Menopause and headaches

 

Headaches are more common around menopause due to fluctuating hormone levels. If you have had headaches in the past – especially if you get migraines – you may notice them getting more frequent or more severe.

Don’t panic yet, there are things you can do to address this frustrating aspect of menopause. Read on to find out more.

HEADACHES DEFINITION

Many different kinds of headaches affect women at the time of menopause. The two most common are:

1. Migraines: These can be severe, usually one-sided headaches that may be associated with nausea, vomiting and sensitivity to light and noise. Migraines can be preceded with sensory changes known as aura. These often cause changes to your vision, including seeing flashing lights or zigzag lines

2. Tension headaches: They are often described as a band-like pain or pressure around the head which lasts from 30 minutes to several hours

Headaches have many different causes. It is important that you see your doctor if you are concerned to get appropriate treatment. In this guide, we focus on migraines as this kind of headache is the most affected by the hormonal fluctuations of menopause.

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HOW LIKELY ARE HEADACHES DURING MENOPAUSE?

  • Fairly common
  • One study of over 500 postmenopausal women found that 13.7% of them suffered from headaches
  • Of these, 82% said that their headaches had started prior to menopause

Read more about the stages of menopause or aches and pains symptoms.

HOW CAN YOU MINIMALISE HEADACHES?

1. Diary. Try keeping a diary of your headaches (including dates, times, symptoms and possible triggers). This will help you and your doctor to identify any patterns, especially if your headaches are linked to your menstrual cycle.

2. Healthy lifestyle. Minimise alcohol, caffeine and any other known headache triggers. Take some aerobic exercise and aim to get enough sleep with a regular routine.

3. Talk to your doctor. Headaches can be caused by a number of different conditions, many of which can be treated effectively once they are diagnosed.

4. Relax. Other recommended measures include yoga and acupuncture.

WOULD HORMONE REPLACEMENT THERAPY (HRT) HELP?

HRT is not a treatment for migraines, although women with migraines can use certain types of HRT to control other menopausal symptoms. Women with headaches have a variable response to HRT. Overall, migraines generally get worse with hormone treatment.

If you are taking HRT to control other menopausal symptoms and find that it makes your headaches worse, you may benefit from switching to a transdermal preparation (HRT patch or gel), or from a reduced dose of oestrogen.

For women with migraines, a transdermal preparation (HRT patch or gel) is usually the safest. This is because women who regularly experience migraines may be at risk of certain conditions. Taking the HRT transdermally greatly reduces this risk.

Although HRT is beneficial for some women, it is not suitable for everyone. Speak to your doctor about whether it is right for you.

Read more about the HRT debate.

Headaches and menopause

Throughout their adult lives, about half of women find that migraines are triggered by the menstrual cycle. The ‘female’ hormone oestrogen seems to be the main cause of this.

Around the time of menopause, the menstrual cycle becomes more erratic, as do the levels of hormones that govern it.

These hormonal changes can also trigger migraines, hence the reason that women tend to experience more frequent and severe attacks at menopause.

There is no definite answer to this question and every woman’s body will respond to menopause in a slightly different way. Migraines affect between 10-29% of menopausal women. Among those women who get migraines during menopause, 45% will see a deterioration, 30-45% will see no change and 15% will see an improvement.

Women who have gone into menopause after having their ovaries removed (known as surgical menopause) tend to struggle more.

Migraines tend to improve once you have passed menopause, especially if they were affected by your menstrual cycle earlier in life. One study found that two-thirds of women can expect an improvement. Expect to see the maximum improvement two to three years after your last period, as hormones can still fluctuate up until this point.

Your migraine triggers will remain the same after menopause.

Tension headaches stay the same or get worse for 70% of women. Your tension headache triggers will remain the same after menopause.

See a doctor if you have any headache that is lasting more than a few days, if you have headaches regularly, or if you are worried about your headaches.

 

When do you need to see a doctor urgently?

  • A severe headache, especially one that is bad enough to wake you from sleep or which comes on suddenly like a thunderclap.
  • A headache which is worse when you lie down, cough or hold your breath.
  • Any migraine aura which lasts for more than 60 minutes.
  • Any changes to your hearing, vision or balance, any pins and needles, numbness or weakness which is not part of your usual pattern of migraine aura.
  • A fever alongside your headache.
  • A red, painful eye, with or without changes to your eyesight.
  • A history of cancer, or if you are on any medications which affect your immune system (immunosuppressants).
  • If you are worried about your headache for any other reason.

Keeping a diary has helped me figure out that too much caffeine triggers my headaches.”

Sue

DISCOVER MORE

Why is the fun police on about my lifestyle? Read more

How exercise can really help keep your anxiety in check. Read more

Your essential guide to the stages of menopause. Read more

WHAT HEADACHE RELIEF IS AVAILABLE?

Download Stella for personalised cognitive behaviour therapy for managing symptoms during menopause

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NHS, 2018, Hormone Headaches, accessed 5th March 2021 https://www.nhs.uk/conditions/hormone-headaches/

NHS, 2019, Migraine, accessed 5th March 2021 https://www.nhs.uk/conditions/migraine/  

NHS, 2018, Tension-type Headaches, accessed 5th March 2021 https://www.nhs.uk/conditions/tension-headaches/ 

Neri I, Granella F, Nappi R, Manzoni GC, Facchinetti F, Genazzani AR, Characteristics of headache at menopause: A clinico-epidemiologic study, Maturitas, Volume 17, Issue 1, 1993, Pages 31-37, https://www.sciencedirect.com/science/article/pii/037851229390121W 

Migraine Trust, Menopause and Midlife, accessed 5th March 2021 https://www.migrainetrust.org/about-migraine/trigger-factors/menopause-and-midlife/

National Migraine Centre, Migraine, Menopause and HRT, accessed 5th March 2021 https://www.nationalmigrainecentre.org.uk/migraine-and-headaches/migraine-and-headache-factsheets/migraine-menopause-and-hrt/ 

Kuruvilla D, Understanding and Treating Headache Related to Menopause, American Headache Society, accessed 5th March 2021 https://americanheadachesociety.org/news/understanding-and-treating-headache-related-to-menopause/

Lauritsen CG, Chua AL & Nahas SJ, Current Treatment Options: Headache Related to Menopause—Diagnosis and Management. Curr Treat Options Neurol 20, 7 (2018). https://link.springer.com/article/10.1007/s11940-018-0492-7