MidLife
Migraines and Menopause
The prevalence of migraine is 2-3 times higher in women than in men. The character of the headaches also differs between the sexes. Women tend to report higher levels of pain, longer duration of headaches, and more associated symptoms, such as nausea and vomiting. Visual symptoms are also less common in women.
There is a long recognized association between ovarian hormones and migraine. Over half the women who experience migraine report an association between their headaches and their menstrual cycle. The frequency and severity of migraine is increased commonly with the use of oral contraceptive pills and during menopause.
Because migraine is affected by hormonal fluctuation, estrogen use during the premenstrual period is sometimes helpful. However, ironically, estrogen may also trigger migraines. Women should discuss with their physicians the use of estrogen such as oral contraceptives and hormonal therapy for migraines.
Because stress often triggers migraines, women who are habitual sufferers should learn relaxation and stress management techniques. These are especially helpful in aborting headaches when warning signs are felt. Massage as well as relaxation exercises of the neck, shoulder, and jaw muscles may all be helpful. Rest in a dark room with cool compresses can prevent the headache. Foods such as alcohol, aged cheeses, chocolate, fermented or marinated foods, MSG, artificial sweeteners such as aspartame, and caffeine all may trigger headaches; diet should be monitored to reduce or eliminate intake of these. Nicotine may cause migraine - yet another good reason to give up smoking!
In summary, each woman's migraine pain, her triggers, and her "headache calendar" (when headaches tend to occur) are unique. Treatments are also unique for each case. To properly plan treatment, individual triggers, lifestyle issues, stress levels, eating habits, and willingness to accept drug therapy, must be considered.
Women with moderate migraines may need prescription drugs for relief. These could include agents that affect neurotransmitters (the chemicals that are the messengers in the brain) such as sumatriptan and various antidepressants. Other drugs might include agents that dilate (widen) the blood vessels in the brain. In some cases, painkillers are prescribed.
