Perimenopausal Hormone Changes and Migraine
Headaches in general and migraines in particular are very common, especially in women. Migraines have a lifetime prevalence rate of 26% for women compared to 15% for men. With the onset of perimenopause, fluctuations in estradiol levels can lead to more frequent or severe headaches or migraines in some women. This is in addition to the myriad of other stressful symptoms of perimenopause, such as fatigue, insomnia, irritability, hot flashes, night sweats, difficulty concentrating, heart palpitations, unexplained weight gain, urinary incontinence and reduced sex drive.
Perimenopausal Migraine with Aura Predicts Heart Attack and Stroke
New research shows perimenopausal migraineurs may have one more thing to worry about – an increased risk for heart attack or stroke.
The study, to be presented at the American Academy of Neurology’s 65th Annual Meeting in March, investigated connections between migraine and cardiovascular events in 27,860 women including 1,435 women who had migraines with aura.
Over the 15 years of the study, 1,030 cases of heart attack, stroke or death from a cardiovascular cause occurred. After high blood pressure, migraines with aura were the second largest risk contributor to heart attacks and strokes.
The study mentions that even though individuals have an increased risk, it does not mean that they will have a heart attack or stroke. In addition, women with migraine aura can decrease their risk by lowering their blood pressure, keeping their weight down and exercising.
Migraine With Aura Plus Newer Oral Contraceptives: A Potentially Deadly Combination
Another study from the same group, found that women suffering from migraine – and especially those with aura – who use combined hormonal contraceptives, are at elevated risk for thrombotic events – blood clots.
Newer combinations – such as drospirenone, the norelgestromin/ethinyl estradiol transdermal patch, and the etonogestrel/ethinyl estradiol vaginal ring — have been associated with an increased risk of thrombotic events, including deep vein thrombosis (DVT). The study found that 7.6% of women who had migraine with aura and used drospirenone-ethinyl estradiol were diagnosed with DVT. Among women on the same combination but whose migraines did not have aura, the rate was 6.3%. Data for the these findings have not yet been published. In general, however, the combined oral contraceptives have a higher rate of serious adverse events for all women and should be avoided, see The High Cost of Bad Birth Control.