Fluctuating levels of hormones associated with the menstrual cycle have been found to trigger migraines in women who unfortunately are three times more likely to suffer with this kind of headache than men. Some women also experience ‘aura’ which can mean there is severe headaches are associated with visual disturbances a change in smell or taste or even weakness in parts of their body.

In older women migraines can become more common during the perimenopausal and menopausal stages of life when oestrogen levels naturally decline, and the other hormones fluctuate. Migraines without aura can worsen around the perimenopause but migraine with aura may be made worse by hormone replacement therapy in some women.

Migraines seem to be more common in women in their 40s as hormonal fluctuations become more marked and erratic around the perimenopause. it is very common for migraines (without aura) to worsen at this stage and may coincide with your periods becoming heavier and more erratic. Migraines can also be brought about by other perimenopausal symptoms, such as hot flushes, night sweats, poor sleep, and mood swings. 

Once a woman has gone through her true menopause many find the frequency of migraines reduces or they stop as the hormonal triggers disappear. There are some unfortunate women there who continues to struggle well into their 60’s and 70’s though as not all migraines are hormone related. 

Migraine and HRT 

HRT can be very effective at alleviating the symptoms of migraine, as well as the other symptoms of the perimenopause and menopause and is a perfectly safe option whether a woman has migraine with aura or without. Evidence suggests that the transdermal route of HRT delivery i.e., patches gels and sprays are the safest option for migraine sufferers. We always start with the lowest possible dose of oestrogen to see how a woman’s migraines respond and some people need varying doses at different times of their cycle depending on when the migraines are worse.

Does anything else help migraine? 

A healthy lifestyle can reduce the occurrence of migraine, and avoiding the regular triggers such as caffeine, alcohol, spicy foods, and chocolate may help some. Taking regular exercise and maintaining a good sleep pattern may also help as well as drinking lots of water and taking regular small meals to avoid fluctuations in blood sugar levels that can trigger migraines in some. 

Riboflavin B2, Magnesium and Co-enzyme Q10 are all natural supplements that have been shown to have some benefit in migraine prevention and treatment.

Painkillers such as paracetamol and ibuprofen can alleviate the headache pain as can the use of Triptans. Preventative medicines such as Beta blockers, Amitriptyline and Topiramate can be discussed with your GP.