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[CrazyD]

Firstly - I am post meno, but think this topic isn't related to peri or post necessarily! Mods, please feel free to move this if you think otherwise.
History - I had early meno following chemo, but for a non-hormone cancer so was given the OK for HRT, which was Tibolone. Gradually my migraines got worse, I have always had them very occasionally, every 6 months, but not related to my cycle. However, in the years I was taking HRT they got worse, I often had no warning, would wake up, be sick and would then be pretty much bed-ridden for 48 hours. The GP never linked this to hormones/HRT, so I went through years of various drugs to try and control them, but although I managed a 'coping' type of regime, it was still life-affecting. At 56 I was taken off HRT and miraculously, almost overnight, they stopped. Phew!

But then all the meno symptoms came back and they also became life-affecting. So recently after a bit of a fight as I am now 60, I have been put on Oestrogel (1 pump) and Utrogestan tabs. After 2 months I feel SO much better, it has made a huge difference. But of course, back have come the migraines.
Unfortunately the Almotriptan tablets that were once my 'silver bullet' seem to no longer work, I tried some Nurofen Migraine tablets this morning and they do seem to have helped when they didn't in the past.

I saw the GP yesterday and she suggested I move to patches and seems I have a choice of Evorel or Estraderm MX 25mg. And to continue to take Utrogestan separately as she said the migraines are linked to Estrogen and not progesterone.

Do any of you ladies have any other advice to offer please? I did a search on the forum, and read a few threads but they don't seem to be directly related, (many were about using HRT to control migraine) but did read one about taking Aspirin as a preventative. Also and success stories at this stage would be very reassuring, as I was feeling pretty low about it all!!
Thank you.

[lillith112]

I'm a migraine sufferer and the only hrt that didn't give me constant migraines is Estraderm MX patches. I'm on the 75 ones. I still get bad heads when I finish the utrogestan so I figure it's drop in progesterone. I've been offered the mirena coil to try as that will stop the sequential bleeds.

[Dotty]

Have you tried increasing the Oestrogel?

[CrazyD]

I'm a migraine sufferer and the only hrt that didn't give me constant migraines is Estraderm MX patches. I'm on the 75 ones. I still get bad heads when I finish the utrogestan so I figure it's drop in progesterone. I've been offered the mirena coil to try as that will stop the sequential bleeds.

Thanks - that type was one I have been offered so will ask for that. Interesting regarding the progesterone though, the GP said it wasn't related to that so that's worth me checking.

[CrazyD]

Have you tried increasing the Oestrogel?

I'm on the lowest level as I'm post meno, but thought an increase in estrogen would make things worse as it's starting back on HRT that has kicked this off again - is there a reason you suggest this, is there some connection? I'm willing to try anything right now as otherwise I have a choice of living with one of 2 life-affecting conditions!!

[sheila99]

I don't suffer from them so haven't taken much notice of the posts but I would look at the posts by maryg, I think hers are related to progesterone.

[joziel]

One theory is that migraines are triggered by fluctuations in estrogen, so if you're on the patches in theory that should provide a more steady constant supply of hormones and hopefully be more stable than the gel.

I suffer from migraines when estrogen is low, although it took me a while to work that out. Have you tried the Cefaly device? It's like a TENS machine which sticks to your forehead. I love it as it's very effective and drug-free. It stops all pain whilst it is on me (1hr) and it makes me very sleepy so I then try to sleep immediately afterwards - and sleep is what makes my migraine go...

[Sage 🍃]

One theory is that migraines are triggered by fluctuations in estrogen, so if you're on the patches in theory that should provide a more steady constant supply of hormones and hopefully be more stable than the gel.

I suffer from migraines when estrogen is low, although it took me a while to work that out. Have you tried the Cefaly device? It's like a TENS machine which sticks to your forehead. I love it as it's very effective and drug-free. It stops all pain whilst it is on me (1hr) and it makes me very sleepy so I then try to sleep immediately afterwards - and sleep is what makes my migraine go...

Excellent post, joziel. It's my experience as well. 

[Mary G]

CrazyD, sorry to hear that you are a fellow migraine sufferer.

My silent migraines (30 minutes of aura with no headache) started at the very beginning of the menopause in 2004 aged 43.  I had a Mirena coil for contraception at the time.  It's taken me years to get there but my migraines are caused by various factors namely low oestrogen, high doses of progesterone and spiking/unstable hormones.  This has made them very difficult to treat but unlike you, I have migraines post menopause without HRT.  In my particular case, stopping HRT is out of the question.

I controlled lol lolthe migraines successfully for a number of years with hormone manipulation but that suddenly stopped working over a year ago so now I have to take a low dose antidepressant to keep my seratonin levels up.  The type of migraine I have is caused by low seratonin which in turn is caused by low oestrogen, high progesterone (norethisterone caused 5 migraine aura attacks in one day) and wildly fluctuating hormones.  I did not have any migraines pre menopause.  I'm now settled on a low, continuous dose of oestrogen, progesterone and testosterone plus the low dose AD - initially amitriptyline now nortriptyline. 

It sounds like your migraines are painful and made worse by HRT.  It could be that the balance/ratio is wrong.  Did you have migraines pre menopause and if so, were they before a period?  Do you have migraine with or without aura?  This would make a difference to the type of HRT that you need.

Patches might be better and more stable so definitely worth a try.  It might be worth your consulting a hormonal migraine specialist if they persist.

[CrazyD]

Thank you Mary G!! All interesting reading..... I did not suffer with migraines pre menopause (just the odd one here and there, but no more than 1 or 2 a year) They are without aura.... I get spasms in my neck/upper back, in the worse cases I am sick repeatedly (stomach spasms) every 20 mins for several hours. I am sensitive to light/noise and it's like someone has unwired my brain, can't function. It starts with a pain behind one eye or behind the bridge of my nose..... and it usually affects me for 48 hours, getting better in the evening and then worse the next morning.

I'm waiting on patches now, and will try those although they are estrogen only, I still have progesterone tablets. I had no idea there were such people as hormonal migraine specialists, thanks, how would I go about finding one, would the GP advise??

I'll also experiment with the estrogen levels too!

Thanks everyone, I was feeling pretty despondent but I have things to try now.