When to Talk to a Healthcare Provider About Migraines in Perimenopause

Perimenopause |
4 min read

Published

June 19, 2026

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

You might be wondering, are migraines just a normal part of life during perimenopause?

Migraine frequency may peak during your 30s and 40s, due either to hormonal changes or to reasons unrelated to menopause.^1,2 In this article, Bonafide Chief Medical Officer, Dr. Alyssa Dweck, explains why some women may experience migraines in midlife and offers her thoughts regarding when to see a healthcare provider for migraines in perimenopause.

When to Seek Help for Perimenopause Migraines

While it’s not unusual to experience headaches upon occasion during perimenopause, if you’re noticing more severe headaches and/or disruptive migraines, it may be time to talk with your healthcare provider.

Consider contacting your physician if:^3,4

You notice a new pattern or type of migraines
Migraines are having an impact on your daily life
You experience pain after a head injury
Pain is severe or sudden
You have changes in your vision, speech, or balance
You notice swelling of your eyes, arms, or legs

Why Do I Have Chronic Migraines in Menopause?

Think back, did you ever have severe headaches around the time of your period?

If so, you may be part of the 60% of women who experience hormonal migraines, which tend to occur when hormones, like estrogen and progesterone, drop.⁵ Dr. Dweck explains it’s just one reason why women—who undergo a series of hormonal changes throughout puberty, menstruation, and menopause—experience migraines three times more often than men.⁶

“Headaches are common during times of hormone volatility, including during perimenopause,” Dr. Dweck explains. “Many headaches are self-limited and manageable with over-the-counter analgesia; those with formally-diagnosed migraines often do best with one’s most preferred and individualized prescribed medication.”

But what if at-home remedies aren’t making an impact on your migraine symptoms? How do you know if your head pain is an emergency? Here, Dr. Dweck elaborates on migraine warning signs for women and when to seek medical care.

Migraine Warning Signs in Women

Have you ever wondered if it may be time to see a healthcare provider about your migraines? Here, Dr. Dweck lists the following red flags that may signal it’s time to seek emergency care from a medical professional for your migraines:^7,8

● Experiencing a new type of headaches

● Changes in headache pattern

● Severe and sudden pain

● Migraine with changes in speech, vision, or weakness

● A headache with fever and/or chills

● Rapid swelling of the eyes or extremities

● A headache after a head injury

"For those with a formal diagnosis of migraine with aura, combination oral contraceptive pills, often used during perimenopause, might be contraindicated due to potential increased risk of stroke. This of course is a shared decision typically involving neurologist input" notes Dr. Dweck. She also cautions women to seek emergency care if any headache is accompanied by loss of balance, weakness, face drooping, or changes in vision, balance, or speech.⁹

Perimenopause Migraine Treatment

Dr. Dweck adds that some women may find relief for migraines that are stemming from non-emergency causes, such as hormonal migraines, with simple lifestyle changes.

“Migraine management during the perimenopausal years might include lifestyle modification including shifts in diet, hydration, sleep hygiene, and supplements as well as paying specific attention to cardiovascular risk,” she says. “Hormone initiation and/or adjustments to dosage, regimen, and route of administration, to minimize fluctuation, might be considered. There are multiple prescription options both for prevention and on-demand use that might also be implemented.”

Treatment for Chronic Migraines in Menopause

There are a variety of options you can explore to potentially control your migraines and their associated symptoms in menopause. These can include:^10,11,12

Stress management
Regular exercise
Balanced diet
Regular meals
Acupuncture
Proper hydration
Adequate sleep
Hormonal contraceptives
Triptans (preventative migraine medication)
Nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen or naproxen
Antidepressants
Magnesium supplements
Calcitonin gene-related peptide monoclonal antibody injections

There’s Help for Migraines in Perimenopause

If migraines are a part of your everyday life in perimenopause, know that help is available. Talking to a healthcare provider about your frequent migraines may help to identify a hormonal trigger. Plus, seeking urgent medical care when experiencing migraine red flags is essential for advocating for your health.

For a quick video on headaches and migraines experienced during the menopause transition from our Chief Medical Officer, Dr. Alyssa Dweck, check out the below:

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