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Perimenopause is a time when headaches and migraines may get worse or even start in women who have not suffered them before. They can be one of the first signs of perimenopause. 


In early perimenopause women who have previously experienced migraines may find they are worse and those who have never had them before might start getting them. This is particularly true for those who have a history of menstrual cycle related migraines, which most commonly occur just before your period.


Headaches are believed to be due to changing oestrogen levels.

The drop immediately before a regular menstrual period and the fluctuating swings associated with the perimenopause are responsible. In fact, increasing headaches, both worse and more often, are one of the key symptoms of early perimenopause and might occur before you notice any changes to your period. The silver lining here is these migraines due to fluctuating oestrogen tend to settle once you hit menopause.

There is a difference between a migraine and just a bad headache. A true migraine is a severe headache with throbbing pain, usually on one side of the head. It is often accompanied by nausea, vomiting and extreme sensitivity to light and sound. Some cases are associated with aura, meaning there are strange neurological features such as seeing flashes of light, blind spots, loss of vision, loss of speech or tingling in your hands and face. 

Many women can identify headache triggers. 

Hormonal headaches can be improved with hormone treatments (and careful manipulation of hormone levels). Sometime the menstrual cycle can be supported with HRT in the form of progesterone in the second half of the cycle, sometimes with a small dose of oestrogen across the the time just before and during the period and sometime the cycle needs to be overridden by using a low dose pill.

The standard treatments also apply.


This information is for general educational purposes only and does not constitute medical advice. Please see your health professional for advice that is personalised to you.
Key Take Aways

Headaches can be an early sign of perimenopause

Fluctuating oestrogen levels are thought to be responsible


Other resources

Listen to Rossella Nappi speak on Migraine Headaches for the International Menopause Society

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