Headaches and migraines

What are migraines?

Migraines are a neurological disorder characterised by recurring, severe headaches that are frequently accompanied by additional symptoms. It’s more than simply a headache; it’s a complex disorder with serious consequences.

A migraine headache has the following characteristics:

• Pain: Migraine headaches are characterised by moderate to severe pulsating or throbbing pain on one side of the brain. The pain, on the other hand, might sometimes impact both sides or move from one side to the other.
• Duration: Migraine attacks typically last 4 to 72 hours if left untreated.
• Sensitivity to stimuli: Migraine sufferers may be sensitive to light, sound, or certain odours. Some people may also feel queasy or vomit.
• Auras: Some people have auras before or during a headache. Auras are typically visual disruptions such as perceiving light flashes, blind areas, or zigzag lines. Tingling feelings in the face or hands are also possible.
• Triggers: Hormonal changes, specific meals, stress, lack of sleep, strong sensory stimuli, or environmental factors can all cause migraines.

Because of the severity of the symptoms, migraines can greatly disrupt daily life, resulting in lost work or social engagements. Medication to prevent or alleviate symptoms, as well as lifestyle adjustments to control triggers and reduce the impact of migraines, are all treatment possibilities. Seeking medical advice is recommended if migraines have a substantial influence on one’s life or become more regular or severe.

Causes

Changes in hormones: Oestrogen regulates blood vessel and pain pathways in a complicated way. This equilibrium can be upset by fluctuations and reductions in oestrogen levels throughout menopause, which can also contribute to the onset or aggravation of migraines and headaches.

Hormone withdrawal: Oestrogen withdrawal can cause headaches or migraines, especially during the perimenopause. For some people, the sudden drop in oestrogen levels before menstruation or during hormone therapy adjustments can be a trigger.

Hormone replacement therapy (HRT): While HRT might help some women with the symptoms of menopause, it can also be a headache and migraine trigger. Hormone therapy’s effect on headaches can vary depending on the kind, dose, and manner of administration.

Changes to the menstrual cycle: As menopause approaches in women, the menstrual cycle may become erratic or stop entirely. Some women may experience headaches or migraines throughout their menstrual cycles. Menstrual migraines, also known as hormonal migraines, can be attributed to changes in hormone levels and variations throughout this period.

Increased worry and stress: Menopause is frequently accompanied by feelings of anxiety, stress, and mood swings. These emotional circumstances have the power to start a migraine or headache, intensify an already existing one, or both.

Sleep disturbances: Insomnia and disturbed sleep brought on by night sweats are both known migraine and headache triggers. The pain threshold can be lowered by getting insufficient or poor quality sleep, which increases a person’s susceptibility to headaches.

Lifestyle factors: Some lifestyle elements that are frequently linked to menopause can cause migraines or headaches. Dietary triggers (such certain foods, coffee, or alcohol), dehydration, skipping meals, erratic eating patterns, and inactivity all fall under this category.

Treatments

Combinations of methods targeted at managing symptoms and preventing recurrence are used to treat headaches and migraines during menopause. Here are a few regularly used therapy options:

Lifestyle modifications:

• Keep a consistent sleep pattern: To create a healthy sleep schedule, aim for regular bedtimes and wake-up times.
• Reduce stress: Use relaxation methods to reduce your stress levels, such as yoga, meditation, and deep breathing exercises.
• Remain hydrated: To avoid dehydration, which can lead to headaches, drink enough water throughout the day.
• Recognise and prevent triggers: Keep a headache journal to track your triggers, such as particular foods, environments, or stressors.
• Make an effort to limit or prevent exposure to these triggers.
• Exercise frequently: As tolerated, engage in regular physical activity because it can lessen headache frequency and intensity. Intense exertion should be avoided when experiencing a headache, though.

Over-the-counter pain relievers: Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen or aspirin, can be used to treat mild to moderate headaches. Always observe the dose recommendations and instructions.

Medications on prescription:

• Triptans: These drugs are designed to treat migraines only, and they operate by tightening blood vessels and lowering inflammation. They come in a number of different forms, including as tablets, nasal sprays, and injections.
• Preventive medications: Beta blockers, antiepileptic medications, or tricyclic antidepressants, may be prescribed by your doctor if headaches or migraines are frequent or severe. Regular use of these drugs helps to lessen headache frequency and severity.
• HRT: Hormone replacement treatment is sometimes prescribed for women to treat the symptoms of menopause, such as migraines. Hormonal variations that cause headaches can be stabilised with oestrogen supplementation with HRT. However, the choice to use HRT should only be made after thorough deliberation and consultation with a medical expert, taking into account unique circumstances and potential hazards.
• Alternative and complementary therapies: Acupuncture, biofeedback, relaxation methods, and herbal supplements are examples of complementary therapies that some people use to treat their headaches or migraines. A healthcare expert should be consulted before utilising these remedies because there isn’t enough data to support their efficacy.
• Botulinum toxin (Botox) injections: Injections may occasionally be used to treat chronic migraines as a preventive measure. These injections, which are given by a medical expert, can lessen the frequency and intensity of migraine attacks.

Working with a healthcare professional to create a specialised treatment plan based on the severity, frequency, and features of your headaches or migraines is essential. This practitioner could be your GP or a headache specialist. They can assess your symptoms, pinpoint the causes, and make individualised therapy recommendations.

National Migraine Centre

For more information about migraines, we recommend the National Migraine Centre.

They offer a range of free resources including factsheets, headache diaries and the award-winning Heads Up podcast all produced by leading headache doctors and researchers.

As a not-for-profit charity, the National Migraine Centre partner with world class headache specialists who choose to work for a fraction of NHS and private rates. They offer both donation-based and fixed-fee appointments with experts from the comfort of your own home.