5 Coping Strategies for Menopause Paired with Migraines



Menopause: Know Your Family History

At some point during the next few years I will be entering menopause while dealing with Migraine disease. For some women with both, they sail through menopause without any problems and see a reduction in their migraines. Others however, don’t make it through menopause so easily. Between hot flashes, anxiety, depression, insomnia and more, it can be a difficult time. For those of us with migraines, menopause may become a real challenge.

The history of menopause in my family is a bit unclear. My maternal grandmother who was from County Cork, Ireland went through menopause without a peep. Coming from tough Irish stock, she didn’t complain when things hurt, and if she had migraines or headaches, no one ever knew about it. My mom has mentioned that my grandmother started to become “depressed” during her mid-50’s, but other than that, she doesn’t recall any issues with my grandmother’s menopause. My mother, however, never went through natural menopause due to a hysterectomy when she was 53 years-old. She continued to have heavy, regular periods right up until her surgery, never having a migraine or many headaches. Now, my paternal grandmother’s menopause is anyone’s guess. You see, my dad is an only child and has absolutely no recollection of this time in his mother’s life.

Do Surgical Interventions Help?

In 2009, I had an endometrial ablation that essentially stopped my periods (thank you very much) but left my ovaries intact, enabling them to produce estrogen and progesterone. If anyone was wondering, the ablation did not ease my migraine pain. Seeing as my mom didn’t start menopause by age 53, I’m probably good for a few more years. The average age for menopause seems to be between 51 and 52 years-old, but can really start anytime after 40. No one can tell us for sure whether the onset of menopause will make our migraines better, worse or stay the same. For some women, their migraines may become less of a problem as they age, but this isn’t always the case. There are women who have opted to have a hysterectomy in hopes of reducing their migraine pain. No one should have a hysterectomy for that reason alone, there just aren’t any guarantees that your migraines will get better. The statistics for women with Migraine disease who entered menopause naturally are:

  • 67% of women notice their migraines are better.
  • 24% of women notice no change in their migraines at all.
  • 9% of women notice their migraines get worse.

But for the women who have hysterectomies (or surgical menopause) the figures are a bit different:

  • 67% of women saw their migraines get worse.
  • 33% of women saw their migraines get better.
  • The percentage of women whose migraines didn’t change was not significant.

Keep a Diary

How do we handle migraines and menopause? The standard rule of thumb is anyone having three or more migraines a month needs to talk with their doctor about migraine prevention, period. Part of that conversation needs to include trigger identification and management. Keeping a migraine dairy is a must. If diabetics can keep track of their numbers, why shouldn’t we be responsible for our triggers? Then once triggers are identified, avoidance is key to migraine reduction. Of course some triggers like hormones and changes in the weather we can’t avoid.

Attend to Your Physical and Mental Needs

Lifestyle changes are a great idea to be healthy, manage migraines, and help with menopause. If you’ve never exercised before, now is the time to start. Begin by walking around the block slowly for 10 minutes three days a week. Try to set realistic goals and “just do it.” Why not look into biofeedback, physical therapy and massage for relief?

Pharmacological Treatments

When medication is warranted, did you know there are over 100 used to treat Migraine? In fact, there are five medications the FDA has approved to treat migraines. Hormone replacement therapy (HRT) may be an option but can be difficult to manage. If your migraines are hormonally triggered, estrogen and progestin could be considered, but only by a migraine specialist or gynecologist who is familiar with you, your history and the current literature on HRT.

Now I feel as prepared as I can for menopause and migraines. How about you? Have you been through menopause and can share some tips with us? We’d love to hear from you.


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Nancy Bonk

Nancy Bonk is a patient advocate for living with migraine, a regular contributor to Hormones Matter and other online journals.


  1. Is it possible for migraines to start during perimenopause? I’ve never had a problem with migraines but just this past year, at age 46, have had horrendous headaches, right sided and feels like they never go away. I joined a menopause Facebook group and it seemed to be a common peri and menopause symptom. Is this considered a migraine or just a hormone related headache? My mom suffered from debi,itating migraines but only during her menopause years and hasn’t had them since.

  2. Great article. Now I am just praying that when menopause finishes my migraines ease. One indication is that they have reduced in the months I skip my period. I remain hopeful.

    • One more thing – I was on bio-identical hormones for over 10 years (progesterone 6%, tri-est cream which I reacted badly to, DHEA and was considering pregnenolone when Dr. decided to wean off all of them). There was NO change in my 20 migraine days each month. What a waste of money. But then I guess keeping the hormones balanced is a good thing even if it didn’t help my stubborn migraines.

  3. I think there is a strong association between migraines and hormonal imbalances. I would like to emphasize that hormone “replacements” including Premarin and progestin are synthetic products, i.e., they are not completely recognized by our bodies. Hormone therapy should only be bioidentical, typically compounded for one’s individual needs as prescribed by a healthcare practitioner. (Note: men also endure migraines and estradiol imbalances–deficiency as well as dominance.)

    • Thanks for reading Sue. You are absolutely correct about the association between Migraine and hormones. Migraines that are triggered by hormones can be difficult to manage for both men and women. Hormones may be just one of the things that trigger a Migraine attack.

      As I said in the piece, estrogen and progestin may be considered, but only by a migraine specialist or gynecologist who is familiar with you, your history and the current literature on HRT.

      There are many other things that trigger a Migraine attack; changes in the weather, certain foods, dehydration and changes in our sleeping patterns. Identifying and managing Migraine triggers is an important part of any Migraine management plan.


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