migraines and menopause
June 25, 2014

Menopause Could Make Migraines Worse, According To A New Study

April Flowers for redOrbit.com - Your Universe Online

If you have ever suffered from a migraine, you know that it is a miserable situation with nausea, vomiting and light sensitivity on top of a pounding headache. For years, women have been telling their clinicians that migraine attacks seem to worsen in the years before and during menopause. Now, HealthDay reports that a new study proves that women were right.

"In women who have migraine, headaches increase by 50 to 60 percent when they go through the perimenopause and menopausal time periods," said Dr. Vincent Martin, professor of medicine and co-director of the Headache and Facial Pain Program at the University of Cincinnati.

Martin says that the study "basically confirms what women have been telling us physicians for decades. We finally have some evidence."

The period of time it takes a woman's body to transition from normal menstruation to menopause, which is when periods end, is called perimenopause and can last several years. Perimenopause, which can begin in a woman's 40s, is typically marked by irregular periods, hot flashes and problems sleeping. This can last until menopause occurs around age 51, according to the US National Institute on Aging.

Martin and his colleagues will present their findings at the 56th annual meeting of the American Headache Society. Even after being presented at meetings such as this, findings are considered preliminary until they are published in a peer-reviewed journal.

The researchers surveyed over 3,600 women between the ages of 35 and 65 using a mailed questionnaire. The questions covered menopausal status, whether or not they suffered from migraines, and if so, how often. Women having 10 or more headache days in a month were classified as having high frequency headaches.

The results showed that the respondents were evenly divided between premenopausal, perimenopausal and postmenopausal. Frequent headaches were reported by eight percent of the premenopausal group, 12.2 percent of the perimenopausal group, and 12 percent of the menopausal group.

The fact that younger women often get migraines just before and during the beginning of their menstrual cycle made the results seem puzzling at first.

"Women with migraine are most likely to get them a couple days before bleeding through the first few days of the cycle, when estrogen and progesterone both fall. The idea that women who have fewer periods [during perimenopause] would get more migraines seems paradoxical," Dr. Richard Lipton, director of the Montefiore Medical Center Headache Center and professor of neurology at the Albert Einstein College of Medicine, in New York City, told HealthDay's Kathleen Doheny.

Decreasing estrogen levels could be to blame in both cases.

Dr. Elizabeth Loder, chief of the division of headache and pain in the department of neurology at Brigham & Women's Hospital, believes the study provides needed new information on migraines.

"I think this study is particularly valuable because they went to the trouble of carefully determining what phase the women were in," she told Doheny.

According to Loder, the study not only validates the anecdotal evidence that patients have been providing for years, but the size of the study lends credibility to its findings as well.

She cautions that the study should be viewed in perspective, however. "Although the relative differences [in headache frequency] between groups look big, the absolute numbers are not," Loder said. For example, in percentages the difference between 8 percent of premenopausal women and 12 percent in post menopausal looks large, but the actual number of women in each group is very similar.

Martin suggests that women suffering from migraines at this time of their lives could discuss switching or adjusting migraine medications with their headache specialist, as well as hormone replacement therapy as a short term answer. He cautions, however, that women and their doctors should discuss both the possible benefits and the possible risks of hormone therapy, such as an increased risk of stroke.