Managing menopausal migraines:Lifestyle, prevention, and hormone replacement therapy

In part two of her series on menopause and migraines, Dr Ashlesha Dhairyawan gives us her insights. She talks about how lifestyle factors such as diet and exercise influence migraines during menopause, if there any preventative measures or lifestyle changes that can help alleviate migraines in menopausal women and how hormonal replacement therapy can affect migraines in menopausal women.

How do lifestyle factors such as diet and exercise influence migraines during menopause?

Lifestyle factors can hugely affect migraines during the menopause. Some women find that there are triggers and then they try and avoid these which can improve frequency and severity of their symptoms. For some women, certain foods, such as sugary and processed foods, act as common migraine triggers.

Eating a healthy, balanced diet is key to reducing the chances of getting migraines. Caffeine and alcohol can also make symptoms like hot flushes and night sweats worse and these can in turn affect sleep and we know that poor sleep and tiredness can also bring on a migraine attack.

Make sure to drink enough water throughout the day since dehydration can trigger migraines. Also, it's a good idea to include regular exercise in your routine. This can help reduce the number of migraines you get and is beneficial for maintaining muscle mass, bone density, and overall health, which is important during menopause.

Are there any preventative measures or lifestyle changes that can help alleviate migraines of menopausal women?

It's important to remember that each woman is different and the effectiveness of preventative measures and lifestyle changes can vary from woman to woman. Various measures can have an impact on migraines. Lifestyle changes are important as they can ease migraine symptoms. For instance, engaging in regular exercise, such as two to four sessions per week, has demonstrated effectiveness in preventing migraines.

Additionally, incorporating mind-body exercises like yoga and Tai Chi into your routine can be beneficial for managing stress and anxiety, common triggers for migraines. Keeping a headache diary can help pinpoint dietary triggers, including well-known ones like caffeine, alcohol, sugary, and processed foods. Avoiding these foods is crucial if they tend to trigger your migraines. Additionally, maintaining regular meals is important, as skipping them or eating at irregular times can provoke migraine attacks. Staying well-hydrated is key, as dehydration can trigger migraine symptoms. Prioritising sufficient sleep, aiming for at least seven hours each night, and establishing a consistent bedtime routine contribute to migraine management. Overall, these lifestyle adjustments are vital in reducing the severity and frequency of migraines in menopausal women.

How does hormone replacement therapy affect migraines in menopausal women?

Hormone replacement therapy (HRT) is highly effective in managing menopausal symptoms and proves to be equally effective in reducing the severity and frequency of migraines. HRT plays a crucial role in stabilising hormone fluctuations that can trigger migraines. Through the use of HRT, it helps to steady the erratic oestrogen levels associated with migraines during the perimenopausal phase. Notably, HRT delivered through the skin, in the form of patches, gels, or spray, contains natural oestrogens.

It can be very effective to help ease migraine especially if started at a low dose and then built up. This form poses a lower risk of stroke or blood clots compared to oral hormone replacement therapy (HRT). Notably, women, especially those with migraines accompanied by aura, face a heightened stroke risk with oral HRT. However, transdermal oestrogen, delivered via the skin, is considered safe for these individuals, allowing even those with migraine with aura to use HRT.

Women experiencing severe migraines often find that they coincide with intense hot flushes or night sweats. By incorporating HRT, not only do their menopausal symptoms decrease, but it also contributes to a reduction in migraines.

Dr Ashlesha Dhairyawan is an esteemed menopause specialist with over 20 years of experience. You can schedule an appointment with Dr Dhairyawan on her Top Doctors profile.