Menopause and Headaches: How are they Connected?

Last updated 01.16.2024 | by Dr. Karen Pike | 12 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Headaches during menopause are relatively common. A study of more than 500 perimenopausal women found that almost 14% of participants suffered from headaches. But of these women, less than 20% said their headaches began after menopause. The rest had been suffering from repeated symptoms before they entered this phase of life.

People get headaches for all kinds of reasons. For some, the trigger could be stress or red wine, and for others, it might be bright lights or lack of sleep. But for some women, the hormonal shifts experienced during menopause can bring on a  whole new set of headaches and migraines.

So, it’s important to identify what’s causing the pain and discomfort. Is it an external or environmental factor, or are natural hormonal changes in our bodies to blame? After all, knowing the root cause of the problem is the first step to finding relief.

I’ve suffered from recurrent migraines throughout much of my adult life. But before menopause, migraine attacks were relatively infrequent, and I’d only experience symptoms once every couple of years. However, once I entered perimenopause and my hormones began to shift, they became much more frequent.

Every few months, usually in conjunction with my period, I was struck down by a throbbing and pulsating pain in my temples, forehead, and eyes. I’d become lightheaded and nauseous, and the only way to get through it was to lie in a dark, quiet room until the symptoms passed. I knew almost immediately that the problem was related to menopause, and so, I began researching why it was happening, and what I could do to find relief.

Are you also experiencing an uptick in headaches or migraines during your menopausal transition? Hormonal shifts could be to blame, or at the very least, they could be making the problem worse.

So, in this post, I’ll share what I’ve learned about the connection between menopause and headaches. I’ll examine what causes the symptoms, who is most at risk, and what we can do to manage the discomfort and find relief.

What Causes Headaches During Menopause?

Hormonal headaches aren’t exclusively a menopausal problem. They can affect women of all ages. They can strike just before your period, during pregnancy, or while using birth control. But they’re particularly common during perimenopause and menopause.

When a woman enters perimenopause (the build-up to menopause), the hormones begin to shift. The estrogen and progesterone, which regulate her monthly cycle, both rise and fall dramatically.

Yet these vital hormones don’t just regulate periods. They have an effect on a whole host of other functions, including chemicals in the brain that affect pain. Estrogen also dilates the blood vessels in the brain. Progesterone works in the opposite way, causing them to constrict. So, when these hormones begin to fluctuate, the expanding and contracting blood vessels can leave you with a pounding head.

Who is at Risk of Menopausal Headaches?

Anyone going through menopause can suffer from hormone headaches. That being said, certain risk factors can increase the chances of it happening to you.

  • A History of Menstrual Migraines

Women who usually suffer from headaches before and during their period are at a higher risk of developing menopause-related headaches and migraines when they enter this new phase of life.

  • HRT

Hormone replacement therapy (HRT)is known to help with many of the side effects of menopause. But for some, it can actually make hormonal headaches worse.

  • Stress

Stress is a major risk factor for headaches. According to research by the American Headache Society, 4 in every 5 people who suffer from frequent migraines report stress as the cause.

What Types of Headaches are Associated With Menopause?

There are several different types of menopause-related hormone headaches, but the most commonly reported are tension headaches and migraines.

  • Tension Headaches

Tension headaches are described as a squeezing sensation, like a tight band wrapped around the skull. The pain usually affects both sides of the head. Plus, it can also extend to the back of the neck and the base of the skull. The skin may feel tender to the touch.

  • Migraines

Migraines are a more severe form of headache characterized by a deep throbbing sensation, usually on one side of the head. I know from personal experience just how debilitating migraines can be. For me, the pain is often accompanied by nausea and an overwhelming sensitivity to light, sounds, and smells. These symptoms can last anywhere from a few hours, to a few days.

My menopause related migraines usually appear without warning, and the same is true for most women. However, some people experience what is known as an aura just before a migraine begins. The main symptoms of auras are visual disturbances such as flashes of light, dark spots, and sparks.

What Can Trigger Hormone Headaches?

Avoiding hormone headaches during perimenopause and menopause isn’t easy. But knowing what can cause them may help to stave them off or at least make them less frequent and severe.

Here are some of the most common triggers of headaches in menopausal women:

  • Bright lights
  • Loud noises
  • Strong odors
  • Stress
  • Alcohol
  • Coffee
  • Lack of sleep
  • Blood sugar spikes and falls
  • Certain food additives, such as monosodium glutamate (MSG).
  • Your period Menstrual migraines and headaches before and during your period are relatively common throughout the female population. But during perimenopause, when periods become more frequent and erratic, these types of headaches can become more regular and severe.

My own menopause related migraines would usually appear around the time of my period. So, I became stricter at tracking my cycle and anticipating when my period might arrive. After all, there’s no avoiding your period. But if you know when it’s coming, you can prepare for the potential headache that might accompany it.

How to Find Relief from Menopausal Headaches

How to Find Relief from Menopausal Headaches

Menopausal headaches can be painful and even debilitating. However, there are several ways to manage the symptoms and find some relief.

Medication

Popular over the counter pain relief options are Tylenol (acetaminophen), Advil (ibuprofen), and Aleve (naproxen).

The over-the-counter pain reliever Excedrin is particularly effective for treating headaches and migraines. Excedrin contains 500mg of aspirin, 500mg of paracetamol (acetaminophen), and 130 mg of caffeine, which research suggests is the golden ratio for pain relief.

For me, these over the counter medications weren’t enough to tackle the pain of my menopause related migraines. So, I booked an appointment with my doctor. After a full assessment, she prescribed me more powerful pain relief and anti-nausea medications to help manage my symptoms while they were at their worst.

Avoid Light and Sound

At the peak of a migraine, I find that lying down in a dark, quiet, and comfortable space can help to minimize the symptoms. I try to block out all light and noise, and keep the environment as stimulus free as possible. A cold towel on my forehead also seems to help soothe the pain.

Stay Hydrated

Dehydration can exacerbate existing headaches and even trigger new ones. I’ve noticed that when I’m dehydrated, my migraine symptoms are significantly worse. So, I always keep a bottle of water with me and I take regular sips throughout the day.

It’s also important to drink extra water if you’re dealing with hot flashes and night sweats. Both of these menopause symptoms can make dehydration worse.

Get Plenty of Sleep

Insomnia is a common symptom of menopause. And unfortunately, a lack of sleep can bring other unpleasant side effects, such as headaches and migraines. So, if you’re struggling with insomnia on your menopausal journey, it’s important to try and fix the issue as soon as possible.

I don’t always find it easy to fall asleep, and during perimenopause, I would often lay awake late at night, unable to drift off. But this lack of sleep was beginning to make my migraine symptoms worse. So, I took steps to improve my sleep hygiene and get the best rest possible each night.

I began avoiding screen time in the evenings, and using essential oils such as lavender and chamomile. I also like to listen to soothing sleep tracks and guided meditations which help to put me into a relaxed state and fall asleep quickly.

Balance Your Hormones

Shifting hormones are the driving force behind menopausal headaches. So, to get to the root of the issue, you’ll need to address the hormonal imbalance.

Hormone replacement therapy (HRT) can help. However, there are serious risks of side effects with this type of medication. Plus, in some women, it can make their menopausal headaches worse.

I found that foods rich in phytoestrogens (such as soy and flaxseed) helped to relieve my hormone related headaches and migraines. Plus, they reduced several other menopausal symptoms, too, such as hot flashes, night sweats, and mood swings.

Alongside phytoestrogens, I also began taking herbal supplements such as black cohosh and red clover. These herbs have been shown to boost estrogen and relieve headaches in some people, and they certainly worked for me. The migraines would still come, but the worst of the symptoms were significantly reduced.

However, these natural remedies aren’t suitable for everyone. So, before taking any medication or supplement, please discuss these therapies with your doctor.

Visit Your Doctor

If you’re journeying through menopause and you’re suffering from recurrent headaches, the most likely cause is your hormones.

But that doesn’t mean you have to resign yourself to pain and discomfort for the next several years. Visit your doctor, who can confirm the cause of your headaches and suggest a treatment plan that can help.

In very rare cases, headaches and migraines can point to a more serious, potentially life-threatening condition.

You should seek medical advice if you experience any of the following symptoms:

  • Headaches that are increasing in severity
  • Headaches with unintentional weight loss
  • Headaches that can’t be relieved with over-the-counter prescription painkillers
  • Headaches that are becoming more frequent

Seek emergency medical treatment if you experience any of the following symptoms:

  • A sudden headache with extreme pain
  • A headache accompanied by a fever
  • A headache accompanied by a rash
  • A headache accompanied by weakness and/or dizziness
  • A headache that wakes you in the night
  • A headache with blurred vision

FAQ’s

Q. How long do menopausal headaches last?

Menopausal headaches can last anywhere from 30 minutes to several hours or even days. They can strike at any time during your menopause journey. However, they’re most common during perimenopause.
Perimenopause is the build-up to menopause. During this phase, your hormones are in a constant state of flux. So, many of the most bothersome symptoms of menopause, including headaches and migraines, are at their peak.
Most women find that once they reach menopause, their headaches become less frequent and severe, and in many cases, they disappear completely. Thankfully, this was the case for me, and today, I no longer suffer from chronic migraines or headaches.

Q. Can menopausal headache and menopausal migraine both occur during menopause? 

Headache is a general term to describe pain in the head region. Tension headaches are the most common type during menopause, but sinus headaches and cluster headaches are also prevalent during menopause.
Migraines are another specific type of headache. However, they are more severe and long-lasting, and they’re often accompanied by visual and sensory symptoms during menopause. 

Q. Can menopausal headaches and migraines be a sign of an underlying health problem?

Yes, if you’re a woman in your 40s or 50s, occasional headaches are likely to be a symptom of menopause.
That being said, headaches and migraines can be caused by a variety of conditions, including:
• Acute sinusitis
• High blood pressure
• Carbon monoxide poisoning
• Dehydration
• Ear infection
• Influenza
• Hearing problems
• Fibromyalgia
• Depression and anxiety
• Pregnancy
• Glaucoma
• Idiopathic intracranial hypertension (IIH)
• Stroke
• Heart disease
• Brain tumor
If you’re concerned about the severity or frequency of your headaches, visit your doctor to rule out any underlying cause.

Conclusion

Regular headaches and migraines can interfere with your daily life and affect your overall well being. I know from personal experience just how debilitating they can be.

So, if you’re experiencing frequent headaches or migraines, don’t suffer in silence. Speak to your doctor. They can assess your symptoms and rule out any underlying health conditions. Then, they can recommend a treatment plan to help manage your symptoms.

And remember, in most cases, frequent headaches during perimenopause are a temporary problem. Once you officially reach menopause and your hormones settle, the headaches are likely to become less severe.

References:

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.