For years, many women had been telling their doctors that their migraines worsened as they approached menopause. Now a new study has shown that they were right, and offers some insight into the possible reasons.
The study comes from researchers at the University of Cincinnati, the Montefiore Headache Center, the Albert Einstein College of Medicine, and Vedanta Research. The results were published Thursday in Headache: The Journal of Head and Face Pain from the American Headache Society.
The researchers examined the experiences of 3,664 women aged 35 to 65 who had migraines before and during perimenopause and menopause. Menopause is defined as starting when a women has not menstruated for one year and perimenopause is the time before menopause when menstrual periods are irregular. Both perimenopause and menopause commonly display symptoms like hot flashes, insomnia, irritability, and depression. Based on characteristics of their menstrual cycles, the women were divided into pre-menopause, perimenopause, or menopause groups. They self-reported the presence of migraines to the researchers for six years.
What the researchers found is that high frequency headaches, defined as headaches for ten or more days per month, increased during perimenopause. Compared to women experiencing their normal menstrual cycles, the middle-aged women in perimenopause had a sixty percent greater chance of having high frequency headache. As they neared the end of perimenopause, the risk of high frequency headache tended to be highest. The women in the study reported about seventy-six percent more migraines during menopause. Most of the women who had high-frequency headache did not see a reduction in frequency after menopause.
Although scientists are still trying to sort out the causes of migraines, there does tend to be a link between migraines and hormones in many cases. The researchers speculate that the women in the study may be experiencing more migraines during perimenopause because they have low estrogen levels in their body at this time. However, they believe this may not be the only cause of the migraine increase. Women in that age group also tend to experience more aches and pains, from osteoarthritis and other causes, and may be taking more painkillers for those issues. Those painkillers could then be contributing to an increase in migraines if the women are overusing these drugs. Genetic factors may also be contributing. However, researchers did not find a link between either smoking or body mass index to the increase in migraine frequency.
The researchers say their findings do offer hope for women suffering from increased migraine frequency near menopause. Because of the link to hormonal changes before menopause, doctors could prescribe hormonal birth control pills to help regulate the hormones and thus reduce the migraine frequency. Nearer to menopause, doctors could prescribe estrogen patches to help with migraines and menopause symptoms.
Migraines are a particular type of headache characterized by an intense pulsing or throbbing sensation usually on one side of the head. Other migraine symptoms usually include nausea, vomiting, and increased sensitivity to sound and light, and migraines are sometimes preceded by aura including flashes of light and tingling sensations in the limbs, irritability, stiff neck, depression, yawning, constipation, and food cravings. Symptoms can last from about four to seventy-two hours, and migraines range in frequency from the occasional attack to many attacks per month.
The cause of migraines may include genetic and environmental factors. Migraines may be caused by interactions between the brainstem and nerves, and may be related to imbalances in serotonin levels in the brain. They are sometimes triggered by hormonal changes, stress, changes in sleep patterns, food and drink, the environment, medication, or bright lights, sounds, and smells.
About twelve percent of Americans are estimated to be suffering from migraines. Of that group, there are about three times as many women as men.