“Women have been telling their doctors that their migraine headaches worsen around menopause and now we have proof they were right,” says Vincent Martin, MD, professor of internal medicine in the University of Cincinnati’s (UC) Division of General Internal Medicine and co-director of the Headache and Facial Pain Program at the UC Neuroscience Institute.
The risk for high frequency headache, or more than 10 days with headache per month, increased by 60% in middle-aged women with migraine during the perimenopause – the transitional period into menopause marked by irregular menstrual cycles – as compared to normally cycling women, says Martin, the study’s lead author.
The findings were published online this week in Headache: The Journal of Head and Face Pain, a publication of the American Headache Society.
Martin teamed up with Richard Lipton, MD, Jelena Pavlovic, MD, PhD, and Dawn Buse, PhD, from Montefiore Headache Center and Albert Einstein College of Medicine, and Kristina Fanning, PhD, and Michael Reed, PhD, from Vedanta Research, Chapel Hill, NC, to study 3,664 women who experienced migraine before and during their menopausal years.
The menopausal years include both the perimenopause and menopause. Menopause begins when women have not had a menstrual period for one year. Symptoms such as hot flashes, irritability, depression and insomnia are common during both.
“Changes in female hormones such as estrogen and progesterone that occur during the perimenopause might trigger increased headaches during this time,” says Richard Lipton, MD, director, Montefiore Headache Center.
The risk of headache was most apparent during the later stage of perimenopause, which is a time during which women first begin skipping menstrual periods and experience low levels of estrogen, adds Lipton.
Martin says women who participated in the study also reported that high frequency headache increased by 76% during menopause. However, researchers think that it may not necessarily be the direct result of hormonal changes, but rather due to medication overuse that commonly happens during this time.
“Women as they get older develop lots of aches and pain, joints and back pain and it is possible their overuse of pain medications for headache and other conditions might actually drive an increase in headaches for the menopause group,” says Martin.
January 21, 2016