Experiences of managing hormonal migraines when switching from Yasmin to HRT

[HormonalAndie]

Hi Everyone – I’m hoping that someone out there with similar experiences can give me some advice – as I clearly already know much than my GP from my endless research so can’t get help there. I was forced to stop use of the Yasmin combined pill due to my age as approaching 50, which I have used to control perimenopause symptoms for the last few years – but most specifically hormonal migraines – worked very well apart from when on the occasional pill break had to do every few months due to breakthrough bleeding. I have been made to go on HRT instead. I did this immediately from Yasmin and the first few days felt amazing – I’m assuming this is from still having some of the synthetic oestrogen in my bloodstream and two pumps of Oestrogel on top. However since then the effects have lessened and I’m suffering again with migraines that are being very easily triggered – from things such as a very small amount of alcohol or tiredness etc– it’s clear my migraine threshold has been lowered.
I am using Slynd as the progesterone component to stop my own natural hormonal fluctuations.
So my theory is that the amount of Oestrogel I am currently on – 2 1/2 pumps – isn’t enough to keep my oestrogen levels sufficiently high to keep my migraine threshold higher. I am therefore thinking that increasing my pumps to 3 or possibly even 4 may affectively do this and help me gain the control I had on Yasmin.
I’m looking for experiences of anyone who has suffered with hormonal migraines that has been managed by oestrogen in HRT and the levels of oestrogen it took to do this. I am very wary of accidentally having too much oestrogen – although going off my history of severe premenstrual migraine et cetera due to oestrogen drop, I suspect that I respond well to high oestrogen levels. I suppose I’m just concerned that the symptoms of both too much oestrogen and too low both include headaches and migraines so it feels like a minefield knowing what is the right thing to do, and hope that the additional half pump I have added isn’t making things worse more than better.
Please help if you have any experiences to offer! Thank you so much

I have hormonal and chronic migraines, I have never been able to tolerate hormonal contraception so my situation is not the same, however I do have hrt in patch form as this gives a more stable form of oestrogen as when I had the gel i occasionally forgot it and gave myself a migraine as it get them when oestrogen dips. I take norethisterone as my progesterone as I tolerate it better then utrogestran. My gp is quite knowledgeable about hrt though and maximising it to manage migraines.
do you have a preventative and acute medication for migraines? I have also had to change them recently due to the impact on my blood pressure and I am having Botox now for migraines which is working well so far.

Hi thank you for responding – can I ask what dose of oestrogen patch you are on? And if you think it helps or different levels of the dose have helped more or less?
Yes I have triptans and naproxen and they help a little but not enough to make me fully functional – however I previously knew when I would get a migraine due to it being a pill break whereas now my threshold is so low I feel like they are triggered easily and I’m constantly on the edge of one.
Can I ask how Botox helps and where you have it to get this effect? Thank you so much.

I am on a 75 patch which is fine for my peri symptoms. To be honest it hadn’t helped my migraines they are as bad as ever. I have tried about 5 different preventatives now and take a cgrp med now, I am now under the migraine clinic in Salford for the Botox. You have to have tried at least 4 preventives to be eligible, have chronic migraines, so a certain number of days a month and keep a diary.
the Botox is 31 injections in the forehead, scalp and neck.
I had it 6 weeks ago and haven’t had much effect yet, it is supposed to be more effective after the second treatment.
my neurologist said that many of his patients are perimenopausal women as it is so common to really suffer at this age.
i don’t think you are going to get the fix you want from hrt and might need to discuss other migraine medications or options with your gp.

Is it not just an initial flare-up from changing your hormones so dramatically? If I change anything at all in my HRT it causes a flare-up... add, subtract, apply poorly...

I use 100mg estrogen patch + 1pump gel + 200mg utrogestan daily.

It doesn't control my migraines but it has improved them from my pre-HRT baseline. The biggest improvement was having a high daily dose of progesterone, I haven't found increasing estrogen particularly helpful for migraine.

I think when I'm post menopausal HRT will stop them completely, it's my own hormones fluctuating that triggers them so badly in peri, and HRT won't stop that because its not designed to suppress your cycle like the pill does.

If I was 50 and I knew Yasmin would stop them, I'd go see a specialist and ask if I could have it until 55 instead... I'm too scared of the flare-up to switch and try it.

I didn't find botox helped at all, but I am on an oral CGRP med which does, I was shocked after trying so many other preventatives that failed.

Can I ask about your experiences with Yasmin for peri, particularly migraine? Did you find it relieved all your symptoms ? Any down sides ?

I had exactly the same problem (and I too used to be on Yasmin).

I stopped HRT because my migraines got worse and now I take supplements to try and control them (with some success but not 100%).

Yes I took it continuously apart from every few months when breakthrough bleeding meant I had to do a pill break – then would reliably get a horrible migraine for a couple of days – but other than that it kept me migraine free as suppressed all natural fluctuations x