You may find hormone headaches suddenly get worse as you move through menopause – or you may start getting them for the first time. Here’s why you may be getting more headaches, and how you can get on top of them.
How are headaches linked to menopause?
Doctors have long known there’s a link between headaches and hormones, with many women experiencing migraines just before a period (read our article on irregular bleeding here), or in the first few days of bleeding. This happens due to a drop in oestrogen at the end of a menstrual cycle.
So it makes sense headaches may become worse or more frequent during menopause, when oestrogen levels are up and down. And the fact you may have periods more often at this time can also contribute. Lack of sleep can be a trigger, so night sweats and hormone-related insomnia can come into play, too. And any stress in your life at this time can be another piece of the jigsaw. For women prone to migraine, studies suggest the headaches get worse for up to 45 per cent of women and stay the same in about 30 to 45 per cent, while 15 per cent notice an improvement.
"My worst symptom is horrible headaches with brain fog and extreme fatigue, making it very hard at work," says Live Better With Menopause community member Munkeybites. "It takes away from my family time because I'd rather sleep. I feel like I've been on a three-day bender and I don't even drink." The good news is these hormone headaches usually settle in the years after menopause, as oestrogen levels remain consistently low.
Headache or migraine?
Migraine is known to affect 15 per cent of the population, with women more commonly affected (probably due to hormonal causes). However, many experts believe migraine is vastly under-diagnosed and may be far more common than thought. Migraine headaches aren’t necessarily always as severe as most people imagine, and not everyone has the visual disturbances and nausea that are classically considered signs. There’s a school of thought that what are known as tension headaches are in fact mild migraines.
Is it hormonal?
Not all regular headaches are linked to hormones, and migraines are known to have a number of different causes – women will often have them in response to a combination of factors. During the menopause transition, when hormones are all over the place and periods irregular, it can be difficult to spot a pattern. It’s a good idea to keep a symptom diary, noting when you have headaches and seeing whether they tend to be connected to your periods.
What your doctor can do
You should always see your doctor if headaches are new for you, severe or getting in the way of life. You don’t need to put up with them and medical help could be a game-changer. Also, very rarely, headaches may have a more serious cause so it’s worth ruling this out, particularly if you’ve only just started getting them, or they’ve suddenly worsened.
HRT can be hit-and-miss when it comes to hormone headaches. Your doctor probably won’t recommend it in tablet form if you’re a migraine sufferer, as the hormones in this form change throughout the month, which may make your headaches worse. But you can still use it in patch or gel form. Although there isn’t much evidence to support taking HRT purely to help headaches and migraines, you should still be able take it to help other symptoms. And some women – like community member Kaz - find it does help with headaches.
Other treatments your doctor can offer include painkillers and medications called triptans that can nip migraines in the bud.
Your headache-easing lifestyle plan
You can take painkillers if necessary but you should try not to take them too often – regular use can lead to withdrawal headaches. So it’s better to put some steps in place to try to prevent headaches. Even if your headaches are linked to hormonal ups and downs, addressing the other contributing factors can make a significant difference.
Have a regular schedule
It’s thought migraines may be connected to your body clock, the in-built sleep-wake cycle. If this finely tuned system is knocked out of whack, it may react by triggering a headache. Keeping to a routine can help – try to go to bed and get up at roughly the same time each day, and eat at about the same times, too. Avoid skipping meals, which can affect your blood sugar levels and trigger a headache.
Consider your caffeine intake
Some experts believe regular headaches are linked to caffeine intake. Caffeine has pain-relieving properties, which is the reason it’s added to many all over-the-counter painkillers. The trouble is, once caffeine starts to wear off, it can trigger rebound headaches and keep you in a continual cycle of withdrawal and addiction. So quitting it entirely can be a good plan if your headaches are severe. You may feel worse to start with but after a week symptoms will clear and you’ll start to notice the real benefits. Caffeine’s found not just in tea and coffee, but also chocolate and some painkillers. Try switching your regular cuppa for a herbal brew.
Stress can aggravate any headache. Yoga, regular massage and plenty of exercise will all help. And check your posture – hunching over a computer all day may lead to tight muscles and headaches.
Try the alternatives
Some women swear by the herb feverfew for migraines – you could try MigraHerb Migraine Relief. Acupuncture can also sometimes be helpful for preventing headaches and migraines.
Get an eye test
Make an an appointment with your optician for a checkup as eye strain is a common cause of headaches.