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Hormone Replacement Therapy and Migraines

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Hormone Replacement Therapy and Migraines

Hormone replacement therapy (HRT) can be used to alleviate menopausal symptoms such as hot flushes and sweats, plus it may provide temporary relief from migraines.

Migraines are extremely common among women. According to statistics, 28 million Americans suffer from them annually and 70% of all patients who experience them are female. During perimenopause, many women may notice their migraines getting worse as well as feeling fatigued and having trouble sleeping. Some migraines even cause an aura – a visual disturbance such as bright flashes or shimmering spots – which could indicate an underlying mental disturbance such as anxiety.

Estrogen plays an integral role in the menstrual cycle, and low estrogen levels can cause migraines. Women who have undergone hysterectomy or had their ovaries removed may find their oestrogen levels to be very low. Fortunately, postmenopausal women can receive short-term oestrogen therapy which may reduce migraine frequency for them.

If you are taking oestrogen to reduce hot flushes or sweats, ask your doctor about adding a low-dose estrogen skin patch or gel to your regimen. These products keep the level of oestrogen steady and are less likely to trigger migraines than pills.

Studies have identified an association between estrogen and migraines, yet its precise role remains elusive. Researchers speculate that fluctuations in estrogen during periods or the withdrawal of estrogen during menstruation might trigger migraines.

Brandes’ study of 17 postmenopausal women revealed that taking a daily dose of 0.625 mg estradiol reduced the number of days with migraine attacks, although some patients experienced an increase in intensity after starting treatment. Misakian’s work revealed similar results: daily doses of ethinyl estradiol reduced migraine attacks but cyproterone acetate increased them among a small group of postmenopausal women with a history of migraine attacks.

Some of the most effective ways to manage migraines are by making healthy lifestyle changes, avoiding trigger foods and beverages, restricting alcohol consumption, and managing stress. Additionally, regular physical activity can be very helpful.

As women approach menopause, their menstrual cycle can become unpredictable and their oestrogen level may dip drastically. Studies have demonstrated that those who take oestrogen for hot flushes or sweats also tend to have better control over their migraines.

Somerville conducted the first research to link estrogen and migraines in 1972, using six women with a history of migraine who received supplemental estradiol treatment. Although the sample size was small, this research demonstrated that estrogen can be an important migraine trigger.

Other studies have confirmed the estrogen-migraine connection, with one of the most remarkable conducted by Calhoun in 2004 [14]. This experiment compared women who took a GnRH analog with those taking placebos and found that adding back depo-leuprolide acetate with an added daily transdermal dose of ethinyl estradiol at five months significantly reduced headache days per month.

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