For women whose headaches have been closely linked with their menstrual periods, the elimination of that headache trigger with menopause can result in real improvement in headaches, although it is rare for them to disappear entirely. Getting older also usually is associated with headaches becoming less severe. Many women, for example, notice that nausea, vomiting and even headache pain are much less severe as time goes by. So it may not be only menopause, but also aging, which produces headache improvement in many cases.

In women experiencing spontaneous menopause, migraine headache improved in 67%, was unchanged in 24% and worsened in 9%. Surgical ovariectomy (removal of the ovaries) on the other hand, led to improvement in 33% and worsening in 67%.

Unfortunately, not all women find menopause improves their headaches. For some women, the worsening of migraine (and occasionally even the onset of migraine) is seen just prior to the onset of menopause. This period in a woman's life if referred to as "perimenopause". It is characterized by hormonal fluctuations in estrogen and progesterone. Symptoms include hot flashes, night sweats and emotional symptoms as well as worsening of headaches. Once a woman is completely menopausal, she no longer has the wide fluctuations in hormones and may then experience improvement in her headaches. However, if a perimenopausal or menopausal woman goes on HRT (hormone replacement therapy), she should carefully monitor her headache pattern. Worsening of her migraines could be associated with HRT.

Causes Of Migraine During Menopause

The worsening of migraine just prior to menopause in some women may be related to hormone fluctuations. As menopause progresses, the plasma levels of sex steroids decline and migraine headaches frequently abate. Researchers feel that, at least in part, these changing levels of hormones cause headache for some women. However, in the general population over the age of 55 to 60, the incidence of migraine in females is still higher than males (2:1). This suggests that some factors other than sex hormones contributes to the predominance of migraine in women, and reasons for this are not well understood.

Reprinted from the website of the American Council for Headache Education