Migraines are, quite literally, a monumental pain. But do your fluctuating and falling hormone levels during perimenopause and menopause ease or exacerbate attacks – and what can you do to reduce the likelihood of getting them and/or remedy them if they do strike?
Most of us know what a migraine is. Even if we have not personally suffered an attack, we know someone who has and the misery and pain they can cause. A migraine is not any old irritating headache – it is in a class of its own – debilitating and characterised by throbbing (frequently excruciating) pain on one, or both, sides of the head as well as sensitivity to light (around 25% of people with migraine experience visual disturbances that often start before the headache does when they start seeing ‘auras’ or flashing lights), sound and smell – very often accompanied by nausea and/or vomiting. Symptoms can build a day or two before the actual pain episode and can make the sufferer feel out of sorts for a few days afterwards too. They can last anything between a few hours and a few days and can occur as often as a few times a week or as little as every few years.
If you have never had a migraine attack it is unlikely you will suddenly start getting them in your 50s – just three per cent are diagnosed at 50+. If you do get them, the good news is that they tend to be less severe and frequent – and may disappear altogether – by your late 50s.
There are several different types of migraine including those with aura (where visual disturbances tend to occur as a warning sign before migraine starts), those without aura (the most common type) and migraine aura with headache where you can experience aura and other common migraine symptoms but without a headache.
You might just be unlucky and have a genetic predisposition to migraine. Stress is also a common trigger – anxiety, excitement, tension can all be a factor. Other potential triggers include tiredness, dehydration, low blood sugar caused by skipping meals and certain food and drink triggers (see below). We also know that the majority of women complain, if not of migraines, then certainly of headaches triggered by their hormones/periods and there is evidence to show fluctuating hormones become more of a trigger around the time of the perimenopause and menopause. Presenter and broadcaster Kay Burley, 58, recently spoke about her menopausal migraines: ‘My eyes start to flicker, I know what is coming. I know to drink a pint of lemonade and have three ibuprofen or whatever. The sugar helps a lot.’
Getting older definitely appears to be something of an advantage when it comes to migraine particularly if yours have been hormonally-triggered. But it should be pointed out attacks may get worse before they get better: one piece of 2016 research from the University of Cincinnati found the risk of getting more than 10 migraines a month increased by a whopping 60% in perimenopausal women. This is generally attributed to fluctuating and falling oestrogen levels which can lead to an initial worsening of attacks as your periods become more erratic and very likely more frequent – resulting in more migraine attacks. As the charity the Migraine Trust point out, ‘The irregularity of your periods can make it harder to cope with your migraine as they may be more difficult to predict. Typically, the problems that can be experienced at the menopause (hot flushes and night sweats) result in disturbed sleep, adding to your stress levels and therefore increasing the likelihood of you experiencing a migraine. ’ It adds, ‘Some women find their attacks continue to follow a cyclical pattern years after the menopause and the reason for this is unclear. Hormones as a trigger factor for migraine should settle within two and half years after the menopause.’
The link between menopause and migraines isn’t always entirely clear but as research continues so we are beginning to understand more. One recent piece of research led by Dr Vincent Martin, for example, suggests that increased migraine frequency during perimenopause and menopause may also be linked to overuse of medication taken to ease menopausal joint pain. The question of whether hormone replacement therapy (HRT) can ease migraine is another continuing avenue of research.
HRT is not a treatment or remedy for migraine and not every menopausal woman can or wants to take it. However, as the National Migraine Centre points out, ‘many women notice that migraine is more likely to occur when they have bad hot flushes and night sweats. Since HRT is very effective at controlling these menopause symptoms it can help reduce the likelihood of migraines. However, some forms of HRT can create more hormonal fluctuations triggering migraine. The advice is if one type of HRT exacerbates migraine try an alternative one. Patches or gel can also be a better option than tablets as these maintain more stable hormone levels.
Ultimately, according to the Migraine Trust, ‘It is generally true that migraines improve as we get in our 50s and 60s. Studies show 40% of people with migraine no longer have attacks by the age of 65.’ Of course, not all migraines are triggered by your hormones and non-hormonal ones can go on happening post menopause so continue to take steps to avoid any known triggers. The advice from the National Migraine Centre is: ’Maintain good migraine habits – regular meals, exercise, sleep, avoid known triggers – it is important to look after your general health.’
While there is no cure for migraine it can be effectively managed. To help reduce your likelihood of experiencing migraine and/or reduce the severity of an attack should it happen try these natural remedies:
In the largest ever double-blind, randomised placebo-controlled trial from Tehran University probiotics have been shown to significantly reduce the frequency and severity of migraine. Dr Katy Munro from the National Migraine Centre says, ‘There is certainly a link between migraine and the functioning of the gut as many sufferers tell us’. One of the explanations for how gut microbiota is linked may be an increase in intestinal permeability which means bacterial compounds can leak into the bloodstream, triggering inflammation and then migraine. Try new Bio-Kult Migréa £19.95 for 60. These probiotics contain 14 strains of live bacteria with added magnesium and vitamin B6. Expect to see results within eight weeks.
Rob Hobson Healthspan Head of Nutrition says: ‘Food can play a role in the onset of migraines for some people, with the most common triggers being chocolate and caffeine, as well as red wine (all of these contain high amounts of the amino acid tyramine) and pickled foods. Certain foods contain chemicals and additives that are often mentioned by migraine sufferers as causing problems like monosodium glutamate, nitrates (found in processed meats) and aspartame (used to sweeten low calorie food and drink).’ Dehydration can lead to migraine so keeping well hydrated is important.
Dr Dick Middleton from Schwabe Pharma UK says, ‘Clinical studies have found that dried Feverfew leaf reduces both the frequency and intensity of migraines. Feverfew extract does not have the same beneficial effect. It is important to take the dried herb continuously for several months to see maximum benefit.’ You can find the dried leaf in Schwabe MigraHerb Feverfew Migraine Relief Capsules £8.45 for 30 and Healthspan Feverfew Migraine Relief Capsules* £16.99 for 60.
There are a range of de-stressing techniques to help you deal with stress and help head off migraine. Exercise is one of the simplest and most effective – not only does exercising take you away from your worries and help you work off any ‘nervous energy’, any sustained exercise can also release brain chemicals that counteract stress and anxiety. Mindfulness and meditation apps are easily downloadable and helpful for many. For other quick and natural ways to reduce stress and mild anxiety try A.Vogel Stress Relief Daytime Valerian-Hops oral drops £10.50 or AvenaCalm £10.50 containing stress-relieving hops and the herb valerian.
Rub one to two drops of lavender and peppermint essential oil firmly in circular motion into your temples when you feel a migraine coming on. One small study has also shown inhaling lavender oil can help reduce the severity of migraines in some people. Try Puressentials Headache Roll-On* with 9 essential oils £7.99.
A 2014 study involving 100 migraine sufferers compared the effectiveness of ginger powder with sumatriptan, a widely used migraine drug. Ginger is also helpful for alleviating nausea.
There is some evidence that magnesium levels in a person’s brain may be low during a migraine. Good sources of magnesium-rich foods include bananas, avocado, nuts and seeds, pulses, mackerel, low fat yogurt and figs. Research has shown supplementation of magnesium can reduce the frequency of migraines (especially those with aura and other visual disturbances) for some people when compared to a placebo. Try Healthspan Opti-Magnesium* 90 tables £10.95