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[Birrdie]

Hello everyone, I'm new here and hoping I can tap into your expertise to get some help with what direction to take with my care.  I'm 48, migraine sufferer since childhood (aura migraines). In my forties my migraines have gone crazy - vestibular, abdominal, some aura ones, lots of non-aura, neck migraines, all manner of long crazy prodromes, postdromes. Prolonged intense migraines lasting 4 days up to 2 weeks. It's a misery!   Other peri issues quite mild, periods regular, had a couple of mild hot flushes last week, insomnia, joint pain, dry hair etc.  Nothing unmanageable apart from these migraines.
Impossible to get any care via NHS practice, they're understaffed and the online service is never on etc (same story everywhere, I know). I've had one phone call with the nurse practitioner who recommended HRT but can't treat me because of my family history of breast cancer.  So she would need to refer me to a menopause specialist and we all know what the waiting lists are like for any NHS services so it will be months and months. I can't go on having migraines at this crazy rate, it's so debilitating so I'm going to have to go private for my care. Arrgh how do I decide who is going to be the right specialist for migraine as the top issue?  I've done lots of research and it seems like it's a minefield getting the right HRT and the right dose and a very glacial process making changes to an already unstable brain chemistry.   Any advice?  Has anyone used a private menopause specialist who was experienced with migraine management?  Do you have to continue with their services or can you get prescriptions via NHS - and/or return to your local GP for care?  Just thinking about dwindling finances here.  Thanks all! 

[VanillaLover]

Hi, what do you take for the migraines at the moment? If you’ve exhausted GP options they should refer you to a neurologist. I have suffered terribly with migraines this past year. I have to say that taking HRT (mainly for other reasons) has made no difference to the migraines per se though.

[Birrdie]

Hi, what do you take for the migraines at the moment? If you’ve exhausted GP options they should refer you to a neurologist. I have suffered terribly with migraines this past year. I have to say that taking HRT (mainly for other reasons) has made no difference to the migraines per se though.

Did your migraines get worse in your peri before you took HRT? I'm on the waiting list for National Migraine Centre (self-referral) due to little support from GP (who recommends triptans (which I can't take) or combined pill...and given that I'm an aura migraine sufferer etc that's totally unsuitable). There's not much else the NHS is offering for me and I've never been referred to a neurologist.

[Mary G]

Fellow aura migraine sufferer here.  Mine are silent migraines ie 30 minutes of scintillating scotoma (visual disturbance) but no ensuing headache.

You might want to read some of my previous posts on here but to summarise, they started 18 years ago when I hit the menopause, subsided for a number of years with hormone manipulation via HRT but suddenly ramped up over the past year.   

My migraine specialist (who I am not allowed to name on here) said it was time to introduce preventative medication so she prescribed amitriptyline which has been a real game changer.   It's an antidepressant but at a lower dose (40mg) it is extremely effective as a migraine preventative - it also helps IBS-D.   I also take 3 x propranolol 40mg every day which eradicates the postdrome.

Your migraines sound very debilitating so I think you would benefit with a consultation with a hormonal migraine specialist.  I will send you a personal message with the details of my specialist but (I think) that can only be once you have posted 10 times!

You don't necessarily have to rule out HRT but again, it's worth taking some expert advice on that.   GPs are not really specialised enough to deal with the complexities of hormones/migraines.

I hope that helps.