Does menopause cause migraine?


Migraine awareness in menopause

The Migraine Trust say at least 90% of people who suffer migraines begin their attacks before the age of 40. Predominantly beginning in their teens or early twenties. Apparently starting migraines in later life is fairly rare.

We look at the connection between the hormonal fluctuations during the onset of menopause and how this may impact migraines.


Does menopause cause migraine?

The North American Menopause Society say “menopause can affect your migraines in a number of ways. Menopause may make migraines less severe if they were linked to the hormonal fluctuations of your menstrual cycle. Or migraines may start for the first time, or worsen, around perimenopause because of new hormonal fluctuations. Hormone therapy for menopausal symptoms may also be linked to migraines at this time.”

Confusing? They do however assure us that hormonal migraines tend to stop post menopause, when hormone levels are constantly low.

Why can hormones cause migraines?

Our entire menstrual cycle, not just our periods are linked to the biological changes in our bodies, physically and psychologically. The physical and chemical process that produces our sex hormones, oestrogen and progesterone, have a massive impact. The Migraine Trust report around 50% of women say their menstrual cycle directly affects their migraine.

Some women are more sensitive to hormonal fluctuations within their menstrual cycle and it has been recognised that there is a strong tie between sex hormones and migraine. Most commonly just prior to our periods. Studies suggest migraine attacks at this time may be the result of falling oestrogen levels in the latter phase of the menstrual cycle.

It’s not fully understood what causes migraine attacks, some research suggests they are caused by changes in levels in brain chemicals, causing inflammation and swelling of blood vessels that press on nerves. Hormonal changes may also be linked to the amount of serotonin in our brain.

Genetics may also play a part, if migraines run in the family, you may be unlucky enough to suffer them too!

Migraines are often misunderstood, underdiagnosed, and incorrectly treated.


What triggers a migraine attack during menopause?

Women may react to various “triggers”. These vary and don’t always lead to a migraine attack.

A combination of triggers may set off a migraine, these include:

  • Bright or flashing lights

  • Lack of food or sleep

  • Stress

  • Changes in hormones and hormonal levels (such as menstrual periods, pregnancy, and perimenopause)

One way to manage your migraines is by keeping a diary for at least three months, to pin point when they occur. This helps you identify your triggers and if there’s any relation to your menstrual cycle or hot flushes. Show your doctor so you can discuss the best course of action to manage migraines and your menopause.

Irregular periods make it problematic to cope with their occurrence as they’re not easy to predict through menopause. Typically, other menopause symptoms like hot flushes and night sweats result in disturbed sleep, adding to stress levels and increases the likelihood of a migraine.

What’s the difference between a headache and a migraine?

According to the NHS a migraine is a moderate or severe headache felt as a throbbing pain on one side of the head. Other symptoms including nausea, vomiting and increased sensitivity to light or sound. They can last between 4 to 72 hours.

The migraine Trust explain that there is a difference between the two. “Headaches are not usually accompanied by other symptoms associated with migraine. However, it is quite likely that if you have a migraine you will also experience other headaches.” Oh joy!


How can you treat hormonal migraines?

There are natural treatments you can try that do not involve medication, these include:

  • relaxation techniques

  • changes in your diet

  • stress reduction

  • acupuncture

  • biofeedback therapy is used to help control muscle tension to reduce the intensity of migraines

  • a regular sleep schedule

  • Daith migraine piercing: Recommended by a Hot Flush follower. A form of VNS therapy can also help with IBS, anxiety and depression, and other neurological disorders.

  • Supplements and herbs: Feverfew, magnesium, vitamin B2.The Migraine Trust has detailed information and studies. Always inform your doctor if taking herbal remedies

Medication that prevents migraines occurring include:

  • magnesium

  • aspirin

  • triptans; these are a group of medicines used to treat migraines

  • HRT

 Medication to stop a migraine that has already begun

  • triptans

  • nonsteroidal anti-inflammatory drugs


HRT and migraines?

HRT affects every woman differently. Some women experience a reduction in migraines, and symptoms may get worse for others.

The National Migraine Centre say HRT should not be used as a treatment for migraine. However, many women notice that migraine is more likely to occur when they have bad hot flushes and night sweats. Since HRT is effective at controlling these symptoms, it may help reduce the likelihood of migraine. Some forms of HRT might create more hormone fluctuations, triggering migraine. This is more likely to occur with tablets of HRT.

If you start HRT the Migraine Trust recommend you try it for three months so your body finds its balance. Other health issues should be considered such as the incidence of breast cancer in your family.

HRT if taken in a way that suits you with the right dose might help peri-menopausal migraine.

If you need HRT for menopausal symptoms but develop headaches as a result, then managing your headaches can be difficult. You’ll need to work with your doctor to find the right dose and hormone balance. Also, by trying different ways of taking HRT you’ll hopefully find what suits you best.

The different forms of HRT available and the effect on migraine can vary depending on the type used. You may find that switching from pills helps. Non-oral HRT, either skin patches or gel you rub on your skin, provide stable levels of hormones and tend to be better for women with migraine.



Only a few studies have been conducted on the effects of menopause and migraine, these suggested that the menopause makes migraine worse for up to 45% of women, 30-45% do not notice a difference and 15% notice an improvement. Some women find their attacks still follow a cyclical pattern years after menopause and the reason for this is unclear?

The hormonal cycle can continue for some years after your last period, although the hormone changes are not sufficient to result in a bleed but may still trigger migraine. As hormones are a trigger factor, migraine attacks should settle within 2 to 5 years post menopause.

Although a few women continue to have regular attacks after their menopause, for most the end of a natural menopause can be a time of significant improvement in migraine.


This information is provided as a general guide only. If you have any queries or concerns about your headaches or medications please discuss them with your doctor.



The Migraine Trust

National Migraine Centre


The Medical Daith