Menopause and headaches: What's the connection?
Updated: Jul 26
Headaches are a pain. Literally. You can be minding your own business, playing with your dog or watching your favourite movie, when all of a sudden, you feel tension in your head. The pressure builds until your head is throbbing.
Sometimes this pain is manageable with some over-the-counter pain medication. You can keep going about your day. But sometimes it interrupts your life a bit more forcefully, and you have to lock yourself away in a dark room like an ailing Victorian lady.
Headaches are a part of life for many people. And, as if hot flushes and insomnia aren’t enough, migraines can also be a symptom of menopause.
Those in the menopause phase of their life may experience an increase or change in the severity of migraines, tension headaches, and cluster headaches. However, it’s really difficult to predict who might experience the worst of these symptoms.
Let’s take a quick look at the different types of headaches, how they might be connected to menopause, and what you can do when they make an appearance.
Types of menopause headaches
Migraines are intense throbbing headaches that usually occur on one side of your head. They sometimes happen with other symptoms like nausea, vomiting, and light sensitivity.
Alongside this, they may also be experienced with or without auras and visual disturbances like flashes of light or blind spots. This is often the most common type of headache experienced in menopause.
Tension headaches are mild to moderate headaches that often feel like a band of pressure around your head.
Cluster headaches are intense headaches that are often felt on one side of your head, near your eye. They happen in clusters over a period of time that could range from weeks to months in length followed by periods of remission with no pain.
Ok, so headaches are a possible symptom of menopause. But what causes them?
What causes headaches and migraines in menopause?
Surprise! Hormones are likely the primary reason people might experience an increase in the number of headaches or migraines they have during menopause. Fluctuations in oestrogen are likely to blame.
In addition to oestogen, recent research has explored the connection between oestrogen and serotonin, and how serotonin levels impact symptoms, including headaches, during menopause as well.
Basically, how the body processes serotonin impacts how oestrogen is moderated in the brain. When hormone levels change, these processes are interrupted, and you get symptoms like headaches.
There is also evidence to suggest challenges with coping with stress and anxiety may also lead to head pain during this time of someone’s life.
Finally, since headaches are sometimes triggered by changes in hormones, each person’s specific medical history factors into whether or not they experience this type of symptom as a part of menopause.
Ok, let’s explore how headaches and migraines can change as you move into menopause.
Menopause headaches: What can I expect?
Some research has shown that people with a previous history of migraines may experience an increase in frequency as they go through menopause. Likewise, people who have difficulty coping with stress may also experience an increase during this time of their lives.
Those who go through surgical menopause may experience worse symptoms than those who experience natural menopause. And evidence suggests that both oestrogen “withdrawal” and increased levels of oestrogen may trigger migraines in people in menopause.
The frequency and severity of different types of headaches may shift over time. For instance, migraine severity often decreases as a person moves from perimenopause, through menopause, and into the postmenopause phase of their life.
In comparison, tension headaches beginning in perimenopause may get more severe or stay relatively the same through each phase of menopause.
How do people deal with menopause headaches?
Fun, right? Well, thankfully, there are a few things you can do to prevent and deal with menopause headaches if they become a nuisance for you.
Standard migraine prevention
There are some things migraine sufferers can do to hopefully prevent them from happening, whether you’re in menopause or not.
There are preventative techniques to help reduce the frequency, severity, and duration of migraines if they occur. And they might even help in the moment when experiencing head pain.
While medication or medical intervention can help prevent migraines for some people, we'll learn more about that in a minute, simple lifestyle changes can also be useful.
Since stress can be a trigger for some people, finding ways to reduce stress and anxiety in your daily life can be an effective way to prevent menopause headaches.
The easiest lifestyle changes you can make to help prevent headaches include:
Keeping a consistent sleep schedule and bedtime routine
Getting 30-50 minutes of aerobic exercise 3-5 times a week
Maintaining a regular diet
Avoiding foods that may trigger headaches (caffeine, alcohol, etc)
Keeping a diary to track headache symptoms
Avoiding activities that increase stress (excessive screen time, etc)
Doing activities that reduce stress (meditation, etc)
Again, everyone experiences menopause symptoms differently, and you need to find what works best for you!
There are a number of medications that have been found to reduce migraines. Many of these medications were developed to treat other things, but often much lower doses can be useful in the prevention of head pain.
Some examples of these types of medications include blood pressure medication, antidepressants, and anti-seizure medication.
In addition, some vitamins and minerals have been useful in preventing pain. And even neurotoxins, like Botox, can reduce migraine frequency and severity.
With any medication, it’s important to consult your doctor and work to find the best course of treatment for you.
Ok, so you’ve done all of the things you need to do to prevent menopause headaches, but you still get one. Ouch! What can you do?
Acute migraine management
One of the cheapest and most effective ways to deal with these symptoms is using over-the-counter pain relievers. These medications are often readily available, and you may already use them to treat other conditions.
Something to consider when using these types of medications is that some of them can have negative side effects if used regularly or over longer periods of time.
Also, the dosage of medication available over-the-counter might also not be quite right for treating headaches and migraine pain.
Another possible treatment option is a type of non-hormonal medication called triptans. Triptans are a type of medication used to treat migraines and cluster headaches. Used with other medications or lifestyle changes, triptans can go some way in offering pain relief.
It’s important to talk with your doctor to determine which medications and doses might work best for you.
The treatments already mentioned are can be used for anyone who may be experiencing migraines. But the following options are specifically for the treatment of menopause headaches.
Hormonal medical treatment
Hormone replacement therapy (HRT) can be useful for balancing hormone levels during menopause. But the use of HRT to treat menopause migraines and headaches might not be the best option for all people.
One study found that HRT can sometimes result in worsening migraine symptoms. And it can create the potential for increased risk of cardiovascular side effects and stroke. Oestrogen replacement therapy (ERT) was also found to possibly increase the risk of stroke.
Overall, the use of HRT and ERT to treat headaches in menopause may have more risks than benefits for most people.
Nonhormonal medical treatment
A number of studies looking at how various antidepressants might alleviate migraine symptoms during menopause show some promise. In some of the studies, participants reported fewer migraine days than usual.
And antidepressants may be a useful choice for those with anxiety and depression in addition to menopause headaches. However, as with all medications, there are some negative side effects that might outweigh the potential benefits.
Many non-medication treatment options may reduce menopause symptoms like hot flushes and anxiety, but only a couple have been shown to impact menopause migraines.
For example, acupuncture can help decrease overall menopause symptom severity, but there isn’t a direct link between acupuncture and menopause migraine relief.
Similarly, dietary supplements like black cohosh may reduce menopause symptoms, but there isn’t a connection in the research linking these supplements to decreased head pain.
On the other hand, yoga, when practised 60 minutes per day, 5 days per week, can decrease migraine severity and frequency. It can also be useful for decreasing anxiety and depression.
But, that’s a lot of yoga! So it may be useful to work up to intensive practice, starting with fewer, shorter sessions.
Aerobic exercise has also been shown to decrease the number of migraine days people experience. Finally, Vitamin E has been shown to decrease the severity and frequency of hot flushes and migraines due to its interaction with the hormone progesterone.
Navigating menopause migraines
Menopause migraines and headaches are often connected to changes in hormone levels. And as such, maintaining consistent levels of hormones during menopause can be one way to potentially limit the frequency and severity of migraines.
But, that’s easier said than done.
The good news is that there are preventative measures and treatment options available to deal with menopause headaches.
Some people find success with hormone replacement therapy (HRT) while others may find relief with non-hormonal treatments like acupuncture, aerobic exercise, and yoga. Others may find over-the-counter pain medication to help with menopause headache symptoms.
Each person’s experience during menopause is unique, and the treatments that may help with symptoms associated with this phase of life are also varied.
It’s important to consult with your healthcare provider if you’re concerned about your symptoms and to make the best decisions about headache and migraine treatments for you.
There is still a lot to be learned about the relationship between headaches, migraines, and menopause. But being aware that you might experience headaches as a symptom of menopause can alleviate some of the anxiety or stress during this time in your life.
Da Silva, Arnaldo Neves. "Acupuncture For Migraine Prevention". Headache: The Journal Of Head And Face Pain, vol 55, no. 3, 2015, pp. 470-473. Wiley, https://doi.org/10.1111/head.12525. Accessed 22 June 2022.
Daley, A.J. et al. "Exercise To Reduce Vasomotor And Other Menopausal Symptoms: A Review". Maturitas, vol 63, no. 3, 2009, pp. 176-180. Elsevier BV, https://doi.org/10.1016/j.maturitas.2009.02.004. Accessed 22 June 2022.
Goadsby, Peter J, and Till Sprenger. "Current Practice And Future Directions In The Prevention And Acute Management Of Migraine". The Lancet Neurology, vol 9, no. 3, 2010, pp. 285-298. Elsevier BV, https://doi.org/10.1016/s1474-4422(10)70005-3. Accessed 22 June 2022.
Handley, Amy P., and Mary Williams. "The Efficacy And Tolerability Of SSRI/Snris In The Treatment Of Vasomotor Symptoms In Menopausal Women: A Systematic Review". Journal Of The American Association Of Nurse Practitioners, vol 27, no. 1, 2015, pp. 54-61. Ovid Technologies (Wolters Kluwer Health), https://doi.org/10.1002/2327-6924.12137. Accessed 22 June 2022.
Lauritsen, Clinton G. et al. "Current Treatment Options: Headache Related To Menopause—Diagnosis And Management". Current Treatment Options In Neurology, vol 20, no. 4, 2018. Springer Science And Business Media LLC, https://doi.org/10.1007/s11940-018-0492-7. Accessed 22 June 2022.
Loder, Elizabeth et al. "Hormonal Management Of Migraine Associated With Menses And The Menopause: A Clinical Review.". Headache: The Journal Of Head And Face Pain, vol 47, no. 2, 2007, pp. 329-340. Wiley, https://doi.org/10.1111/j.1526-4610.2006.00710.x. Accessed 22 June 2022.
MacGregor, E. Anne. "Migraine Headache In Perimenopausal And Menopausal Women". Current Pain And Headache Reports, vol 13, no. 5, 2009, pp. 399-403. Springer Science And Business Media LLC, https://doi.org/10.1007/s11916-009-0065-2. Accessed 22 June 2022.
Oh, Kyungmi et al. "Headaches In Middle-Aged Women During Menopausal Transition: A Headache Clinic-Based Study". European Neurology, vol 68, no. 2, 2012, pp. 79-83. S. Karger AG, https://doi.org/10.1159/000336838. Accessed 22 June 2022.
Ozyalcin, Suleyman N. et al. "The Efficacy And Safety Of Venlafaxine In The Prophylaxis Of Migraine". Headache: The Journal Of Head And Face Pain, vol 45, no. 2, 2005, pp. 144-152. Wiley, https://doi.org/10.1111/j.1526-4610.2005.05029.x. Accessed 22 June 2022.
Sheikh, Huma U. et al. "Risk Of Stroke Associated With Use Of Estrogen Containing Contraceptives In Women With Migraine: A Systematic Review". Headache: The Journal Of Head And Face Pain, vol 58, no. 1, 2017, pp. 5-21. Wiley, https://doi.org/10.1111/head.13229. Accessed 22 June 2022.
Wang, Shuu-Jiun et al. "Migraine Prevalence During Menopausal Transition". Headache: The Journal Of Head And Face Pain, vol 43, no. 5, 2003, pp. 470-478. Wiley, https://doi.org/10.1046/j.1526-4610.2003.03092.x. Accessed 22 June 2022.