Migraine and menopause?

We are experienced in helping you manage your migraine in perimenopause and menopause. We can guide you on the how to manage an acute migraine attack, what medications work best; how to look for your triggers and how to monitor your migraine attacks. We can guide you on preventer treatments, if you need them.

Migraine can become worse during perimenopause. It is safe for women who suffer from migraine to start transdermal oestrogen HRT, even if you have migraine with aura. Transdermal HRT does not increase the risk of blood clot or stroke in healthy women with normal doses.

If you suffer from migraine we will carefully manage your HRT, gradually and slowly changing doses. Some women find taking continuous combined HRT helps keep their hormones more stable (oestrogen and progesterone taken every day rather than cyclical progesterone). Do read this FAQ to explain this further. A patch of oestrogen may also be better than a gel or spray, so absorption is more controlled.

It is not safe to take the combined contraceptive pill if you have migraine with aura, due to increased risk of stroke.

Managing migraine is done in a number of ways, looking for triggers and keeping a simple diary; treating the acute attack with high dose NSAIDS like 900mg soluble aspirin with a small can or fizzy drink, an anti-sickness tablet and a ‘triptan’ taken as directed and regularly. If you are getting frequent attacks we can consider a preventer treatment like propranolol or an alternative and then review things to see how you are responding.

There is some evidence that taking supplements can help, we can guide you on the correct doses of Riboflavin B2 400mg daily and will turn your urine bright yellow; Magnesium Glycinate 400-600mg daily, co-enzyme Q10 150mg three times a day (can be expensive), Vitamin D and Omega 3. It is recommended to take these supplements for 3 months at least before you may see an improvement.

I have a live interview with Dr Katy Munro on my instagram account which is incredibly helpful, please contact me if you would like to watch this. It covers triggers, acute treatment, supplements and preventative treatment.

If you need a headache specialist assessment and you are in the UK, you can refer yourself to the National Migraine Centre, they ask for a voluntary donation to cover costs. This book, ‘Managing your Migraine,’ is written by Dr Katy Munro and can be very helpful, she also has a fabulous Heads up podcast.

NICE guidelines and the National Migraine Centre are very helpful.

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