How Your Period and Menopause Affect Migraine

Reviewed by: HU Medical Review Board | Last reviewed: May 2022 | Last updated: November 2022

By the time women reach menopause, around 4 in 10 will have migraine. Migraine is 3 times more common in women than men. This is partly because of hormones that affect women more at different times of their lives.1

Migraine tends to happen more often after a girl’s first period, around the time of your monthly period, and leading up to menopause. This is due to changes in estrogen and progesterone, hormones that play a role in reproductive health. As many as 7 in 10 women and girls with migraine link their headaches to changes in their menstrual cycle.1,2

Migraine and menstruation

Many women have migraine around 5 days before their period. Researchers think this happens because of a sudden drop-off in estrogen during this window of time. Migraine attacks around your period are more likely to be severe, triggering added symptoms like nausea and vomiting.1,2

Perimenopause and menopause

You may notice a spike in migraine symptoms in the years leading up to the end of your menstrual cycle (called perimenopause). You could have migraines more often, and it is possible they will be more severe.1-4

Varying hormone levels are to blame. Plus, women transitioning to menopause have more trouble with sleep, anxiety, and depression, making migraine worse. The good news is, once you reach menopause and your hormones even out, you could feel relief from migraine.1,3

Migraine treatments

Treatments for menstrual-related migraine depend on how severe your symptoms are and how long they last.

During menstruation

If you have regular periods, your doctor may suggest a preventive medicine. You will take it a few days before your period starts and continue for a couple of weeks after.3

It may be best for those who live with irregular periods or more frequent migraine to take preventive drugs every day. To help you avoid migraine, your doctor could prescribe:3

  • Beta-blockers
  • Antiseizure drugs
  • Calcium channel blockers
  • Antidepressants
  • Magnesium
  • Hormonal birth control

During perimenopause and menopause

The unpredictability of hormones around perimenopause can make it challenging to treat migraine. Two options are:2,3

  • NSAIDs (nonsteroidal anti-inflammatory drugs) such as Aleve, Advil, or Motrin IB
  • Triptans, a class of drug that works by cutting off pain signals in the brain

However, keep in mind that women going through menopause may need to avoid triptans. These drugs narrow the blood vessels, adding to the risk of cardiovascular disease that older women already face.2,3

Some women take hormone replacement therapy (HRT) during perimenopause and menopause. This type of treatment can make migraine worse, improve your symptoms, or make no difference at all in how you experience migraine. An estrogen skin patch is less likely to worsen migraine than other forms of HRT.3

Other migraine treatments include:3

  • Ice. Place a cold cloth or ice pack wrapped in a towel on your head.
  • Relaxation exercises. These exercises can help ease stress. Stress can make a migraine worse.
  • Biofeedback. This is a technique to manage your body’s functions, like your heart rate. The idea is to control stress, a known migraine trigger.
  • Acupuncture. A practitioner inserts thin needles into different pressure points on your skin to relieve headaches.

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