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Perimenopausal migraine solutions?

I am new to the forum and have read the articles on this site. I am 45 and a chronic migraine sufferer and had it in control for a while with diet, etc. In the last year it has gotten very bad and clearly related to my hormonal changes. It starts a week before menses (I can feel it along with my mood changes, etc) and lasts of and on for a week after the start, and then comes back during ovulation again. And my cycles are shortening to 25 days, it seems like except for a week, I have migraine all the time. No aura. Medications consist of NSAIDS+Imitrex. My sister who is older had the same (migraines got worse as she went menopausal) and she went for hysterectomy recently. Since then her migraines are gone. Should I consider it? I am looking for an OBGYN to discuss this with. I have tried birth control pills once and they haven't worked. I would appreciate any advise on the course of action.

  1. Hi 1ifsl2c,

    Welcome to the discussion forum - we're so glad you are here!

    I'm happy to hear your sister has found relief, but everyone is not as lucky. Some women find that their migraines get better after natural menopause, while others get worse. In fact we have numbers on surgical menopause vs. natural menopause and migraine I can share with you. They are as follows;

    When women go through natural menopause 67% of women find that their migraines get better;
    9% of women find that their migraines get worse; and
    24% of women find that their migraines don't change at all.

    However, when it comes to surgical menopause following a hysterectomy, it's an entirely different matter. Following surgical menopause:
    33% of women find that their migraines get better;
    67% of women find that their migraines get worse;
    and a statistically insignificant number of women find that their Migraines don't change at all.
    Migraine/headache disorder experts recommend that women considering a hysterectomy do not proceed if they're considering it only because of their migraines.
    So the bottom line is if you are thinking about a hysterectomy ONLY for migraine relief, I personally would caution against it.

    You may want to talk to your doctor about taking Frova (a triptan) for short term prevention just before and during your menses. This seems to work well for many women. Let me share that information with you here; Our section on Women and Migraine may be helpful;

    Most of us have more than one migraine trigger and include certain foods, alcohol, smoking, dehydration, skipping meals, changes in the barometric pressure, irregular sleeping patterns and others. Here is more information on triggers I hope helps; If we can identify and manage our triggers, we may be able to reduce our migraine frequency and severity. The best way to figure out our triggers is to keep a migraine diary and with all the apps out there is really is easier than ever! has the Migraine Meter you may want to take a look at; or if that isn't for you there are many others out there.

    Let me know what you think,

    or create an account to reply.