Headaches and Migraine

Headaches are a common problem in general but can become particularly problematic in midlife. It is important to look for the underlying cause of your headache. This can usually be diagnosed with the help of a detailed history and often a headache diary. See post of sample. 

Can you get headaches in perimenopause and menopause?

Yes. Headaches are a common symptom. Chronic headaches can occur which are often described as a dull pain at the front of your head which is there persistently due to fluctuating or declining oestrogen levels. Migrainous type headache can also occur. This is usually a worsening of background migraine condition exacerbated by oestrogen level changes. 

What is a migraine ?

Migraine is typically a moderate-to-severe headache accompanied by nausea, vomiting and sensitivity to light and/or noise. It is more prevalent among women than among men. Migraine is usually episodic, occurring in attacks lasting hours to a few days. The two principal types are migraine without aura and the less common migraine with aura. One patient may have both types. 

Migraine without aura

Adults with this disorder describe: recurrent episodic moderate or severe headaches which, typically but not always, are unilateral and/or pulsating and  last (when untreated) from 4 h to 3 days.

Associated symptoms include nausea and/or vomiting; sensitivity to light and sound, limit activity during attack and relief with rest in dark quiet space. Patients are typically free of symptoms between attacks. 

Migraine with aura

This type affects about one third of people with migraine. It is characterised by an aura preceding or less commonly accompanying headache and consisting of one or more neurological symptoms such as visual disturbance (>90%), tingling over body, weakness of a body part etc. 

Can HRT help with chronic headache or migraine?

Yes it can. We use transdermal oestrogen generally and it can be of significant benefit in alleviating headache symptoms for many women. There are many other excellent treatments for migraine and avoiding triggers. These vary from person to person but include dark chocolate, cheese and sleep deprivation.

Good resources for further information include Managing Your Migraine, by Kathy Munro, @migrainedoc

Headache diary https://migrainetrust.org/live-with-migraine/self-management/keeping-a-migraine-diary/

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