There are currently 34 recognized symptoms associated with the menopause transition that are all, more-or-less, related to the hormonal fluctuations experienced during this time. Just like during the hormonal shifts experienced during periods of PMS, these changes during perimenopause and menopause can also contribute to the onset of hormonal headaches and migraines.
This short video, featuring Bonafide Chief Medical Officer, Dr. Alyssa Dweck discusses why headaches and migraines may occur during menopause, along with certain symptoms to look out for and what to do about them.
VIDEO SUMMARY (previously approved video)
Hi, I'm Dr. Alyssa Dweck, a gynecologist in New York and the Chief Medical Officer at Bonafide. Today, I wanted to talk about migraine headaches and menopause, since this is something that I commonly see in my office, day to day.
Are Headaches and Migraines During Menopause Common?
In general, headaches are super common. Most women will experience an occasional stress or tension headache, a headache related to sleep disruption or maybe other medical issues.
But migraine headaches can be specifically increased in the female population. In fact, it seems women are around three times more likely to experience migraines than men. And by age 50, more than 40% of women will have experienced a migraine.
What is a Migraine and What Causes Migraines During Menopause?
A migraine is that type of headache that is throbbing or pulsating, and usually is felt on one side of the head or unilaterally. In general, it’s thought that hormones, specifically low or plummeting estrogen levels, have something to do with these migraine headaches. Many hormonal milestones will be marked by an increase in headaches.
Think about puberty, premenstrual syndrome, pregnancy, postpartum, and during perimenopause. One mechanism connected to headaches that's been posed is that low estrogen affects the brain, and the release of inflammatory substances can influence blood vessels and therefore lead to headaches. So, low estrogen during the perimenopausal or menopausal transition does matter.
What to Watch Out for Regarding Menopause Migraines
A word about aura. We've heard about migraines with aura, which means that there are other sensory stimuli that go along with headache, like flashing lights or even blind spots. And the reason that aura is important to distinguish is that the risk of stroke may be increased in those who experience an aura along with their migraine, even though this risk is still quite low.
What to Do About Migraines in Perimenopause and Menopause
What can we do to manage headaches, specifically migraines, during perimenopause and menopause?
Well, first, keeping a tracker can be very helpful. This can show what might trigger headaches, such as dietary influences, weather, specific times of the menstrual cycle, if they are trackable, and also, medications that might help, over-the-counter or prescription, can be used in preparation.
In addition, supplements like magnesium can be helpful for some people. We also consider hormone therapy, whether it's replacement type therapy or oral contraception if needed, or indicated for those who are suffering with migraines.
When to Talk with Your Provider About Menopause Headaches
When should one see their healthcare provider for headaches? Well, surely, if they're recurrent, persistent, or worsening, if they're severe, or waking you up in the middle of the night abruptly – these are reasons to see a healthcare provider for a more thorough evaluation.
