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[Kat36]

Hello ladies,

I’m two weeks into a different regime and I’m suffering once again with silent migraines with aura. My question for those who suffer from migraines with aura, did you suffer an increase in silent migraines as you started hrt/start having them again after many years dormant. I haven’t had migraines since I was a teenager and they were without aura (although I couldn’t swear to that as I probably wasn’t aware as I am now).
I’ve mentioned the symptoms to my gynae and she didn’t seem concerned.  She said just to start on a lower dose of estrogen.
If you have suffered with this, did this state pass as you became estrogenised again? Is there issue that I’m stuck in a state of estrogen lack and therefore it’s bouncing around at a low level? I’m on evorel 25, never been on more than 50. My doc said due to me being 39 she would expect that eventually I would need 75 or more.

[menomope]

hi Kat 36
I suffer from silent migraines with aura. I get the zigzag lines and they last around 20 mins.
I have about 2/3 a year. Never worked out a trigger. it is possible I have more of these than I know but without the aura.
I never had them until I hit menopause and I have never mentioned them to Dr. I am now on HRT and dont get any more of them or any less.
interestingly my husband also gets these. He gets them more than me and started getting them about the same time as me after having never suffered from them before. So maybe its an age thing?
I am not sure I have been of any help

[VanillaLover]

Hi yes when I started HRT I did have a couple of aura migraines within a month or two. That is unusual - normally have them maybe once a year?  (Though non aura migraines 8-10 a month sadly). That has calmed down now and seem back to normal after 3plus months on HRT.

Interestingly I was first diagnosed with migraines (first had aura ones anyway) when pregnant, when oestrogen is also higher than usual.

[Kat36]

Thank you for your replies.
@Vanillalover- That’s interesting that they presented themselves during pregnancy the first time for you.   Just goes to shore really it’s probably the estrogen.  I think that it’s possible with hindsight that I’ve had silent migraines the past few years too…and just shrugged it off because it was short lived and I’ve def had classic migraine over the years, often as a result of alcohol intake.  During my early teen years I had classic migraine a lot (probably as those pesky hormones figured themselves out). Ironically after I started the pill at 19 they really settled down. I wonder if when these hormones settle a little more they will just go away. They are just so very unpleasant and scary 

[Sid]

Hi Kat36

I started having migraine with aura around puberty. At that time, the symptoms were horrendous and included aura, debilitating headaches and vomiting. From the age of around 20 until about 44 (when perimenopause struck) I had no migraines at all.  In perimenopause, silent migraine with aura returned with a vengeance (sometimes 20-30 per month). I tried all kinds of medication but nothing worked. Now I am 57 and have been on HRT for 4 years. Recently, the frequency of the migraines has reduced hugely. I think that it was fluctuations in oestrogen that caused my migraines. Now that I am post meno and oestrogen is stable on HRT the migraines have virtually disappeared xx

[Minnie64]

Recently prescribed Everol 50 patches as pharmacies unable to source Sandrina gel, I also have the Marina coil fitted. Within a week my Migraines are back with a vengeance so much so I have removed the patch & am waiting for a call back from GP to ask for Estrogel which wasn’t offered when I informed him I couldn’t source Sandrina Gel. I can’t believe how in just a week how unwell I now feel as well as very short tempered 🙁

[Kat36]

Thank you for your reply and I’m so sorry you are sufferers also. I’d be interested to know if anyone who suffers from migraine gets on with the patches?
Minnie64- hopefully you managed to source the gel. My gynae prescribed it after a bad initial reaction to Evorel patches.  I’m still struggling to find the
gel. 

Sid - I’m hoping that as I climb to a higher stable level of estrogen I’ll feel better too.

[Mary G]

I'm a fellow sufferer so anyone who has this terrible affliction has my sympathy.

I'm not sure if oestrogen dosage comes into the equation in the earlier part of the menopause, the only thing you can do is try taking a higher dose and see what happens.  You might need a higher dose of progesterone to balance the oestrogen.

I first started having silent migraine (aura without headache) 18 years ago when I hit the menopause.   I had a Mirena coil at the time and the aura would strike just before a period when the oestrogen spiked.

Generally speaking, the aura is caused by unstable oestrogen which triggers cortical spreading depression.   This can start at menopause when you no longer produce enough progesterone and lose its protective effects.   

Hormonal migraine migraine specialists recommend continuous combined HRT and avoiding a cycle.   They also recommend you take the lowest possible dose of oestrogen.   If aura persists, the first line medication is a steady dose of propranolol.   You may also need to add an AD.

My advice is to read up on cortical spreading depression and also Professor Anne MacGregor's research.

I hope that helps.

[Kat36]

Thank you so much for this Mary G. This is really useful information.  What is your opinion in the safety of using HRT in silent migraines?

[VanillaLover]

Hi just wanted to say have a quick read of my update yesterday as there is a little info on HRT/aura migraines from what I’ve found in my own journey.  Sorry I can’t be bothered to type it out again! [lazy]!

[VanillaLover]

Just to add that my HRT as it stands has made no difference to frequency/severity of my migraines once the initial blip was over. That’s on a medium dose though. My migraines still very much cyclical/hormonal.

[Mary G]

Kat36, HRT is safe for women who suffer with migraine aura but transdermal delivery is recommended.