Hormonal changes

Research shows that in adolescents and adults, migraines disproportionately affect women. Shifts in hormones during the years of menstruation, pregnancy, perimenopause and menopause can be triggers, which helps explain why twice as many women as men suffer. Hormone replacement therapy is an option but Susan Davis, professor of women’s health in the School of Public Health and Preventative Medicine at Monash University, says that women with menopausal symptoms and migraine need to be evaluated carefully before using it.

“Some women experience worsening of their migraines at menopause when oestrogen levels fall, whereas other women report lessening of migraine symptoms after menopause,”

Davis explains.

“Before taking HRT they should talk to their doctor about their individual risk factors for migraine and stroke.” Fluctuations in oestrogen levels can make symptoms worse, so Davis often starts her patients on a low dose of transdermal oestradiol (an HRT as a patch or a gel) to see if symptoms improve, stay the same, or worsen.