Migraine is a type of severe headache that might also cause other symptoms, such as nausea and light sensitivity. It may improve or worsen during menopause.

Migraine is commonTrusted Source in menstruating females of reproductive age. However, this can change over the years, particularly during the stages of menopause, which include:

  • Premenopause: The time before menopause symptoms begin.
  • Perimenopause: The transitional period leading up to menopause when a person is likely to experience symptoms such as changes in their menstrual cycle, hot flashes, or other symptoms.
  • Menopause: This starts 12 months after the last period or when menstruation has stopped for a clinical reason, such as the removal of the ovaries.
  • Postmenopause: The years after menopause.

This article discusses the link between migraine and menopause and why it might exist. It also provides more information about menopause and how to help alleviate migraine symptoms.

Migraine is commonTrusted Source in females of childbearing age. For many people with migraine, the days before and during a period are significant migraine triggers.

During the menstrual cycle, estrogen levels drop right before a period starts. This estrogen withdrawal may triggerTrusted Source migraine.

Headaches may temporarily worsenTrusted Source during perimenopause, the transitional period leading up to menopause.

However, migraine headaches tend to improve after menopause. This may be because a person no longer experiences the hormone shifts that once triggered their migraine pain.

There is no way to predict how menopause will affect someone’s migraine pattern. A change in migraine pattern leading up to menopause may occur due to shifting hormone levels.

Menopause marks the end of a person’s ability to conceive. It begins once someone has gone 12 monthsTrusted Source without menstrual cycles.

The median age of menopause is 51 years, but it may begin as early as age 40 years or as late as during a person’s 60s. In some people, premature menopause in their 20s or 30s causes infertility.

Perimenopause is the time leading up to menopause. During this time, a person’s periods may become more irregular. They may also experience a wide range of symptoms, including:

  • hot flashes
  • night sweats
  • heart palpitations
  • painful sex
  • vaginal dryness
  • mood changes, such as irritability, anxiety, and depression
  • weight gain
  • increased blood pressure

Many classic menopause symptoms, such as hot flashes and night sweats, go away after perimenopause. However, some — such as vaginal dryness — may linger due to lower estrogen levels.

Menopause may ease migraine headaches, cause them to worsen, or have no effect at all. For people whose menstrual cycles trigger migraine, migraine may improve once those end.

A 2016 studyTrusted Source compared premenopausal, perimenopausal, and postmenopausal headache rates among people with a history of migraine. The researchers defined a high headache rate as having 10 or more headaches per month.

They found a high headache rate in:

  • 8% of premenopausal participants
  • 12.2% of perimenopausal participants
  • 12% of postmenopausal participants

This suggests that the transition to menopause is often a trigger for more frequent headaches in people with a history of migraine.

For some, hormone replacement therapy (HRT) may actually make menopausal migraine worse, especially when it causes fluctuating hormone levels. However, for some, HRT may lead to improvement in headaches or no changes at all. So, a person may need to be willing to try various treatments and monitor their effects.

Some people may choose hormone therapy to manage other menopause symptoms, such as hot flashes and vaginal dryness. Low dose treatments are less likely to trigger migraine.

A doctor may recommend continuous hormone therapy to reduce the risk of hormonal shifts that may trigger migraine. Patch applications may also be recommended over oral pills to help with migraine.

A wide range of treatments can help with migraine, but no single treatment works for everyone. Therefore, a person may need to experiment with various remedies and keep a headache log to monitor any improvements.

Some options includeTrusted Source:

Pain medications

This includes medications such as nonsteroidal anti-inflammatory drugs, which a person can buy over the counter, and prescription pain medications. These medications may offer immediate migraine relief.

Migraine abortives

These are drugs that stop or lessen the severity of acute migraine episodes. They include medications such as triptans.

Migraine prevention drugs

A wide range of drugs may help prevent or reduce the frequency of migraine episodes. Topiramate is a drug approved to treat migraine, but it has some notable side effects. Other drugs — including antidepressants, beta-blockers, calcium channel blockers, and antiseizure drugs — may also help.

A new class of migraine drugs called anti-CGRPs are formulated specifically for the prevention of migraine.

Transcranial magnetic stimulation

This type of brain stimulation may help reduce the frequency of headaches or ease the symptoms when migraine occurs.

Alternative treatments

Certain complementary and alternative therapies can also be incorporated into a migraine treatment plan to help improve the quality of life. That may include:

  • acupuncture
  • biofeedback, which involves learning to control some bodily processes that are usually involuntary
  • cognitive behavioral therapy
  • relaxation techniques
  • yoga
  • supplements and herbs, such as butterbur or melatonin

Lifestyle changes

Certain lifestyle changes can also offer migraine relief, including:

  • getting more frequent exercise
  • managing stress
  • monitoring and avoiding migraine triggers

However, it can be difficult for people with migraine to undertake some of these activities when experiencing painful episodes.

Hormone replacement therapy

HRT can help ease menopause symptoms. Research into its role in headaches has produced mixed results, though more recent studies suggest that it may worsen them. A person should talk with a doctor about the risks and benefits of this option.

Menopause is not a medical condition, and a person does not need to consult a doctor solely due to this.

Instead, a person should contact a doctor if:

  • Their migraine condition has stopped or improved, and they would like to stop taking migraine medications.
  • Their migraine headaches change or worsen during menopause or perimenopause.
  • They do not get relief from migraine medications.
  • They would like to try HRT.
  • They began menopause very early, before the age of 40 years, or their periods suddenly stopped without explanation.

Migraine is an unpredictable neurological condition, and it may improve or worsen as a person transitions through menopause.

Although it can be challenging to treat, a person does not have to live with migraine forever. The right combination of medications and lifestyle changes can help ease symptoms, so people should try to contact a doctor who takes their symptoms seriously and specializes in migraine.