Perimenopause Headaches – What’s The Deal?

July 17, 2020.

Hey you! Are headaches getting you down? If so, you are not alone. Headaches can be a painful and debilitating symptom of perimenopause. Unfortunately, they are much more likely to afflict women than men. Headaches are fickle: triggers that affect one woman’s headaches just might be the cure for another. For example, if you find caffeine cures your headaches, it just may be the trigger for the  woman seated next to you. A report in Current Treatment Options in Neurology found that between 10-29% of women report migraines in perimenopause. Let’s explore the links between headache and perimenopause

Can Perimenopause Cause Headaches?

Well, it depends on who you are! Remember, headaches are fickle. Some women that had headaches throughout their reproductive years find that their headaches improved or decreased in severity during perimenopause. Other women find just the opposite: they all of a sudden have debilitating headaches once they enter perimenopause. The most likely culprit behind perimenopause headaches? You probably guessed it – hormones.

Perimenopause marks the beginning of a woman’s transition to the end of her reproductive years. This transitional period is usually accompanied by a number of symptoms that can be aggravating and even debilitating. The symptoms associated with perimenopause are commonly due to the hormonal fluctuations that occur in your body as you approach menopause. Throughout the perimenopausal period, estrogen and progesterone decline, as well as testosterone. However, in the case of perimenopausal headaches, estrogen is usually the cause of headaches.

Estrogen withdrawal is usually the most common trigger for perimenopause headaches. Women that had headaches during their menstrual period may likely find their headaches get worse and more frequent with perimenopause. This is due to the inconsistent fluctuations in circulating estrogen. Remember, during your menstrual period, estrogen levels are much lower than they are during the rest of your cycle. Thus, because the decline in estrogen is not always consistent during perimenopause, headaches may be more frequent, and more debilitating. However, some women have the exact opposite experience. Women who found their headaches were hormonal in nature, (that is, they were worse when estrogen levels were high), find significant improvement during perimenopause.

So, Can Menopause Cause Headaches?

We have just looked at how the fluctuating hormone levels may likely be the cause of headaches in perimenopause. Many perimenopausal women believe that menopause will cure their headaches. Certainly, it seems plausible that headaches should go away once estrogen decreases and levels out. However, research has not found that menopause will always cure headaches. Indeed, clinical-based studies have shown that while 24% of women found improvement in their headaches once they reached menopause, 36% found their headaches worsened.

Many women seek out hormone replacement therapy (HRT) to help treat perimenopause headaches, along with other symptoms of perimenopause. The reasoning behind women seeking hormone therapy is that it may help level out fluctuating hormones, which are the culprit of most perimenopause symptoms. However, HRT has demonstrated that it is not a guaranteed fix. HRT can improve or worsen headaches, or it can also not cause any changes.

How long do menopause headaches last?

If you are suffering from headaches, you may be questioning how long do perimenopause headaches last. Most women report improvement in their headaches around age 50. This time in a woman’s life usually correlates with a number of life factors that may play a significant role in improving headaches. These factors include menopause (again, 50 is an average age for menopause), reduced stress, and a change in lifestyle (perhaps early retirement, empty nesting, etc.). However, many women will continue to live on with headaches after menopause.

If you find that headaches are debilitating and are having a negative impact on your quality of life, talk to your doctor about how to manage and treat your perimenopause headaches.

Disclaimer: this is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment. 

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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