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[lilian]

I am 50, in peri, suffered enough for the past 5 years with too many symptoms, dizzy, out of balance nauseous, panicky anxiety, can not deal with any stress. went to see neuro  and ENT said it is
vestibular migraine  but I do not have head pain, but do sometime see a star and  also during mid cycle and when period due , when close my eyes I feel some bright lines shaking and jumping it  disappear a few minutes later, also this happens sometime when look at
some patterns on the carpet. so I assume this is migraine with aura.   now because of this
my doc are reluctant to prescribe  HRT, and Birth control pills is a no no .

I am desperately need to get better,  my period is irregular now .   what to do now?should I try estrogen or not ,  will it make things better or worse .

[Nicodemus]

Migraine doesn't always have head pain associated. Some get aura and no head pain. I get pain without aura but the stuff you're seeing sounds like aura to me based on what others have described.

Doctors won't prescribe the combined pill if you have migraine but they can prescribe a progestogen only pill (POP).
They should also be able to prescribe HRT as it is not contraindicated for migraine.  You can take HRT and the POP together. I do this and I have had hormonal migraines for many years.

It might be worth seeing a different GP. The migraines on their own should not be a barrier to getting HRT.  I hope you get to see a more clued up GP, sadly it seems some of them aren't.

Can't really say whether HRT will make things better or worse, you normally try it for at least 3 months. It leaves your system pretty quickly though so if you can't tolerate it and have to stop it shouldn't be long before it wears off. I've not been on it long myself but I feel better on it than before and my migraines haven't worsened.

[Dandelion]

I am 50, in peri, suffered enough for the past 5 years with too many symptoms, dizzy, out of balance nauseous, panicky anxiety, can not deal with any stress. went to see neuro  and ENT said it is
vestibular migraine  but I do not have head pain, but do sometime see a star and  also during mid cycle and when period due , when close my eyes I feel some bright lines shaking and jumping it  disappear a few minutes later, also this happens sometime when look at
some patterns on the carpet. so I assume this is migraine with aura.   now because of this
my doc are reluctant to prescribe  HRT, and Birth control pills is a no no .

I am desperately need to get better,  my period is irregular now .   what to do now?should I try estrogen or not ,  will it make things better or worse .

When on trazodone, years ago, and once, last week, I would get a tiny bright point of light in my vision, one eye, this would grow to a "C" shape, with black and silver triangles like this sort of thing - weird a bit like some of the pictures, almost psychedelic https://www.google.com/search?q=visual+migraine&tbm=isch&ved=2ahUKEwjM-syN-4D5AhUSTRoKHUCdBjMQ2-cCegQIABAA&oq=visual+migraine&gs_lcp=CgNpbWcQAzIECAAQQzIICAAQgAQQsQMyBQgAEIAEMgUIABCABDIFCAAQgAQyBQgAEIAEMgUIABCABDIFCAAQgAQyBQgAEIAEMgUIABCABDoHCAAQsQMQQzoICAAQsQMQgwE6BAgAEANQmAtYtSlg3CtoAHAAeACAAT-IAf4GkgECMTaYAQCgAQGqAQtnd3Mtd2l6LWltZ8ABAQ&sclient=img&ei=xIvUYsyIL5KaacC6mpgD&bih=567&biw=1152&safe=images&hl=en
No head pain, not meno as it went when I went off the trazodone, except for one last week, I guess must be stress, as that has given me the runs since xmas.

They are weird.
I am sorry you have had other horrible symptoms, I never realised how bad meno was for some women till I got it, horrible anxiety and depression, insomnia, sweats, burn-ups from boobs up.

I really do not know why Doctors are on willing to prescribe HRT, maybe migraine is contraindicated but that is just a guess. I know they do not like to prescribe it with high blood pressure.
I think I didn't tell them about migraines, but last week is the first one I had since stopping the trazodone in 2015.
I am no medic, so I don't know what to suggest.
Maybe ask about plant based photo oestrogens, but from what I can gather, rightly or wrongly, I think most women say only hrt works, sorry I am not much help.
You could try looking on the alternative therapies thread on here https://www.menopausematters.co.uk/forum/index.php/board,17.0.html

[Pippa52]

I am 50, in peri, suffered enough for the past 5 years with too many symptoms, dizzy, out of balance nauseous, panicky anxiety, can not deal with any stress. went to see neuro  and ENT said it is
vestibular migraine  but I do not have head pain, but do sometime see a star and  also during mid cycle and when period due , when close my eyes I feel some bright lines shaking and jumping it  disappear a few minutes later, also this happens sometime when look at
some patterns on the carpet. so I assume this is migraine with aura.   now because of this
my doc are reluctant to prescribe  HRT, and Birth control pills is a no no .

I am desperately need to get better,  my period is irregular now .   what to do now?should I try estrogen or not ,  will it make things better or worse .

Hi lilian, I have vestibular migraines and ordinary migraines with or without aura and have been on HRT for over 20 years.  The type of HRT really makes a difference.  I found on patches it made them much much worse in fact I even got something I now know to be a pixalated migraine which was very scary at the time just like then they block someones face out on the TV but on the gel or the spray (which I am on now) many many less migraines.  The spray particularly seems to suit me as it is apparently a lower strength of oestrogen and I did find the higher the dose of oestrogen I took the more migraines I had.  Certainly no way would I want to not be on HRT but I was told with careful management it was ok for me to have it but to only take it transdermally.   xx

[VanillaLover]

Helllo,

Yes I have migraine without aura and with none or only moderate head pain (ie can carry on normally just about). My main symptoms are nausea and dizziness, as you say. I am 46 and my migraines have been getting more and more problematic over the years. Eventually got to the stage that I couldn’t drive due to the dizziness.

I take HRT at a medium dose, it hasn’t made them any worse or any better. Like you I only get them at specific times of the month. You will need to take transdermally as PP has said. So not tablets but spray, patch, gel etc.

I am hoping that when my periods stop altogether they will stop!

Are you on any medication for the migraines ? Do you take rescue medication or preventatives? I take Ibuprofen and prochlorperazine when one starts. I don’t take a preventative but I do use a Cefaly device daily which has halved the number of migraines I get. They don’t work for everyone (but then that’s the same for migraine drugs too).

VL

[VanillaLover]

I should say I also had trouble getting HRT prescribed from GP because of migraines, eventually they spoke to the menopause clinic and asked them and were told there was no additional risk from transdermal.

[Nicodemus]

I take Ibuprofen and prochlorperazine when one starts.

Do you find the prochlorperazine effective VL? I am now at the point where none of the relievers or preventers I've tried works so am on the lookout for new things to try.

[VanillaLover]

Yes I do, my main first symptoms are nausea and dizziness so the prochlorperazine tackles that. I believe it can also be used as a stand alone rescue treatment as it quite slowly down other areas of the brain, not just the nausea centre

[VanillaLover]

Sorry I mean quietens  down areas of the brain

[Mary G]

lilian, I'm sorry to hear about your migraines, I'm a fellow sufferer so I know how debilitating they are.  From what you have said, it sounds like a silent migraine.

HRT is very definitely NOT contraindicated for women with migraines (with or without aura) in fact in many cases it can help as long as you use transdermal oestrogen.

As others have said, it is better to avoid a high dose of oestrogen because it could make the migraines worse.   Getting the dose right is very difficult but migraine specialists always recommend a low dose continuous combined regime and to avoid a cycle.   

During my last follow up appointment with the migraine clinic, the doctor was talking about the important role of testosterone and how it prevents cortical spreading depression which is thought to be the cause of migraine auras. 

Pippa, it's interesting that patches made your migraines worse.  Was it because they were not sticking properly and giving you an uneven dose?   What type of progesterone do you use?  I tried Lenzetto and found it very user friendly but it made my symptoms worse so I went back to the gel.

Vanillalover, I now take propranolol 3 x daily which is not a great preventative but it has stopped the postdrome.   Apparently low dose amiltyptaline is good for preventing migraine with or without aura.  It sounds like you have menstrual migraines which are often treated with continuous hormones and usually stop at menopause.
 Unfortunately silent migraines are often for life.

[VanillaLover]

That’s interesting Mary. Unfortunately I can’t take a lot of the usual preventatives as I have asthma and already take an antidepressant. For me Cefaly is a game changer but even using that I’ve been terrible the last couple of weeks with the heat. So hot weather is another trigger I’ve found. Or rather, makes migraines much more likely if that coincides with ovulation or before period.

 I am pretty sure my migraines will stop or very much lessen when my cycle stops. She says, fingers cossed etc.

I do take utrogestan on a cyclical regime but it doesn’t control my cycle in any way so I don’t think it’s affecting my migraines much not taking it continuously.

I have also found that stopping alcohol, only one cup of caffeine per day, avoiding stress, very strict consistent bedtime and alarm clock time have all helped a little.

[VanillaLover]

I should add that as well as the usual migraines I also get aura migraines very infrequently (like once a year!) I have no idea what sets them off. I imagine I will still get those after menopause but luckily they are not a great problem to me.

[lilian]

thank you every one for you support

[Pippa52]

lilian, I'm sorry to hear about your migraines, I'm a fellow sufferer so I know how debilitating they are.  From what you have said, it sounds like a silent migraine.

HRT is very definitely NOT contraindicated for women with migraines (with or without aura) in fact in many cases it can help as long as you use transdermal oestrogen.

As others have said, it is better to avoid a high dose of oestrogen because it could make the migraines worse.   Getting the dose right is very difficult but migraine specialists always recommend a low dose continuous combined regime and to avoid a cycle.   

During my last follow up appointment with the migraine clinic, the doctor was talking about the important role of testosterone and how it prevents cortical spreading depression which is thought to be the cause of migraine auras. 

Pippa, it's interesting that patches made your migraines worse.  Was it because they were not sticking properly and giving you an uneven dose?   What type of progesterone do you use?  I tried Lenzetto and found it very user friendly but it made my symptoms worse so I went back to the gel.

Vanillalover, I now take propranolol 3 x daily which is not a great preventative but it has stopped the postdrome.   Apparently low dose amiltyptaline is good for preventing migraine with or without aura.  It sounds like you have menstrual migraines which are often treated with continuous hormones and usually stop at menopause.
 Unfortunately silent migraines are often for life.

Mary G many apologies for not replying sooner I missed your post.  I don't know why patches affected  me so badly its strange they seemed to give me a real whack of oestrogen the next day after putting them on and caused me really severe migraines and the final straw was I re-acted badly to the adhesive with big red weals and hives under where the patches were but I am now back on Lenzetto and slowly improving - have just been put up to 3 sprays so need to adjust to the new dose but definitely am beginning to feel a bit better albeit it vey slowly xx

[Mary G]

Pippa52, thanks, that is interesting and having looked back at my migraine diary, I too find gel provides a more stable dose of oestrogen.
I had problems getting the patches to stick and I think I was getting a very uneven dose.

My migraine specialist said that although balanced hormones can help to prevent migraine auras, it is not always enough and as you get older, additional preventative medication is often needed.   

I have just started taking 10mg amiltyptaline at night and so far so good.   It's a very low dose with minimal side effects (actually none so far!) and seems to have great reviews for treating migraines and IBS-D.   For depression and anxiety a much higher dose is needed.

I'll let you know how I get on.