We have oestrogen receptors all over the body, including the brain.

So, it isn’t surprising that hormones can affect Migraines. To start with, Women are three times more likely to suffer with Migraines than men.

The natural history of Migraines during a Woman’s life also tells a story:

Falls in oestrogen levels just before the period, can trigger Migraines. For some women, this is the only time they experience Migraines. These are called Menstrual Migraines. Taking the contraceptive Pill which contains oestrogen to flatten out the natural hormonal cycles and running packs together to avoid the break can help with this. The one caveat is that if you are someone who gets aura with their migraines, you cannot have the combined pill because of the increased risk of stroke. An aura is a sensory disturbance like blurred/patchy vision, flashing light, wavy lines or specific muscle weakness or speech difficulties before or during the migraine. https://my.clevelandclinic.org/health/diseases/22131-migraine-aura You may need a different type of Oestrogen free treatment.

During the perimenopause, fluctuations in oestrogen level can also trigger or worsen migraines. To add insult to injury, women who get migraines quite often have worse hot flushes!  Replacing oestrogen in the form of HRT can help with both hot flushes and migraines. Luckily even women who have migraines with aura can take the Oestrogen in HRT. We just prefer it to be the more modern body identical oestrogen, ideally given through the skin in the form of a patch or gel, rather than in tablet form. Natural, Micronised progesterone tablets can also help migraine as they can help with sleep and have a calming effect on the brain.

The other good news is that migraines can improve once menopause is established. We can say that menopause is established when a woman has had no periods for a year if she is over 50, or 2 years under 50. For more information on the difference between the peri and menopause see here: https://amesmedicalservices.com/whats-the-difference-between-the-perimenopause-and-the-menopause/

So what about Heart Health? Interestingly, Migraines with aura can be associated with an increased risk of stroke and an increased risk of heart disease. Also, women who get migraines tend to have worse hot flushes during the perimenopause. Women who have worse hot flushes, independent of other risk factors like being overweight, have an increased risk of heart attacks. Menopause increases your heart attack risk. So, if you are a migraine sufferer and also have bad hot flushes see your doctor to check your other risk factors for heart attacks. You MAY wish to discuss considering modern, body identical estrogen through the skin too. This may help your migraines, hot flushes and if started within 10 years of the menopause, it may help reduce your risk of heart attacks. Your individualized risk assessment is very important to make an informed choice about this.

Now, with regard to this safer, more modern form of HRT please allow me my second plug asking for you to sign this petition to get this type of HRT available in Trinidad and Tobago. If interested, please sign the petition below. You don’t have to be of menopausal age. And you don’t even have to be a woman!