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Any migraine sufferers found HRT that doesn't make them worse?!(14 Posts)
I tried Evorel Sequi patches for menopausal symptoms last year (esp hot flushes). It worked really well for a few months then I started having several migraines a day. Previously, I'd only had a few a year!
My migraines have always been hormone-triggered, never food, etc.
Anyone in a similar situation found a form of HRT that works for them?
I've been taking fluoxetine for the hot flushes for about six months now - it worked great until about six weeks ago - flushes are worse than ever! (No migraines though!)
I'm seeing a GP on Wednesday, but I don't really know what to ask for.
I was on Premique low dose, but they stopped manufacturing it and have struggled ever since. I'm just starting to try FemSeven Conti patches. The first one I applied, I woke up the following morning with a thumping headache and then managed to lose the damn thing during the day, so I've put another one on this morning. Headache started this afternoon. It's so frustrating.
I've found no difference. I've had occasional migraines since I was about twelve though I can usually predict what my triggers are- missing meals, especially lunch if out and about, stress and the sudden fall in hormones just before a period. At most I used to have around 6 migraines a year if I avoided as many triggers as possible.
I use Oestrogel and have had no side effects at all. I do sometimes still get a slight migraine with the withdrawal of the progesterone part of HRT but it's manageable if I take painkillers at the first hint of it.
Maybe you need a higher or lower dose in your patch? or you could try swapping to gel. That way you can adjust the dose yourself easily, but give each dose a couple of weeks to see what works.
If you ask for gel, don't let your GP wriggle out of it and say they don't recommend it. Sometimes - reading forums!- it's because they don't know how to prescribe it. As it's only oestrogen you have to use a progestogen each month too (as is added to a patch) so you will also need a prescription for something like Norethisterone or micronised progesterone (Utrogestan.) Both are taken for 10-12 days a month.
Gel is the main form of HRT in France and many European countries- it's UK GPs who are out of date sadly.
I see online that gel isn't recommended for women who have a close relative who's had breast cancer (my mum) and women who have migraines. Not for me then?
Can you show a link to that info? It doesn't make sense really because Oestrogel is estrodiol, which is the same oestrogen that is in all HRT except premarin and prempak with are made from synthetic oestrogens. In other words, it's exactly the same as the oestrogen in the patch you already use.
I assume what you have read is information about HRT which is the same information that is in every leaflet/ manufacturer's info for every type and every brand.
Transdermal HRT ( patches and gel) is safer for women who have migraines because it doesn't cause blood clots.
Link here. Down the page it says "Oestrogel should be used with caution by ..."
I have found this for you, it says to keep hormones as steady as possible.
You could try different progestogens; femseven has levenorgestrel and there are the separate progestogens above.
The cautions are the same for anything containing oestrogens including vaginal oestrogens which are the equivalent of 1 pill per year. Check out risks and benefits menopausematters.co.uk/balance.php menopausematters.co.uk/risks.php
I have just had a migraine after 1 year it is usually 3+ years . But it may have happened anyway. I had my worst migraine in my teens.
The product in Oestrogel is exactly the same as what you are using now in your patch: estradiol. Here is the Net Doctor link to the patches you use- exactly the same blurb on 'cautions' -word for word. These 'cautions' are on every type of HRT and are not meant to be a substitute for professional guidance from a dr. They are provided by the manufacturers to cover themselves, legally.
This list of products from menopause matters shows the different formulas in each type of HRT. I've linked to separate oestrogens which shows the gel, and sequi patches.
Evorel sequi - under Transdermal estradiol
If it's the same as in the patches, won't it give me migraines just the same then?
I don't know why you are having daily migraines- assume this is on the oestrogen only part of the patch? You need to decide if it's only when you are using a patch with the Norethisterone in it too. My migraines sound very different to yours. I've never had several in a day (before or with HRT.) I get one terrible headache which means I have to go to bed- it lasts for hours - and usually sleeping it off is the only solution. I have never had a migraine that came and went quickly.
The reason for suggesting gel is that usually side effects are to do with dosage. As per my previous post, using gel means you can change the dose easily to see if that helps, which you can't with a patch. Your patch might be giving you too much or too little.
The migraine trust says there has not been enough research on the effect of hrt on migraines, and that migraines have many different triggers. So there is not a best fit hrt.
All the oestrogens are the same, although there are 2 basic doses (+the very low dose now). Gel is useful as you can get the right dose more easily but this does reduce your choice of progestogen There are different progestogens and these may have an effect so it may be worth trying the different ones until you find one to suit.
Transdermal is best for migraine as the levels in your blood do not go up and down daily like they do with tablets.
Your main options with gel are Norethisterone or micronised progesterone.
Norethisterone is in some pills and you can use it separately.
Dydrogesterone is in some HRT pills as is medroxyprogesterone. I don't think these are available separately outside of a 'pill pack'.
They all have different risks re. breast cancer.
These stats are around- think they are in the full NICE report.
I'd not touch medroxyprogesterone as it has something like double the risk (albeit still small) as dydrogesterone, and Norethisterone is in the middle. Latest research shows that micronised progesterone (Utrogestan) has little risk or none on breasts.
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