Why can perimenopause make migraines worse?

For women living with migraines, the transition to menopause known as perimenopause could be a rough ride, according to recent reporting for Everyday Health.

During perimenopause, which typically begins in a woman's mid-40s and lasts eight to 10 years, menstruation becomes erratic as the ovaries produce less and less of the hormone estrogen.

For a significant number of women with migraine headaches, their symptoms are linked to fluctuations in hormone levels, especially estrogen levels. Those can go up and down significantly during perimenopause.

But while many women with migraines will experience an increase in symptoms during perimenopause, many won’t. “It is very individualistic,” said Vincent T. Martin, MD, the director of the headache and facial pain center at the University of Cincinnati's Gardner Neuroscience Institute and professor of internal medicine in the College of Medicine.

He explained that for some women, a dip in estrogen levels is a migraine trigger — but for other women, estrogen itself is a migraine trigger, and they feel better with lower levels. 

After menopause, defined as the time when a woman has gone 12 consecutive months without a period, hormone levels are much more stable. For many — but not all women — this means migraine symptoms cease.

Read about managing migraines during perimenopause with both non-drug interventions and medications.

Featured image at top: iStock/Liudmila Chernetska.