Migraines and (peri)menopause

[BottleBlondeMachiavelli]

I’m being led a merry dance by the GP surgery. They don’t do HRT “in house” and I’ve been referred to the gynaecologist. It’s a long wait though.

My migraines are now chronic, I’m experiencing symptoms four or five days in a row. Probably half the days since Christmas I’ve been affected. Sleep pattern is going to shit.

This is new. Until the end of last year, my migraines were very occasional. They haven’t been frequent since my early twenties, and even in puberty they weren’t this bad. I am now nearly 50.

I am taking OTC triptans and am struggling to buy enough (they are very cautious about selling them) but conversely worried about lack of medical oversight. I have other regular repeat meds and a MedEx.

My menstrual cycle has always been very regular but began to disintegrate last summer. So I’ve assumed this is a hormonal change triggering the chronic migraines.

I’ve now had to take time off work to regroup a bit and try to catch up on sleep. I’ve spoken to the surgery this morning who won’t see me until I’ve seen the gynaecologist. Is that weird?

Is the assumption that this is hormonal a fairly safe one? Should I be checked on the interim or continue to assume? Anything else I can be doing for relief?

Any insights, thoughts, pointers welcome.

Anybody?

In get shot down in real life if I even mention this, so I fully expect to on here, but research using nicotine patches.

They have changed my life. No more migraines and no more pain from my RA.

I’m 45.

I'm a migraineur.

I was on HRT for 2 years for other symptoms and it actually made my migraines worse in severity and more frequent.

My Dr, who specialises in HRT/menopause, said it really depends on the type of migraine. Dr said if you get migraines your whole life, HRT usually doesn't help, whereas if you started getting migraines in peri, HRT does help.

Anyway, I've been off HRT for about a year (because of the migraines) and it's only 2025 that my migraines have really eased off. I suspect that they'll disappear completely post-menopause.

FWIW, I'm 49 and in peri.

I guess it's worth trying? It might work for you, it does for some.

I would say none of that is acceptable. Do you have any other symptoms of peri menopause? How old are you?

Migraines 4-5 times a week should be checked out - they can’t just send you away. It’s appalling that your surgery doesn’t do HRT. They are failing so many women surely? Can you switch doctors? I’d complain too.

Can you afford to go private? You can then get a good hour with a specialist. You shouldn’t have to obviously but this is having such an impact on you.

You could try the HRT if appropriate and then that would indicate whether it’s hormone related or not.

Wow. Wouldn’t have ever guessed at that. I’ll bear it in mind. Although I do still use nicotine lozenges occasionally - admittedly only 1mg - and it’s been 10 years since I quit.

Private might be an option. Which specialism do I need? Neuro I suppose. It annoys me that the NHS gets to be this hopeless. High demand is understandable but these random policies feel less forgivable.

Oh no. So HRT is really just a throw of the dice and not a probable solution? I am going to need to be a lot more proactive to get anywhere. I can see that.

Someone asked about other peri symptoms. I’m a bit foggy headed but that could be prodome from the migraines. Also hot episodes but I’ve had that years, right back to late 30a when I had a high ovarian reserve and all hormone levels optimal.

It's completely unacceptable that your gp doesn't prescribe hrt, completely. This goes against NICE guidelines! I would seriously change gp

I suffer awful migraines so will be watching the thread.
Im knocked down for days cant think cant get words out the list goes on.

Also goes against practice standards, not to mention refusing to offer first line treatment for something which could affect 51% if their patients!!

thebms.org.uk/wp-content/uploads/2022/07/BMS-Menopause-Practice-Standards-JULY2022-01D.pdf

Never heard that nicotine patches can help but willing to give it a go if it will help.
Do you have any more info on it i will do some research on it.

You sound very similar to me - occasional migraines which really ramped up at 48/49. I had mild peri symptoms otherwise, main one being disturbed sleep. I also had high ovarian reserve in my 30s (tested for fertility treatment) very regular periods and a family history of pretty late menopause.

i did try hrt but it actually made the migraines much much worse. The GP theory was that actually I still had enough oestrogen and the hrt was pushing it too high so I promptly came off.

what has worked for me is Q10 and magnesium. If you google there are some studies and clinical evidence re both. My migraines went from clusters of 3/4 days to 2 in the 12 months I have been on it, both correlating to periods of high stress/poor sleep.

i have found stress/sleep was much more of a trigger for it all than has been in the past. I temporarily reduced my hours at work, did a bit of work on life style which helped but the q10 seemed to be the magic bullet.

just my experience and q10 doesn’t work for everyone I know but potentially a low cost/low risk option?

You can be prescribed meds to reduce if not stop your migraine frequency by the gp. These are typically propranolol, topiramate, amitriptaline and a few others that I can’t remember the name of. You need to ask for whichever of these is most appropriate to be prescribed and if it doesn’t work you cycle through the others until you find one that does. This along with a Triptan for when a migraine does occur will make a massive difference. I don’t think you should relay on hrt to solve this, insist on solving the migraines independently- there are lots of options.

Can you change doctor or just seem another for a second opinion? At least try making an appointment for migraines without mentioning menopause and see if that'll get you in. I suffered three day migraines twice a month for decades, all hormone related. My migraines ramped up during peri menopause and continued but I was menopausal when I started hrt and now it's unusual for me to get one and if I do it's not bad and its easy to treat. If I stop hrt (I was away and forgot to bring it) I have a migraine within a few days. My gp wasn't great re hrt, believes its immoral to prescribe it to woman who still have periods, insists on a year free before she'll agree to it, I ended up bypassing her to begin hrt but once I was on it and had my dose settled she prescribed it, I think it's a lack of education.

I think they’ve essentially outsourced all HRT. Which seemed odd and is certainly inconvenient but I wasn’t sure if it was a new initiative or an attempt to streamline waiting lists. Helpful to know that it just shouldn’t happen.

Thanks for that link. It really helps to feel orientated when you’re trying to assert yourself.

I’m already supplementing magnesium but I’ll order Q10 now. It can’t possibly hurt to try. Thanks for the advice.

I take magnesium, b2 and coq10, all documented to help with migraines as mentioned on the migraine charity website.

I also take antihistamines which seems to help.

I was prescribed topiramate previously in my 30s for symptoms that turned out to be something else entirely but were initially diagnosed as a new presentation of migraine. I didn’t have even my normal sporadic migraines while taking it, but when the dx was revised they took me off it. It was consultant prescribed but maybe a GP will be happy to try it. If I can get in front of one.

Amitrypytiline I take for neuropathic symptoms of the revised dx anyway.

DD takes for propanalol for migraine prevention (or did) with mixed success. I wonder if there is a genetic component to treatment suitability?

Thank you. These are all good pointers.

HRT could make things better or worse.

You can self refer to the National Migraine Centre in London. It is not for profit but you do have to pay for the consultations. They used to have some funding for people on low incomes who can’t afford the fees, I don’t know if that is still the case.

www.nationalmigrainecentre.org.uk

That’s hopeful. I’ll look up rizamelts. Ibuprofen and paracetamol don’t work at all unfortunately, and I’m vomiting nearly every time now. I really don’t want to have to cut hours. But I’ll try not to worry about that yet.