By Cindy Moy Carr, founder of mySysters
[This article is reprinted with permission from mySysters.]
The First Migraine
The headache started while I was running errands on a Saturday morning.
I was in my early 40s, and this headache felt different than any I’d ever experienced.
Within a few minutes the pain worsened, and I headed for home.
By the time I reached my house—less than 15 minutes—the pain and nausea were so bad I was seeing spots and could barely walk to the bedroom.
I’d never had a migraine but I’d cared for a friend who had, so I was fairly certain I was experiencing my first one.
Convinced it was a fluke, I went on with life once it passed.
A few weeks later, a second migraine hit; this one even worse.
I knew from caring for my friend that migraines normally begin when people are teenagers.
Why would I get migraines in my 40s?
It would be a decade and dozens of fruitless doctor appointments before the word ‘perimenopause’ would enter my vocabulary.
Nearly 20 years later and we’re still woefully uninformed about the link between migraines, headaches and hormones.
The Estrogen Effect
Estrogen is involved in the development and regulation of the female reproductive system.
Headaches can be triggered whenever estrogen levels fluctuate, including drops in estrogen levels around the menstrual cycle.
Women may also experience more frequent headaches at the onset of menopause and after a hysterectomy.
Pre-adolescent girls and boys suffer from headaches with equal frequency.
However, it occurs more often in girls during puberty or the beginning of menstruation and resolves only after menopause.
To find out if your menstrual cycle is affecting your headaches, try keeping a calendar of when your symptoms start.
If you see a pattern, your doctor may be able to offer some preventive measures and treatments, such as stopping your menstrual cycle, possibly with the help of medication, if the pain is extreme.
Migraine headaches can be particularly troublesome during the transition from perimenopause to menopause.
What is a migraine?
Migraine is a type of headache characterized by pain, nausea, and sensitivity to light and sound.
They usually affect one side of the head and can last hours or days.
For many women, perimenopausal hormonal headaches may be due to the hormonal fluctuations that occur during this time.
Perimenopausal symptoms such as sleep disturbances, stress, and hot flashes can also trigger migraines.
How To Tell If It's A Migraine Or A Severe Headache
But how do you tell if it's a normal headache or something more severe like a migraine?
A few things to note:
Location: Migraines usually cause headaches on only one side, whereas tension headaches usually affect both sides.
Intensity: Migraines are often much more severe than tension headaches. If your headache is severe enough to interfere with your daily life, you may have a migraine.
Duration: Migraines usually last for hours (or days), while tension headaches are shorter.
Symptoms: In addition to pain, migraines often cause other symptoms such as nausea, dizziness, and sensitivity to light and noise. Tension headaches, on the other hand, are usually not accompanied by other symptoms.
Of course, the only way to know for sure if you have menopausal headaches is to see a doctor.
However, if you're unsure whether to see a doctor, use these guidelines to help you decide if it's worth it.
Migraine Headache Symptoms
typically last four to 72 hours (this includes pre-headache and post-headache symptoms)
spots or zigzag lines in vision (only among 15–25 percent of headache sufferers)
pain on one side of the head (15 percent of patients can have pain on both sides)
pain worsened by physical activity
sensitivity to light, sound or smell
nausea and/or vomiting (patients with tension type headaches typically do not have nausea)
Perimenopausal Headache Treatment
Although there is no cure for migraines, there are treatments that can help reduce the frequency and intensity of migraine.
For some women, hormone replacement therapy (HRT)/menopausal hormone therapy (MHT) helps relieve migraines, while others benefit from acupuncture and chiropractic care.
Over-the-counter pain relievers such as ibuprofen and acetaminophen can help relieve pain, while prescription drugs such as triptans can provide more targeted relief.
A healthy lifestyle with an emphasis on stress reduction and sleep hygiene may be recommended for migraine.
Nonetheless, every woman's case is unique, so talk to your doctor to find the best treatment plan for you.
Although it is estimated that menopausal migraines will be experienced at some point in life, there are some things women can do to prevent migraines during this time.
First, it's important to maintain a regular sleep schedule and get enough rest. Adding hot flashes and night sweats is easier said than done, but it's worth a try.
Second, staying hydrated is important because dehydration can cause migraines. Drink plenty of water throughout the day and avoid caffeine and alcohol. Both can cause dehydration.
Finally, try to control your stress levels, as stress is a common trigger for menopausal migraines.
Exercise, meditation, and deep breathing can help reduce stress.
Hopefully, following these tips will reduce your chances of suffering from pre- and post-menopausal migraines.
HRT is not a cure for migraines, but migraine sufferers can use certain types of HRT to control other menopausal symptoms. People with headaches respond differently to HRT. Overall, migraines generally worsen with hormone therapy.
If you are taking HRT to control other menopausal symptoms and find that your headaches get worse, switch to a transdermal formulation (HRT patch or gel) or reduce your estrogen dose.
Transdermal formulations (HRT patches or gels) are usually the safest for people with migraines. This is because people who regularly experience migraines may be at risk for certain medical conditions. Taking HRT transdermally greatly reduces this risk.
HRT works to some extent, but it's not for everyone. Talk to your doctor about whether it's right for you.
For more information on menopause or perimenopause, visit mySysters.
The information and other content provided in this blog, website or in any linked materials
are not intended and should not be considered, or used as a substitute for, medical advice,
diagnosis or treatment.
Sources:
https://americanmigrainefoundation.org/resource-library/migraine-and-menopause/
https://americanheadachesociety.org/news/understanding-and-treating-headache-related-to-menopause/