Get control over menopause headache!

Menopause headache can be a shock to those who have always heard that mid-life means a decrease in headaches. The truth is that in a large percentage of women, migraine may increase during menopause, or even reappear after many headache-free

years! The headaches may or may not go away after menopause is over.

But now that you've reached the determined confidence of mid-life, you've found this page in the hope that you can fight back! There's plenty of hope if you're looking for answers.

By the way, there are a few good sources of information on the topic, but one of the most complete discussions I've seen on menopause headache and specifically migraine is found in the book The Women's Migraine Survival Guide.

Why me?!

As you may guess, menopause headache and migraine is probably related to hormonal changes, and usually hits those who have been sensitive to those fluctuations in the past. Menopause headache will usually be less severe if you go through menopause naturally (which may be bad news if you've had a hysterectomy in hopes of ending migraine. Two thirds of women with migraines before have worse migraines after the surgery).

During perimenopause (the time leading up to menopause. Menopause technically is considered to begin after you've been without a period for over a year) is when the problem often begins. Hormonal levels become uncertain, and it may take a while to sort things out.

Treating menopause headache with hormone replacement therapy

The most common menopause-specific treatment has to do with HRT (hormonal replacement therapy), which is a replacement of estrogen, although many doctors believe that there is less risk and more benefits to replacing a certain amount of both estrogen and progestin.

There are many forms of HRT that you can look into. For the migraine sufferer, the ideal seems to be continuous estrogen therapy. Studies seem to show that your blood levels need to be kept above 50 picograms/millilitre (pg/ml).


Time to take note: As migraine sufferers know better than most, we're all unique (just like everybody else)! In some women, estrogen clearly causes migraine (ok, I know – no one really knows the cause, but you know what I mean!). Work with your doctor to find out what levels may work best for you.


There are significant risks when it comes to HRT. If you have a uterus there is evidence it can cause precancerous lesions on the uterus. The risk of this is far lower if you're on a combined therapy of estrogen and progestin. There is also an increased risk of breast cancer. Have a complete discussion with your doctor of the risks to you, and make your own informed decision.

If you're having problems after you've started hormone therapy, don't give up! Here are some things that may improve the situation: Try reducing your dosage; Change the type of estrogen you're taking, or the way you're taking it; change to continuous therapy; try adding androgens (thanks to WebMD's article on headaches from April 2003 for these tips).

Drug treatments for menopause headache

If you already suffer from headaches or migraines, you may discover during perimenopause or menopause that your previous treatment no longer works. That's the bad news. But now that you know that, you should also know that there are other treatments that probably will work. Check out this summary of painkillers and preventative medications, then talk to your doctor.

Other treatment options

There are many other treatment options for migraine and other headache. The headache home remedies typically used by headache sufferers may be particularly helpful for menopause headache. Try something you haven't tried before! For a fun, clear, well-researched book on migraine, try Migraines For Dummies, written by two women – a health writer and a doctor.

-> read about hormonal headaches here If you want to stay up to date on the latest migraine and headache info, why not take a moment to subscribe to the e-zine, HeadWay? Timeless tips and current research...

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