Still, no matter when in life you have migraines, the right treatment can help prevent the headaches or make the pain go away.
What Makes Migraines Different?
People who get migraines describe them as an intense pulsing or throbbing type of pain, often on one side of the head. Along with the pain they can also have symptoms like:
When you have one, you may be unable to do your normal activities.
Many people get migraines from time to time. But some, usually women, have them as often as 15 or more days each month.
These headaches are triggered by things like:
The Migraine-Hormone Link
A drop in the female hormone, estrogen, can also set off migraines. That's why women who get migraines often have headaches right before their period, when estrogen levels are low. During pregnancy, estrogen levels rise, bringing many women a break from these headaches. But they often start up again after the baby is born.
As you get closer to menopause, your hormone levels can swing up and down, and your periods may get more irregular. If your migraines are tied to your menstrual cycle, they may become as unpredictable as your periods.
Some women get migraines for the first time, or their headaches get more intense, in the years just before menopause. Others find that their migraines become less frequent and less intense.
Women who had their uterus and ovaries removed with surgery often have more of a problem with migraines than those who go into menopause naturally.
Treating Menopause Migraines
You have many options for relieving migraines.
Sometimes a few simple lifestyle changes can help:
- Keep a diary of what you eat, and try to avoid foods that trigger your migraines. Some of these may include: aged cheese, chocolate, or artificial sweeteners.
- Eat meals at regular times.
- Go to sleep and wake up at the same time each day.
- Cut stress using relaxation methods such as deep breathing, exercise, or massage.
You can also try medicines to relieve your headaches. Migraine drugs fall into two categories.
Medicines that help prevent migraines from starting:
- Antidepressants: amitriptyline (Elavil), venlafaxine (Effexor),
- Anti-seizure drugs: divalproex sodium (Depakote), topiramate (Topamax), valproate sodium (Depacon), valproic acid (Depakene and Stavzor)
- Blood pressure medicines: beta blockers, calcium-channel blockers
- CGRP inhibitors: atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality), block the effect of calcitonin gene-related peptide molecules
Medicines that relieve a migraine once it has already started:
- Pain relievers: acetaminophen (Panadol, Tylenol), aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve)
- Prescription NSAIDS: celecoxib (Celebrex, Elyxyb), diclofenac potassium (Cambia), indomethacin (Indocin)
- Triptans and ditans: eletriptan (Relpax), frovatriptan (Frova), lasmiditan (Reyvow), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Alsuma, Imitrex, Treximet), zolmitriptan (Zomig)
- CGRP inhibitors such as rimegepant (Nurtec) and urogepant (Ubrelvy)
For some women, taking the same female hormones used to treat menopause symptoms like hot flashes can also help prevent migraine pain. But hormone replacement therapy (HRT) doesn't work for everyone. And some women find that the hormones make their headaches worse.
Talk to your doctor about what is right for you. If so, ask for the lowest possible dose of hormones needed to control your symptoms. You can get the hormones through a patch or gel that you rub on your skin.
Once estrogen production stops and periods end, you may get a reprieve from your migraine pain. Sometimes, though, menopause doesn't spell the end of migraines.
If you can't take medication or wish not to, a device might be worth considering. Cefaly is a portable headband-like device gives electrical impulses on the skin at the forehead. This stimulates a nerve associated with migraine headaches. Cefaly is used once a day for 20 minutes, and when it's on you may feel a tingling or massaging sensation.
SpringTM may be another option. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain. In addition, there is a noninvasive vagus nerve stimulator called gammaCore. When placed over the vagus nerve in the neck, it releases a mild electrical stimulation to the nerve's fibers to relieve pain. Yet another option is nerivio, a wireless remote electrical neuromodulation devicewhich is self-applied to the upper-arm and should be used in the home environment at the onset of migraine headache or aura.
If you're getting regular migraines before, during, or after menopause, talk to your doctor. Together you can find a treatment that helps prevent or relieve your headache pain.