Hormones Matter TM

5 Coping Strategies for Menopause Paired with Migraines

April 9, 2012  |  Nancy Bonk


Editor’s Note: Welcome to Menopause Monday! Each Monday, Hormones Matter will feature at least one article or personal story about menopause. We hope you will find these posts informative and help you to attain your healthy living goals.


Know Your Family History

At some point during the next few years I will be entering menopause while dealing with Migraine disease. For some women with both, they sail through menopause without any problems and see a reduction in their migraines. Others however, don’t make it through menopause so easily. Between hot flashes, anxiety, depression, insomnia and more, it can be a difficult time. For those of us with migraines, menopause may become a real challenge.

The history of menopause in my family is a bit unclear. My maternal grandmother who was from County Cork, Ireland went through menopause without a peep. Coming from tough Irish stock, she didn’t complain when things hurt, and if she had migraines or headaches, no one ever knew about it. My mom has mentioned that my grandmother started to become “depressed” during her mid-50’s, but other than that, she doesn’t recall any issues with my grandmother’s menopause. My mother, however, never went through natural menopause due to a hysterectomy when she was 53 years-old. She continued to have heavy, regular periods right up until her surgery, never having a migraine or many headaches. Now, my paternal grandmother’s menopause is anyone’s guess. You see, my dad is an only child and has absolutely no recollection of this time in his mother’s life.

Do Surgical Interventions Help?

In 2009, I had an endometrial ablation that essentially stopped my periods (thank you very much) but left my ovaries intact, enabling them to produce estrogen and progesterone. If anyone was wondering, the ablation did not ease my migraine pain. Seeing as my mom didn’t start menopause by age 53, I’m probably good for a few more years. The average age for menopause seems to be between 51 and 52 years-old, but can really start anytime after 40. No one can tell us for sure whether the onset of menopause will make our migraines better, worse or stay the same. For some women, their migraines may become less of a problem as they age, but this isn’t always the case. There are women who have opted to have a hysterectomy in hopes of reducing their migraine pain. No one should have a hysterectomy for that reason alone, there just aren’t any guarantees that your migraines will get better. The statistics for women with Migraine disease who entered menopause naturally are:

  • 67% of women notice their migraines are better.
  • 24% of women notice no change in their migraines at all.
  • 9% of women notice their migraines get worse.

But for the women who have hysterectomies (or surgical menopause) the figures are a bit different:

  • 67% of women saw their migraines get worse.
  • 33% of women saw their migraines get better.
  • The percentage of women whose migraines didn’t change was not significant.

Keep a Diary

How do we handle migraines and menopause? The standard rule of thumb is anyone having three or more migraines a month needs to talk with their doctor about migraine prevention, period. Part of that conversation needs to include trigger identification and management. Keeping a migraine dairy is a must. If diabetics can keep track of their numbers, why shouldn’t we be responsible for our triggers? Then once triggers are identified, avoidance is key to migraine reduction. Of course some triggers like hormones and changes in the weather we can’t avoid.

Attend to Your Physical and Mental Needs

Lifestyle changes are a great idea to be healthy, manage migraines, and help with menopause. If you’ve never exercised before, now is the time to start. Begin by walking around the block slowly for 10 minutes three days a week. Try to set realistic goals and “just do it.” Why not look into biofeedback, physical therapy and massage for relief?

Pharmacological Treatments

When medication is warranted, did you know there are over 100 used to treat Migraine? In fact, there are five medications the FDA has approved to treat migraines. Hormone replacement therapy (HRT) may be an option but can be difficult to manage. If your migraines are hormonally triggered, estrogen and progestin could be considered, but only by a migraine specialist or gynecologist who is familiar with you, your history and the current literature on HRT.

Now I feel as prepared as I can for menopause and migraines. How about you? Have you been through menopause and can share some tips with us? We’d love to hear from you.