Menopause headaches
Headaches are more common around menopause due to changing hormone levels. If you have had headaches in the past – especially if you get migraines – you may notice them getting more frequent or more severe during this time.
Thankfully, there are things you can do to address this frustrating aspect of menopause. Read on to find out more.
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What kind of headaches could you experience?
Many different kinds of headaches can affect you at the time of menopause. The two most common are:
1. Migraines. These are usually one-sided headaches that may be associated with nausea, vomiting, and sensitivity to light and noise. Migraines can be preceded by sensory changes known as aura. Auras often cause changes to your vision, including seeing flashing lights or zigzag lines. Migraines can be severe and can last for hours
2. Tension headaches. They are often described as a band-like pain or pressure around the head which lasts from 30 minutes to several hours
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What do menopause headaches feel like?
Maybe you don’t realize what you are feeling is a headache, just that you have noticed strange head sensations in menopause. Headaches can present in a variety of ways. Here are a few symptoms of headaches:
- Strange head sensations
- Pulsing in your head
- Throbbing sensation
- The feeling of a tight band around your head
- Buzzing feeling
- Sensitivity to light or sound
- Nausea
- Fatigue
- Dizziness
Menopause headaches can affect other symptoms, including sleep issues, anxiety and depression.
How likely are headaches at menopause?
- Fairly common
- One study of over 500 postmenopausal women found that 13.7% of them suffered from headaches
- Of these, 82% said that their headaches had started prior to menopause
Read more about the stages of menopause or aches and pains symptoms.
How can you reduce perimenopause headaches?
1. Diary. Try keeping a diary of your headaches, including dates, times, symptoms, and possible triggers. This will help you and your healthcare provider to identify any patterns, especially if your headaches are linked to your menstrual cycle.
2. Healthy lifestyle. Minimize alcohol, caffeine, and any other known headache triggers. Do exercise that increases your heart rate and try to get enough sleep by establishing a routine.
3. Talk to your healthcare provider. Headaches can be caused by several different conditions, many of which can be treated effectively once they are diagnosed.
4. Relax. Create calm with relaxing activities, such as yoga and acupuncture.
Can hormone therapy (HT) help?
HT is not a treatment for migraines, although those with migraines can use certain types of HT to control other menopausal symptoms. People with headaches have a variable response to HT. Overall, migraines generally get worse with hormone treatment.
If you are taking HT to control other menopausal symptoms and find that it makes your headaches worse, you may benefit from switching to a transdermal preparation (HT patch or gel), or from a reduced dose of estrogen.
For those with migraines, a transdermal preparation (HT patch or gel) is usually the safest. This is because those who regularly experience migraines may be at risk of certain conditions, such as a stroke. Taking the HT transdermally greatly reduces this risk.
Although HT is beneficial for some, it is not suitable for everyone. Speak to your healthcare provider about whether it is right for you.
Read more about HT risks and benefits.
Headaches and menopause FAQs
Half of people find that migraines are triggered by their menstrual cycle. Estrogen seems to be the main cause of this.
Your menstrual cycle becomes more erratic around the time of menopause, which causes levels of hormones to fluctuate more.
These exaggerated hormonal fluctuations can also trigger migraines, which is why you can experience more frequent and severe attacks during menopause.
There is no definite answer to this question and everyone will respond to menopause in a slightly different way.
- Migraines affect between 10-29% of people
- Among those who get migraines during menopause, 45% will have worsening or more frequent migraines, 30-45% will see no change, and 15% will see an improvement
- Those who have gone into menopause after having their ovaries removed, known as surgical menopause, tend to struggle more
- Migraines tend to improve once you have passed menopause, especially if they were affected by your menstrual cycle earlier in life. One study found that two-thirds can expect an improvement
- Expect to see the maximum improvement two to three years after your last period, as hormones can still fluctuate up until this point
- Your migraine triggers will remain the same after menopause
- Tension headaches stay the same or get worse for 70%
- Your tension headache triggers will remain the same after menopause
See a healthcare provider if you have any headaches that last more than a few days, if you have headaches regularly, or if you are worried about your headaches.
When do you need to see a healthcare provider urgently?
- A severe headache, especially one that is bad enough to wake you from sleep or which comes on suddenly and severely.
- A headache that is worse when you lie down, cough, or hold your breath
- Any migraine aura that lasts for more than 60 minutes
- Any changes to your hearing, vision, or balance, any pins, and needles, numbness, or weakness that is not part of your usual pattern of migraine
- A fever with your headache
- A red, painful eye, with or without changes to your eyesight
- A history of cancer, or if you are on any medications which affect your immune system (immunosuppressants)
- If you are worried about your headache for any other reason
Keeping a diary has helped me figure out that too much caffeine triggers my headaches.
- American Migraine Foundation, Migraine and menopause
- Cleveland Clinic, Menstrual Migraines (Hormone Headaches)
- Cleveland Clinic, Migraine Headaches
- Cleveland Clinic,Tension-Type Headaches
- Neri I, Granella F, Nappi R, Manzoni GC, Facchinetti F, Genazzani AR, Characteristics of headache at menopause: A clinico-epidemiologic study, Maturitas, Volume 17, Issue 1, 1993, Pages 31-37
- MacGregor, E. A. (2012). Perimenopausal migraine in women with vasomotor symptoms. Maturitas, 71(1), 79–82. https://doi.org/10.1016/j.maturitas.2011.11.001
- Migraine Trust, Menopause and Midlife
- Kuruvilla D, Understanding and Treating Headache Related to Menopause, American Headache Society
- Lauritsen CG, Chua AL & Nahas SJ, Current Treatment Options: Headache Related to Menopause—Diagnosis and Management. Curr Treat Options Neurol 20, 7 (2018)
