The Relationship Between Migraine And Menopause

The Link Between Migraine And Menopause

Many know that women are two to three times more likely than men to experience migraine attacks. Migraine prevalence in women begins to strike from puberty, have a heightened risk throughout adulthood, but see either an end or continue with the migraine journey after menopause. Why do we see such a sharp difference with menopause, and how exactly is migraine and menopause linked?

Can Menopause “Cause” Migraine?

To begin, why do some patients experience migraine during their menstrual period? A study published in 2021 revealed both estrogens and oxytocin (a neurohormone released by the hypothalamus) might act on the trigeminal ganglion and control the delivery of calcitonin gene-related peptide (CGRP), which initiate the migraine pain. Although the relationship between sex hormones and migraine is complex but not fully understood, the same study also highlighted sex hormones influence nociceptive processes in both central and peripheral pathways.

Hormonal Migraine And Menopause

Research has shown an association between migraine and the rise or drop in estrogen. For women with hormone-related migraine history, their chance of experiencing frequent and severe migraine increases during perimenopause. As women enter menopause, the pituitary gland (the “master” gland of the endocrine system) will change the follicle-stimulating hormone production, which induces the ovaries to produce less estrogen. Change in estrogen level mainly occurs in three stages of a woman’s life: heightening during puberty, worsening in perimenopause, and deactivating in late menopause. Statistics show that the peak prevalence of migraine occurs in pre-menopausal women in their late 30s at approximately 30%, while the annual migraine prevalence in women, regardless of age, is 17%. The same research suggests migraine generally warrens during the transition of menopause and then improves after menopause. Moreover, other conditions associated with perimenopause, like anxiety, depression, and sleep disturbance, may contribute to migraine attacks. There is also a strong relationship between perimenopause and migraine in women with a menstrual migraine history and a decline in attacks after menopause because of the stabilized and decreased estrogen levels. 

Remedies For Migraine During Menopause

Although some people reach an end to this migraine journey after menopause, others still struggle and hope for natural remedies to cope with migraine during menopause. Research suggests non-medication relief such as using lavender or peppermint oil, biofeedback, vitamin E, aerobic exercise, yoga, and black cohosh. Patients can also consider invasive but non-medication relief like acupuncture to reduce migraine and other associated vasomotor symptoms. Patients can also avoid triggering food and beverages such as chocolate, cheese, and alcohol to minimize migraine attacks or pain severity.  

With the decline in estrogen levels, there are medicational therapies that help treat common menopausal symptoms. Hormone replacement therapy can replace some estrogen that decreases during perimenopause by taking pills, using a patch, or delivering vaginally through a cream, vaginal ring, or spray. However, the treatment effect varies in the population: some may see improvement, experience worsened migraines, or see no effect. Common migraine preventive medications like beta blockers for migraine, antidepressants, topiramate, and other second-line medications provide more safe options for midlife women with constant migraines. 

Not sure how to start with managing migraine and menopause or menstrual cycles? Consult with your provider for any treatment or preventive options, and use Migraine Buddy to document if you are in a menstrual cycle during your flare-up.

Reference