Headaches and migraine

Migraine triggers

As well as hormone changes, common triggers for migraine are any changes to your usual routines, stress, sleep changes, caffeine and alcohol, missing meals, dehydration, and environmental triggers like bright lights, loud noises or strong smells. So it’s worth keeping a note of any migraine episodes you have and what the potential triggers for them were. You can then try and avoid any triggers you have identified as much as possible.

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.

Migraine and HRT

Migraine might also occur with other symptoms of peri/menopause such as hot flushes, poor sleep and mood swings. HRT can improve migraine in perimenopause and menopause and bring relief to the other symptoms that might be contributing to your migraine attacks.

It can take time to find the right type and dose of HRT for you to improve your headaches or migraine. Oestrogen via a skin patch is often recommended for those who suffer with migraine as this provides a steady dose of oestrogen throughout the day and helps keep hormone levels more stable. You may wish to start on a low dose and build it up slowly if you need to. It’s best to not have any breaks in treatment as the aim is to get hormone levels as stable as possible, and give any medications at least 3 months to take full effect. It is also important to find the right type of progesterone for you if you still have your womb, and many women find adding testosterone to their HRT helps with their migraines.

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.

Ways to help migraine

Here are some ways to lessen the impact of migraine:

1. Keep a migraine diary and learn about what triggers your migraine attacks.
2. Try and foster a healthy lifestyle by establishing routines of regular exercise, good sleep, nutritious meals, staying well hydrated, avoiding caffeine and alcohol and actively managing stress.
3. Avoid your migraine triggers as best you can but be realistic and aware of how set routines will impact those closest to you.
4. Over the counter painkillers may help, like paracetamol and ibuprofen.
5. If these lifestyle measures and over-the-counter pain relief is not providing enough relief, see your doctor (and possibly a specialist) about trying additional medication for migraine.
6. You may wish to explore alternative and complementary therapies and talk to others who also experience migraine.

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’s headache specialists offer both donation-based and fixed-fee appointments.