My Periods Stopped Four Years Ago Why Do I Still Get Migraine
Even though your periods have stopped, it can take a few years for the hormone fluctuations to completely settle. This is usually just one or two years, although some women find that they still get hot flushes and migraine ten or more years after the menopause. More often, even when hormonal triggers have settled, non-hormonal ones persist and may even increase post menopause. Chronic medical conditions, while not directly triggering migraine, will make migraine more likely to occur as they generally lower the migraine threshold. Maintaining good migraine habits regular meals, regular exercise, a good sleep routine, balancing triggers, and looking after your general health, are all as important after the menopause as before.
What About Conventional Medicine
If you do not find that home or herbal remedies have eased your symptoms, then it is important to speak to your doctor. While headaches at this time of life are likely to be caused by hormonal changes, there are many other causes of headaches. Your doctor will be able to check you for thyroid or adrenal changes, both of which can trigger headaches.
Your doctor may suggest painkillers or hormone treatment to ease your symptoms, although it is important to understand the side effects of these and the length of time that these treatments can be taken for.
Types Of Menopausal Headaches
There are three primary types of headaches that women commonly experience during perimenopause: tension headaches, sinus headaches, and migraines.
Tension headaches. The most common form of headache – also known as an everyday headache – can last from 30 minutes to several hours. The pain has been likened to a tight band around the skull, though throbbing may also occur in the back of the neck and base of the skull during a tension headache.
Sinus headaches. This type is characterized by a feeling of facial tenderness and congestion around the forehead, eyes, and upper cheeks, where inflammation or blockage of the sinuses results in a dull throbbing in the sinus cavities.
Migraines. This is most intense and debilitating form of headache. These can last for several hours, and are often preceded by nausea or vomiting and sensitivity to light, sound, or odor.
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Can I Have A Visual Migraine Without A Headache
Definitely. It is actually very common to have a visual migraine without any headache. The medical term for this is acephalgic migraine, which literally means migraine symptoms without headache. Except for the absence of a headache, the visual symptoms in acephalgic migraine are identical to the episodes that accompany a classic migraine aura.
Your Checklist And Key Points
What brought you to this blog was likely either an uptick in migraine attacks, a concern of future increased attacks in midlife or information about expectations in midlife and later. My goal was for you to come away with at least 3 take-away ideas that you can either implement on your own or consult your healthcare providers about to minimize migraines in menopause. I will list a few
- Track your migraine attacks so you know for sure if things are getting better or worse
- Track your cycles so you can share this with a doctor that can help you fine-tune your treatment plan
- If you are in your 40s and having more migraine attacks, you are probably in perimenopause.
- Theres nothing wrong with our hormones. Our migraine brain just doesnt like change.
- Step it up! If your doctor is not partnering with you get a second opinion or switch doctors. If you have a general neurologist, consider a headache specialist. Be your own advocate.
- Consider bioidentical hormone therapy
- Consider anti-depressants
- Consider consulting with a doctor who specializes in menopause
- Get working on a few slices of The Treatment Pie
- Consider seeking professional help for coping skills
- Make a plan for intentional, daily activity or exercise
- Try evidenced-based supplements for migraine relief
Please download these graphics to remind yourself of some key points as well as a checklist for you to consider and review with your healthcare team.
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What Is The Perimenopause
The period from when you begin to get menopausal signs and symptoms to when your periods ultimately end completely is called the perimenopause. Throughout the perimenopause the ovaries begin to function erratically and slowdown in work. Your periods will become irregular and can become lighter or heavier than regular periods. You might also have signs and symptoms of estrogen shortage, such as hot flushes, vaginal dryness and sweats.
The perimenopause can last about 4 to 8 years on an average, until a womans final period. You are considered to be postmenopausal once youve had 12 continuous months of no periods.
Are There Other Reasons I May Be Getting Headaches/migraines
What else can cause headaches outside of hormonal shifts? The list is long! Any issue that stimulates the pain receptors in your head or neck can trigger a headache. These include:
Ear, nose, and throat disorders
Medication side effects or over-use
High blood pressure
Sensitivity to certain foods, ingredients, or beverages
Your morning coffee may be a trigger. An elimination diet can help determine if your headache or migraine activity is related to a food or beverage.
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Insomnia Or Difficulty Sleeping Through The Night
Night sweats dont help anyone get a good nights sleep. Neither do hormone-related shifts that mess with your circadian rhythms,3 and make you need to get up and go to the bathroom in the middle of the night.1 Anxiety can keep you up, too. And if you reach for your phone and start looking at social media when you cant sleep, the blue light can keep you from getting back to sleep.4 How annoyingly ironic
Eating Well Matters Even More In Menopause
As youve seen repeatedly in the tips above, proper nutrition is one of the best strategies to minimize the symptoms of menopause and any negative impact they can have on the body.
A healthy diet will help balance your hormones, which in turn will support the adrenal glands which are responsible for producing your hormones once your ovaries stop.
Maintain a proper balance of protein, fat, and healthy carbohydrates. Eating 10-15 servings of vegetables daily will help detoxify harmful chemical estrogens that can exacerbate menopause symptoms. Its also highly beneficial to engage in moderate exercise and activities that help reduce stress, such as yoga, walking in nature, and meditation.
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Hot Flashes During Perimenopause
Most women don’t expect to have hot flashes until , so it can be a big surprise when they show up earlier, during perimenopause. Hot flashes sometimes called hot flushes and given the scientific name of vasomotor symptoms are the most commonly reported symptom of perimenopause. They’re also a regular feature of sudden menopause due to surgery or treatment with certain medications, such as chemotherapy drugs.
Hot flashes tend to come on rapidly and can last from one to five minutes. They range in severity from a fleeting sense of warmth to a feeling of being consumed by fire “from the inside out.” A major hot flash can induce facial and upper-body flushing, sweating, chills, and sometimes confusion. Having one of these at an inconvenient time can be quite disconcerting. Hot flash frequency varies widely. Some women have a few over the course of a week others may experience 10 or more in the daytime, plus some at night.
Most American women have hot flashes around the time of menopause, but studies of other cultures suggest this experience is not universal. Far fewer Japanese, Korean, and Southeast Asian women report having hot flashes. In Mexico’s Yucatan peninsula, women appear not to have any at all. These differences may reflect cultural variations in perceptions, semantics, and lifestyle factors, such as diet.
Is Dizziness A Symptom Of Menopause
Hormonal changes and subsequent fatigue in menopause can also cause dizziness. The sensation of feeling dizzy can range from inconvenient to disorienting.
Often, dizziness can indicate a medical problem such as ear infection, drop in blood pressure, or even a side effect of a medicine. For example, in menopause, dizziness can occur due to low blood sugar levels because your body responds differently to insulin.
Women who develop migraines during menopause can also have accompanying dizziness. However, its important to point out that dizziness is more common during the early stages of menopause and will likely subside over time.
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Bioidentical Hormones And Migraine
Hormone replacement therapy . Yes, this is a controversial topic. In her talk, Dr. MacGregor specifically discusses the controversy and what has been learned. She believes it was once overused and wrongly used and is now not used enough and properly to really help women who are struggling with migraine ad menopause. Much of the published literature uses older medications and outdated practices. Things are much different now.
According to Dr. MacGregor, estrogen is given in a safer way now through a patch or gel that is rubbed in. While in perimenopause there is a lot of fluctuation of estrogen. When steady amounts of estrogen are given transdermally, the natural fluctuation that was causing trouble starts to level-off and the symptoms lessen. She advocates bioidentical hormones for migraine. They are plant-sourced but identical and indistinguishable from estrogen made by a womans body. When using estrogen in someone with a uterus, progesterone is also prescribed. Without the progesterone, the lining of the uterus may get too thick and cause serious problems with the uterine lining like cancer.
I was shocked to hear a statistic that Dr. Macgregor shared. She said that HRT is 90% effective for managing menopause symptoms and quite high for migraine in perimenopause. Based on that number, bioidentical hormones and migraine is certainly worth some further exploration even though it has not caught on in many areas of the US.
What Do Menopause Migraines Feel Like
A migraine is often described as a severe headache, often pulsating in nature. It usually occurs on one side of the head and is often associated with nausea, vomiting and a heightened sensitivity to light or sound. Migraines often stop you being able to live normally and do what you want to do. They can last from a few hours to two or three days.
Migraines affect people differently. For example, migraines can occur with or without an aura. This is the name given to a group of symptoms that can occur shortly before a migraine headache occurs. They include:
- visual disturbances such as flashing lights, seeing zig-zag lines or dark spots
- numbness and tingling
Some people who experience migraine headaches dont have an aura, while others have aura symptoms but without the headache. This is called a silent migraine.
Migraines without aura symptoms are heavily affected by falling oestrogen levels. This type of headache is therefore common during the perimenopause. It can also be linked to erratic or heavy periods at this time.
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Sore Aching Muscles And Joints
Turns out, inflammation is yet another thing estrogen was good at controlling. Muscle tension can also be caused by anxiety, or any of the other symptoms, above really. Relaxing with yoga, meditation or a nice massage can help. Equelle can also be helpful with this type of muscle discomfort.
*The active ingredient in Equelle is S-equol, a plant-based, naturally derived compound.
Whats The Relationship Between Hormones And Headaches
Headaches in women, especially migraines, are related to changes in the levels of estrogen. Levels of estrogen drop immediately before the start of your menstrual flow .
Premenstrual migraines regularly occur during or after the time when the female hormones, estrogen and progesterone, drop to their lowest levels.
Migraine attacks usually improve during pregnancy. However, some women have reported that their migraines started during the first trimester of pregnancy, and then went away.
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What About Those Who Worsen After Menopause
This is another area with little published data. While there is no good time to have debilitating migraine, Im sure its especially frustrating when we are usually told things get better in the menopause years.
It seems that there are a few factors that influence whether or not migraine tends to improve. Being clinically depressed is associated with worsening migraine. Having high-frequency episodic migraine or chronic migraine is also less associated with improvement. Taking pain-relief medications during perimenopause and menopause for the aches and pains of aging and getting into rebound may lead to worsening migraine. Also, those who seem to be less likely to improve after menopause are women who have their ovaries removed or induced menopause.
HRT seems to be less successful and less appropriate for women after menopause but it may be an option for you. While the 4 doctors did not lay-out a different approach for those women not helped by having lower and more steady estrogen levels, they were still very encouraging about available treatments. They were emphatic about being more aggressive about lifestyle and medical approaches to minimize attacks. If you arent getting better you must advocate for yourself and find a better approach.
What Does The Research Say
In one study, researchers share that some 60 percent of middle-aged women report difficulty concentrating and other issues with cognition. These issues spike in women going through perimenopause.
Perimenopause is the stage just before the menstrual cycle stops entirely. The women in the study noticed subtle changes in memory, but the researchers also believe that a negative affect may have made these feelings more pronounced.
The researchers explain that women going through menopause may generally feel a more negative mood, and that mood may be related to memory issues. Not only that, but brain fog may also be connected with sleep issues and vascular symptoms associated with menopause, like hot flashes.
Another also focuses on the idea that women in early stages of menopause may experience more noticeable issues with cognition. Specifically, women in the first year of their last menstrual period scored the lowest on tests evaluating:
- verbal learning
- working memory tasks
Memory for the women improved over time, which is the opposite of what the researchers had initially hypothesized.
Can Menopause Cause Migraine
A small number of women may develop headaches for the first time around the time of menopause, and some women with an existing headache disorder may find their headaches worsen, says Mays.
Every woman is different, and it isnt clear why some women experience migraine for the first time during perimenopause, though its likely connected to hormone fluctuations, according to the North American Menopause Society. On the positive side, hormonal migraine typically goes away after menopause when estrogen surges stop and levels are consistently low.
Menopause can cause other types of changes in migraine, says Mays. For example, some women can develop migraine aura, but they dont get the headache with it. Theyll get flashes, the lights, or zigzag lines when theyve never had it before, says Mays.
In migraine with aura, a person experiences visual disturbances, which may include spots, geometric patterns, flashes of light, or temporary vision loss sensory disturbances, such as numbness or tingling in the limbs or face limb weakness speech problems or aural symptoms, in which a person hears noises or music.
Similarly, there are also are some women who have had migraine with aura before, and then they stop having the headache portion of it, Mays says.
When Effective Treatments Stop Working
This is commonly discussed with specialists as girls and women go through many physical changes through their lives. Dr. Allan Purdy, an esteemed headache specialist was interviewed about migraine and aging during the Migraine World Summit in 2018. He detailed how the body changes and why certain medications and interventions may stop working during different stages of life.
Its important to note that as people age and develop other medical conditions, certain treatments often need to be changed. Additionally, the elderly metabolize medications different from younger people. During the MWS in 2020, Dr. Jessica Ailani, a specialist in both headache medicine and womens health spoke at length about how hormones change and how treatment should change through life during. She specifically spoke about women in menopausal years and her frequent advice to try different devices like neuromodulation rather than adding more oral medications. This may also be a good time to try narrow-band green light therapy like the Allay Lamp.
In light of the fact that blood pressure tends to increase with age, for those of us who have not been able to try beta-blockers, a common migraine preventive that sometimes decreases blood pressure too much, this class of medications may now be an option.
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Your Ears Are Ringing
Or whooshing, or buzzing, or making other sounds only you can hear. Its called tinnitus, and its not clear if this annoying condition is menopause-related, or one of those age-related things that happen to pop up at the same time as menopause.8 Its also a known side effect of medications a lot of us take for other symptoms on this list, including aspirin and Prozac. If you really cant stand it, an audiologist can make you an over-the-ear white noise gadget called a tinnitus masker. If you think more noise will help.
What Are The 34 Symptoms Of Menopause
by Haley FritzFeb 2, 2021
When you think of a woman going through menopause, you might think of symptoms like hot flashes, vaginal dryness, or mood swings.
These symptoms receive a lot of attention due to the fact that there are over-the-counter and prescription drug remedies designed especially to target them. However, the symptoms of menopause are actually far more complex than these companies let on!
In total, there are 34 different symptoms that can be attributed to menopause. A woman going through menopause might experience some or all of these symptoms, ranging from mild to severe.
Read on to learn more about the menopause process and how it might affect a womans health and well-being.