Headache and menopause: what you need to know

We know that headaches and migraines can be caused by changes in your hormone levels during the menopausal transition. Just like period headaches (during your menstrual cycle) are related to changes in hormone levels. The headache symptoms are caused by a sudden drop or rise in oestrogen in comparison to progesterone. 

When oestrogen levels fluctuate wildly, this can disrupt the normal communication between the brain and the ovaries, causing the pituitary gland (a small hormone-secreting gland located at the base of the brain) to release extra follicle stimulating hormone (FSH) to the ovaries. The result? Headache.  

There are also other factors which may or may not be related to menopause that can trigger headaches or migraines. Take, for instance, high blood pressure, lack of sleep, hot flashes or stress. External factors can also play a role, such as weather changes or weather-related triggers, skipping meals, allergies, poor posture (for example when working on a laptop), excessive alcohol consumption, smoking and mental problems. 

Hormonal changes can also trigger a variety of menopausal symptoms, such as hot flashes, sleep problems and mood swings. 

Many women suffer from hormone-related headaches. Some also had them before menopause, around the time of their periods. Unfortunately, headaches can become more frequent and severe during the menopausal transition. In fact, 60 to 70 percent of menopausal women suffer from headaches.  

The symptoms may vary in frequency and intensity and can make it difficult to work, relax or enjoy activities. Sometimes, headaches are accompanied by lightheadedness, neck pain or nausea.  

The headaches usually stop after you've reached menopause. However, some postmenopausal women continue to suffer from them. Although headaches are a common symptom of menopause, it is important to see a doctor if the pain persists or gets worse, to rule out any underlying conditions. 

The menopausal transition affects different women in different ways. This is also true when it comes to headache. Some women get hormone-related headaches for the first time around menopause, others experience more frequent and severe attacks. It is estimated than one in three women suffer from migraine attacks (in addition to other menopausal symptoms) in the years leading up to menopause. Women who suffered from migraines before menopause may find they are worse. Read more about migraine. 

There are three different types of headache: tension headache, migraine and cluster headache. Tension headache is the most common type of headache, which presents as a constant ache on both sides of the head. Migraine is a type of headache that involves severe, often pounding pain, usually to one side of the head. In addition to severe headache, migraines are often accompanied by nausea, vomiting and sensitivity to light and sound. The most distinctive characteristic of cluster headaches is that they come in clusters – usually short episodes, one or more times a day. They are marked by excruciating one-sided pain, typically concentrated around the eye and the temple. 

Menopause is a natural part of life and involves hormonal fluctuations. Fortunately, there are many ways to support your body during this time of transition in order to reduce or stop your headaches. 

• Keep a diary to identify headache causes. Track your headaches with a diary to identify triggers, such as stress or certain foods. Every time you have a headache, make notes in your diary. When did it come on? What kind of pain is it? What did you eat or drink before the headache? For example, drinking a lot of coffee can trigger headaches, just like alcohol or sweeteners. 
• A healthy, balanced diet is essential to keep your body healthy and pain free. To be healthy, you need to eat a variety of colourful fruits and vegetables. Eat a rainbow every day! You can't expect your body to perform at its best without the proper nutrients.  
• Support your health with supplements, such as magnesium, CoQ10 and omega 3. Multiple studies have suggested a relationship between magnesium deficiency and headaches. Omega-3 fatty acids are also important for brain health. Research has shown that CoQ10 usage reduces the frequency severity of migraine headache. 
• Keep your blood sugar stable. Fluctuating blood sugar levels can lead to headaches. Avoid sugary and carbohydrate-rich products. Keep your blood sugar levels consistent by eating every three to five hours, and eat fibre-rich foods, such as vegetables, fruits, whole grains and legumes. 
• Drink plenty of water. Insufficient fluid intake can cause headache. Drink at least two litres of water a day, beginning in the morning with a big glass of water.  
• Exercise regularly. Physical activity stimulates the production of endorphins. Endorphins are the body's natural painkillers and are involved in stress relief.  
• Make sure to get plenty of sleep and relaxation. Relaxation and breathing exercises can relieve headaches and associated neck pain. Going for walks in the open air or taking a hot bath can also help to clear your head and release tension.  
• Treat pain with hot or cold temperatures. Depending on what feels good, you can place a heat pad on your neck or a cold compress on your forehead to relieve pain. 
• Medication can provide relief. If necessary, you can use painkillers. Some types of HRT can also improve migraines and headaches.