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Menopause May Increase Migraine Frequency

Many women have been told that their migraine frequency will lessen with menopause. However, women have been telling their doctors for years that their migraine attacks increase with the transition to menopause (perimenopause) or in menopause (postmenopause. Perimenopausal and postmenopausal women had an increase in their migraine frequency, according to a study presented at the American Headache Society meeting in June.

Researchers concluded that women in perimenopause or postmenopause were 50% to 60% more likely to have 10 or more headache days per month in this study of 3,606 women aged 35 to 65. About a third of the study’s participants were premenopausal, a third were in perimenopause and a third were in postmenopause. The percentages of who had 10 or more headache days a month were:

  • 8% of premenopausal women
  • 12.2% of perimenopausal women
  • 12% of postmenopausal women1

(Are you wondering why this says “headache days” and not “migraine attacks”? All the participants of the study had migraine, but researchers asked about number of headache days rather than number of migraine attacks. This is the preferred question in research and in clinical practice. Many physicians believe that when a migraineur has a non-migraine headache, migraine is still the source of that headache, it’s just not a full-blown migraine attack. By asking about headache days rather than migraine days, they get a better picture of what migraine is like for each patient.)

Hormonal changes are thought to be responsible for the difference in migraine frequency. According to lead researcher Vincent Martin, M.D., “I think that estrogen is the most important hormone, but also think that other hormones such as progesterone can play a role as well.” Follicle-stimulating hormone (FSH) may also be a factor. 2,4

I asked Dr. Martin if the research contradicts the belief that migraine frequency lessens with menopause. He said, “No, I don’t think so.  I think our research suggests that the transition into menopause increases the frequency of headache. The perimenopause (particularly the late perimenopause) seems to have the highest frequency of headache compared to premenopausal times.” The degree of disability associated with the migraine “was only increased in the perimenopausal group suggesting that this is the most important times for worsening of headache that likely represent migraine,” Dr. Martin said.3

Most of the participants had been postmenopausal for a short time, so findings can’t be extrapolated through the entire postmenopausal period. It could be that late perimenopause and early postmenopause are the most likely time period for increased migraine frequency. A 2003 study found that women in late perimenopause had the highest migraine prevalence and women who had gone through spontaneous (not surgically induced) menopause had the lowest.4

The study gathered data from a slice of time and did not assess a participant’s migraine history prior to then. Therefore, the data do not show if a woman had frequent migraine attacks prior to that time period or at what stage in menopause (pre-, peri- or post-) the increased migraine frequency began.

When the news of this study first came out, I actually cried. I thought of all the women (including myself) holding out hope that their migraine frequency and severity will lessen with menopause. Upon further investigation, I discovered that this study does not necessarily dash those hopes. The research is in the very early stages and many questions remain before we can draw conclusions. Instead of seeing this study’s findings as bleak, I’m encouraged that researchers are trying to understand the problem. That’s the first step in figuring out how to treat it.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Menopause and attack frequency in migraine. American Headache Society press release. http://www.americanheadachesociety.org/menopause_and_attack_frequency_in_migraine/
  2. Martin, V. T. (2014). Migraine and the menopausal transition. Neurological Sciences, 35(1), 65-69.
  3. Personal communication with Vincent Martin, M.D. July 3, 2014.
  4. Wang, S. J., Fuh, J. L., Lu, S. R., Juang, K. D., & Wang, P. H. (2003). Migraine prevalence during menopausal transition. Headache: The Journal of Head and Face Pain, 43(5), 470-478.

Comments

  • Buthainita
    5 years ago

    I hit menopause at 30. My worst ever migraine attacks occured way after that at 33, and 34. Those were the kind of migraines that blew your head and made your eyes pop out and your stomach flip up and down, and would keep you in a third-dimenssional parallel world of your own for three or four days. So, any talk about less migraines after menopause would bring my fingers into a fist and make me mad. The fact is that even though they might actually be less, they come more harmful, whether that is because we get more vulnerable or because we don’t have the hormones to combat the attacks I don’t even care. What really matters at menopause is having the power to believe it’s still just an attack not the end of the world, lots pf water, and sleeping in for as long as it takes

  • Debbie
    5 years ago

    I was also always told that my migraines would get better after menopause. In fact, I’ve been told by migraine specialists that migraines go away or lessen as you get older (for men and women). I’ve had the opposite experience. My migraines have gotten worse with each decade and I am now 60. I had an early menopause (last period at age 42).
    My mother had menstrual migraine only and hers did stop after menopause. My sister and I continue to be chronic. It makes me wonder if, in some cases, migraine can be a progressive disease. Kerry, do you know of any research in this area?

  • cynajen
    5 years ago

    I’m so happy to say that Dr. Martin is my headache specialist! I’m a perimenopausal chronic Migraineur. I was very excited to see that you interviewed him! I too thought that with menopause my migraines would diminish, but once I hit perimenopause they only increased. I feel incredibly fortunate to be a patient of Dr. Martin’s.

  • Rockin mama
    5 years ago

    Thanks so much for this article. I’ve been peri menopausal for about 3 years and have been impatiently awaiting the much proclaimed decrease in migraines. Instead, I now have chronic migraines, and I’m finally trying to find the right preventative. It’s affirming to see that I’m not crazy.

  • ddnben
    5 years ago

    I appreciate hearing FINALLY that they don’t stop after menopause since I have had NO CHANGE and it really ticked me off that me and both of my sisters have continued to struggle with migraines (as did my grandmother) and I’m sick of hearing that it must just be us. Thank you for the informative article.

  • mygrainetoo
    5 years ago

    Thank you, Kerrie for this article. Although I have identified food/drink triggers & controlled my migraines with diet & abortive generic Fioricet, I never thought about the postmenopausal onset until reading your article.
    I had a totally different type of migraine in my 30’s that I found I could control by taking niacin. Taking niacin daily served as a preventative method of controlling them & they ceased completely. I was floored when the migraines started up again in my 50’s & the niacin didn’t touch them. After they increased in frequency & severity I finally started eliminating foods & drinks & kept a journal. My awareness of the WORST offender – aspertame – came through a friend whose daughter works in the insurance industry. Since then I have seen my 2 biggest problems – aspertame & all yeast products,derivitives & extracts – in the top 10 food-drink migraine triggers on several lists.
    Your article makes me wonder if hormonal changes created digestive or enzyme deficiencies, susceptibility to infections requiring antibiotics created a deficiency..??? There has to be a chemical connection & answer in all of this.
    Again, thank you, Kerrie.

  • Patricia
    5 years ago

    Patti
    Wow! Thank you Kathy for sharing!! My migraines also follow my ovulating & period pattern each month, but my last period was 5 years ago! Thought I was going crazy!! This website has helped me so much. Thanks!

  • marti
    5 years ago

    My mom’s migraines decreased frequency after menopause. She still has them, but not as bad. Several years ago my doctor started me on birth control pills to shrink ovarian cysts, and I swore I’d never take another hormone pill. I was in so much pain I couldn’t breathe. In fact, when my doctor asked if I wanted him to give me an injection for the pain, I told him he could shoot heroin into my eyes if it would make it stop. So I hope that after menopause and my hormone levels decrease things will improve. I’m 48 years old, and no perimenopause yet – here’s hoping……

  • mjsymonds
    5 years ago

    martieedgar – I’m so sorry to hear what you went through when you took BC pills. The worst migraine I ever endured, nine days of pure agony, was as a result of being put on a progesterone only pill. I remember thinking on day eight, if this continues any longer, if this is what my life has been reduced to, then there is simply no point in being alive anymore.

    In my experience most doctors have no clue what they are doing when they proscribe hormones to migraine patients. And unfortunately this leads too many of us to never want to risk taking another hormone again.

    The specialists who do know how to help migraine patients using hormones as part of an individualized preventive management regime are still few and far between. From what I’ve seen, some are migraine specialists, some are endocrinologists and some are specialists in women’s health and mood disorders. But they are out there, and clearly, we need more of them.

    I do wish you all the best and hope your migraines improve with time.

  • Ann B
    5 years ago

    Unfortunately, my migraines also increased after menopause. In fact, they first reached the chronic level (more than 15/month) 2 1/2 years after my last period. The saddest part for me is that my family doctor is convinced that “the migraines should have gotten better if not disappeared” after menopause. I don’t think she means to imply that I am lying, but I sometimes feel that way when she says it to me. Thankfully, she is not the one treating my migraines as I see a headache specialist, who has no such false illusions.

  • mjsymonds
    5 years ago

    Kerrie,

    Thanks so much for this article. It brings attention to such an important issue for women with migraine: the effects of hormone changes on the course of migraine disease throughout our lives, especially as we approach menopause. I feel a bit like a poster child for the clear effects of hormone changes on the frequency, duration and intensity of migraine over the course of a lifetime and how hormone treatment can help return balance and well-being.

    I had menstrual migraines that started out at a mere twenty-four hours of pain each month in my teens but gradually got worse through my twenties, thirties and forties until I was experiencing fifteen days or more of disabling pain every cycle, i.e.: my migraines had become chronic. And by the time I reached forty-seven, with the onset of peri-menopause, there was no such thing as a pain free day for me anymore, just one long non-stop migraine.

    Fortunately, I took action at that point and was able to find several migraine specialists who were instrumental in helping me get my life back. I’m quite convinced if I had not started continuous hormone replacement as part of my migraine management back then, I would still have a never-ending, unrelenting, life-destroying migraine. I’m now fifty-two and the only time I get a migraine now is when I forget to change my estradiol patches on schedule.

    If my body becomes less reactive to estrogen as I age, I may not need to keep using the patches, but it seems clear to me that so much more needs to be done to understand the intricate role hormones play in migraine disease.

    Thanks again Kerrie for sharing some of the most recent research on this topic.

    MJ

  • Woodsl
    5 years ago

    I, too, cried when my migraines failed to diminish with menopause. Having suffered migraines since I was 13, I had great hope for the post menopausal state. Alas, it was not to be. It is now six years since my last period and I still suffer 10 to 15 migraine days per month. Oh well…

  • MigraineSal
    5 years ago

    I have menopausal onset migraines so am a big believer that they can be aggravated by hormonal change.

    I was very fortunate to have not had a migraine until just over a year ago and although my migraines can be triggered by my neck condition ( which I have clearly had for years looking at the MRI result ! ) they did not kick in until the hormones did !

    I have also been very lucky to have had excellent care from a leading Consultant Neurologist and to have found the right preventative medication that suits me and that keeps my migraines under control . . . apart from triggers beyond my control, or poor neck care of course ! My heart goes out to others who have not been so fortunate and who have suffered with this terrible disease most of their lives and are still searching for something to make them easier to bear x

  • hobiegal
    5 years ago

    My mother didn’t have a migraine for 10 years after her hysterectomy, then they started back. Mine got worse when I started menopause and have continued to get more frequent and more severe in the 10 years since. I recently discovered that Gatorade works wonders for me (electrolyte issue?) and maybe it will help someone else. It’s worth a try.

  • Holly
    5 years ago

    I was told that my migraines would decrease once I went through menopause. My mom’s did.So I was very hopeful, But mine have increased. I had my thyroid removed 3 years ago and that is when they got worse, so I think that has a lot to do with it. I still feel it has to do with hormone imbalance. My doctor says my thyroid is fine, but I do not feel well and have headaches every day. I didn’t have headaches every day before I had my thyroid removed. With all that said there is hope for some like my mother that after menopause the migraines will go away. (:

  • Kathy
    5 years ago

    Hi there

    Sorry to report that my migrains got worse over the last three years. I stopped menstruating when I was 47 and I am now 51. Definately due to hormonal imbalance . I feel that they hit when I ovulate and when I menstruate ( although I don’t do either of those any more as I am menopausal !!!!) Make sense? Only to those experiencing the same as me I guess!

    I use to get a migraine every month with my periods which I coped with for the few days and took paracetamol. Now I get hit four days a month but control the pain with Triptans and naproxen . They kill it dead thank goodness!! Otherwise I would be in pain for half the month without pain killers.

    I also feel like I am walking a type rope every day. Having to eat healthy and regularly. Having to sleep nine hours a night. Having to keep my life quiet , stress free and chilled , in order to prevent an attack.

    One symptom is a tight jaw, then I notice my neck and shoulder muscles are so sore. All because of a hormone imbalance that I don’t seem to be able to do anything about.

    My doctors looked at me strange when I said my migrains were due to female hormones and menopause. It seems that there are few medics out there who are aware of the link. I hope more is done to make this connection known in the medical world

    Thanks for the article . Much appreciated.

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