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[Elizabethrose]

Hi Cherry Crumble

I've just read your post. I too have very frequent migraine with aura, brought on by perimenopause, and have for the past 14 years. I won't bore you with the detail here but read my first post if you'd like to read my history.

Over the years, many things have been attempted to try to manage/improve my migraine, and both Prof Anne MacGregor and Nick Panay tried to manipulate my hormones with HRT. Clearly HRT can be used by some women in this situation. I also have a family history of stroke with both of my parents.

Both were very well aware of my history and were trying to actually treat my migraine with HRT. Sadly, my body will not tolerate any hormonal manipulation thus the side effects were impossible to live with. All attempts seriously exacerbated my migraine in addition to lots of other unmanageable side effects. I was also never able to take the contraceptive pill and many were tried. My daughter is also unable to take the contraceptive pill because of her migraine with aura.

Both these specialists are London based and of course I don't know where you are. Is it possible for you to find a hormone specialist with an understanding of migraine to try to investigate this further?

Whilst I know that HRT is a life saver for many women, if I'm honest I would not try HRT again, it was disastrous for me. I am trying very hard to manage 'cold turkey' but I am inordinately lucky in that I've never been affected by mood changes.

I'm sorry, I'm away at the moment so I can't detail what was tried. Do ask though if you'd like any more detail.

I wish you well.

[Cherrycrumble]

Thanks Elizabethrose, think I need to see the doctor again, and push this.  I think her concerns are that I don't suffer with migraine usually, only when I take hormones (the pill) and when I was pregnant. She says it's a progesterone problem, and it seems to be synthetic and natural that both cause it. But surely I'm just bringing my levels back up again, so i wouldn't be having excessive amounts.  To be honest, I'm a bit confused with it all, not really sure what to do. I'm waiting for CBT to try to help me manage the anxiety side of it, so might see how I go with that. x

[Mary G]

Cherrycrumble, if you think it would help, you could cite my case to your GP.  I have to take HRT to avoid getting silent migraine (aura without headache) which is the complete opposite of what she is saying.  The only trigger in my case is synthetic progesterone in conjunction with very low levels of oestrogen.  Therefore I have to seriously limit my Utrogestan intake and keep my oestrogen levels high. 

It is extremely shortsighted to deny you HRT because you might then go on to develop other health problems that are caused by years of oestrogen deprivation.  You just need the right type of HRT at the right dose and don't take too much progesterone. 

If you don't get anywhere with the NHS and don't want wait months for an appointment with a menopause clinic/specialist then it might be an idea to consult Professor Studd.

[Cherrycrumble]

Thanks Mary G - have had a look online at Prof Studd and he's not too far from me, but am going to push the doctor first. Have got an appointment with her in 3 weeks. I don't think it's completely out of the question with her, so think I will push it and see what she says. 

[Hurdity]

Thanks Elizabethrose, think I need to see the doctor again, and push this.  I think her concerns are that I don't suffer with migraine usually, only when I take hormones (the pill) and when I was pregnant. She says it's a progesterone problem, and it seems to be synthetic and natural that both cause it. But surely I'm just bringing my levels back up again, so i wouldn't be having excessive amounts.  To be honest, I'm a bit confused with it all, not really sure what to do. I'm waiting for CBT to try to help me manage the anxiety side of it, so might see how I go with that. x

Hi again Cherrycrumble - I'm not sure what you mean here about bringing your levels up?

The point about progesterone intolerance is that it means different things to different women.

During the menstrual cycle we only have significant amounts of progesterone during the second half of our menstrual cycle which is probably at its peak at the end of the third and beginning of the 4th week of the cycle.  During the first part of the cycle ( from a couple of days into the bleed and for the next fortnight approx) prog levels are very low and negligible - but sufficient - as they also are in post-menopause.

Women who are intolerant of any kind of progesterone suffer side effects for almost all of the second half of the cycle ie pms for two weeks. These women may also suffer during pregnancy when prog levels are very high indeed although this may be attenuated to some extent due to the extremely high levels of oestrogen also circulating. Most women suffer some form of pmt due to progesterone withdrawal - headache (sometimes migraine), tension, irritability etc just before the period starts ie the last couple of days.

Some women are fine with their own prog, but only intolerant to synthetic progestogens, - such as in the Pill (very high doses) or HRT (not quite such high doses), or perhaps only to certain types of progestogen.

Some unfortunate women are very intolerant of both but this is quite rare - and these women benefit from specialist help and a tailored approach to their HRT regime.

If both synthetic and natural prog are causing you problems then you defo should be on the most natural possible ie utrogestan and push for the minimum prescription (fewer days per cycle eg 10 rather than 12 to see how you get on) and regular monitoring ie scan - on NHS.

Hope this helps

Hurdity x

[Cherrycrumble]

Hi Hurdity

I'm still confused with all this At the moment I actually feel at my best in the 2nd half of my cycle (if I have one). I feel best in the week before my period is due, and actually feel ok when my period starts. Then when my period finishes is when my anxiety and mood really plummet. What do you think this means? 

Definitely intolerant to synthetic progesterone, but dr also thinks intolerant to natural progesterone as I had migraines when I was pregnant too (but only with my daughter, no migraines when pregnant with son!) x

[Dandelion]

Had a doctors appointment yesterday and was hoping to try hrt, but the doctor doesn't think it's a good idea. Because I had awful migraines with aura when i tried the pill and also when pregnant, she said hrt would be a stroke risk. She was lovely and is arranging for me to have CBT to cope with the anxiety symptoms, but feeling completely gutted! Was hoping something would help me feel 'normal' again! 

I was getting auras as a side effect of the trazodone I was on, I still get them from tiem to time. I got refused patches cos of this but i got doctor currie to write me an email saying  patches are better for women with aura migraines, and only one doctor out of three read the email and agreed to the patches for me. It cost me £25 to email Dr Currie but it was worth it, cos I dunno if I would even be alive now if it was not for those little patches that have worked their magic.
I need a massive dose though 1000mcg and I am not even post meno yet.
This may be a good next step to take.
I was taking hrt pills but due to meno induced IBS I was not absorbinh them so even the 2mg femosoton didnt work at all, not one bit.
Good old Doctor Currie, got me to get doctors here to issue my patches and Ive been a lot better since. No more wet bras. I didnt even have seven bras to change daily.

[Hurdity]

Hi Hurdity

I'm still confused with all this At the moment I actually feel at my best in the 2nd half of my cycle (if I have one). I feel best in the week before my period is due, and actually feel ok when my period starts. Then when my period finishes is when my anxiety and mood really plummet. What do you think this means? 

Definitely intolerant to synthetic progesterone, but dr also thinks intolerant to natural progesterone as I had migraines when I was pregnant too (but only with my daughter, no migraines when pregnant with son!) x

Cherrycrumble - I have absolutely no idea!!!!! The only thing I can say is that during peri-menopause when hormones are fluctuating madly - then the cycle perhaps is no longer typical so it's anybody's guess how you will feel. If you were intolerant to your own progesterone you would have felt bad during the second half of your cycle throughout your fertile life - but of course during pregnancy levels of both oestrogen and progesterone are extremely high. Sorry I can't be of more help.

Hurdity x