraceptives, avoiding hormonal fluctuations appears to be key.

If you are using hormone replacement therapy to deal with other menopause-related issues such as osteoporosis know that there are nonhormonal treatments available such as Fosamax.