Migraines worsening - should I increase Oestrogel?

[18GingerBiscuits]

Hello, I hope someone might be able to share their experience with me. I started HRT (Oestrogel - gradually increased to 3 pumps daily and a tablet of Utrogestan) 18 months ago. This helped my menopausal symptoms (all the usual horrors, but particularly migraines) but didn’t eradicate them. However, over the past couple of months they’ve got a lot worse with my migraines going through the roof. It’s driving me potty - so many days in bed per month. I’m always reticent to mess around with my HRT dosage as I know underlying hormones are erratic during the peri-menopause (which is where I seem to be), but I’m thinking increasing my Oestrogel pumps to 4 might be the answer. I’ve googled loads to try to find guidelines on whether to increase my Oestrogel (from a moderate to a high dose) in response to worsening hormonal migraines and there seem to be so few studies on this. So many of the studies focus only on oral Oestrogen, or they only make broad conclusions, are very old, contradict other studies findings or conclude that more research covering this issue is needed! Yes please! My GP isn’t particularly knowledgeable on this, so that’s not a fruitful avenue. I would just love to hear from anyone who could cast any light (even a glimmer!), upon this.

I’ve had to switch a few ladies from gel to patches, which has helped their migraines, as there is a more steady level of the oestrogen. That’s also what our local menopause specialist has advised.

Thank you so much for your reply! Do you think that before a switch I should just try increasing the gel pumps to 4, so that I can rule out the possibility that the increase in my migraines over the past months is caused by my average Oestrogel dose throughout the month being too low, rather than it being explained by my levels of oestrogen being too erratic throughout the month? Are there indicators I can look for that can lay the cause at the door of excessive oestrogen fluctuations, rather than the overall level being too low?

Hi OP. There should be no harm in trying the higher dose in the gel for a few weeks before seeing your GP if it hasn’t helped. And in answer to your last question, I don’t believe so.

Thank you so much, I have a plan! I really appreciate you taking the time.