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[BoingBoing]

Morning all

I have been on HRT for 12 months now having started zoladex. Zoladex stopped in February 2022 due to horrendous side affects. However, menopause symptoms continued after this so HRT was continued.

I’m on 2 pumps of Oestrogel and 12 days of utrogestan.

However, every time I’m due to ovulate I get horrendous migraines. Not sure if this is due to high or low Estrogen levels - so was wondering if anyone else experiences migraines around ovulation and what they do.

I take sumatriptan for the migraines when they are really bad.

This month on day 12 of cycle I got the worst migraine ever so decided to pause the oestrogel as I suspected Estrogen may be too high. Now on day 14 of cycle (still not oestrogel) and now on my third day of migraines.

Anyone else have issues with migraines at this time of the month and if so is it low or high Estrogen to blame?

[Mogster71]

Hi Boing Boing

Sorry to hear you are suffering with migraines at ovulation - I was getting them too, mainly at ovulation and on about day 2 of period. Oestrogen drops at both of these times. I was told mine were down to fluctuating levels of hormones, but for me they were helped by an increase in oestrogen, then a move onto a continuous regime, but I am quite late peri. The migraines were also 3 days and I have heard many ladies saying they have a 3-day headache!

If you have been on the same level for over a year it could be time for a review - was this your only symptom and is everything else in check?

Hope you feel better soon

[VanillaLover]

Hello, yes the oestrogen levels falls dramatically just before ovulation (google a graph of hormone levels) so this is well known for triggering migraines. There is then an increase in oestrogen after ovulation before a fall again at the end of the cycle which as PP said is a big culprit for hormonal migraines.

I found I used to be able to predict next correlate migraines to my cycle but now my cycles have gone nuts (seem to be either less than 21 days long or very long or miss altogether or even 28 days!) I can’t see much pattern any more. I suspect I am not ovulating much now (nearly 47)

I have not found HRT has made any difference to migraines (on cyclical HRT but still get bleeds according to my own cycle)

[Bandango42]

Hi

Yes, I've experienced migraines during ovulation for over 16 years. I also take sumatriptan for them. I've not found HRT to make any difference to them, but now I'm having anovulatory cycles due to being in peri, I don't get them anywhere near as much as I used to x

[VanillaLover]

Bandango42 - I’m hoping that they get less when my periods start to get further apart ……here’s hoping!

[Mary G]

What type of migraines do you get ie with or without aura and did you have migraines pre menopause?

For some women migraines are caused by falling oestrogen levels (menstrual migraines) and others (myself included) find they are caused by very unstable hormones in perimenopause.

Either way, it's best to avoid a cycle and to try and stabiliser your hormones as much as possible with a continuous combined regime.   Some women find they can override their cycle by using the contraceptive pill or alternatively with very high doses of oestrogen.

[BoingBoing]

I have never had migraines until I started HRT. Although I did suffer from headaches as a teenaged when I was in the combined pill.

I’m now 42 years of age and now on day 5 of migraines and I’m at my whits end as I genuinely can’t work out if it’s because of too much or too little oestrogen.

My Gp and gynaecologist are also at a loss.

I stopped zoladex in feb 2022 so theoretically my hormone levels should have returned to normal - but since Zoladex I’ve had migraines and neck, shoulder and back pain and sweats which is why HRT was restarted.

Due to the constant pains I’ve had multiple blood tests which show that My Plasma C reactive protein levels are  sky high.

Something ain’t right somewhere and my Plasma TSH levels are getting lower and lower.

I therefore wonder if the Zoladex has caused thyroid issues?

[Kathleen]

Hello BoingBoing and welcome to the forum.


I am not able to advise you but I did have daily headaches as one of my Meno symptoms before starting HRT. They resolved after six months and I rarely have headaches now. I realise that migraines are very different but it seems both can be hormonal.

I do know that CRP is a test for inflammation and if your levels are very high that would indicate that you have some inflammation somewhere that needs to be investigated. I am no expert but perhaps you have an auto immune condition that requires treatment.

I have hypothyroidism and I thought that a high TSH meant that the thyroid was struggling however I don't know the implications of having a low TSH level.

I don't know what Zoladex is but perhaps the patient information leaflet can tell you if it impacts with other drugs or medications.

I'm sorry that I can't be of more help but other ladies will be along soon to advise you.

Wishing you well.

K.

[VanillaLover]

Have you been taking triptans every day for the past few migraine days? I find I can get into a state where the migraines kind of cluster together and feed off themselves and the painkillers. If I go without ibuprofen for a few days and tough it out I can break the cycle. It’s grim though I know.

Alternatively it could be huge hormonal fluctuations setting them off …sorry I can’t be any more help

Best wishes

[BoingBoing]

Thanks for all your kind words and help.

I’ve only take one sumatriptan (day 1) for the migraines. I don’t like taking them as they make me feel awful, so only been taking naproxen since.

I think it’s hormonal as I also feel on edge and like crying all the time.

Not had this before with ovulation so confused as to why it’s happened this time.

I’ve had a topsy turvy time since zoladex. Even since stopping it I haven’t gone back to feeling normal - which is horrible!

I was hoping that after 12 months of being off of it that I would have returned to some sort of normal - in fact I regret even starting zoladex as I’m worse now than I was before it!

I can cope with most things but constant pain, headaches and feeling on edge alongside tiredness and insomnia it’s becoming a challenge!

[Mary G]

BoingBoing, why were you taking zoladex?   

From what you have said it sounds like you have hormonal migraine without aura which have suddenly become worse since you hit the menopause.

Migraines are very common during the menopause but I think you need to look at taking preventative medication as well as stabilising your hormones as much as possible.

I managed my migraines (aura without headache) with hormone manipulation for years but it suddenly stopped working when I was very, very post menopause and hit hormonal rock bottom.  My migraine specialist said more intervention was needed and suggested either amitriptyline or venlafaxine (thought to be the best migraine preventative medication) so I opted for the former, partly because I had already done my own research and already bought some!   

Both the above drugs are antidepressants when used at a higher dose but migraine and depression are closely linked and migraine aura is caused by cortical spreading depression.   Oestrogen and serotonin production are closely linked hence the need for a TCA.

I would add that amitriptyline is also used for pain management so it could be a good option for you.   

Have you had hormone blood tests?

[BoingBoing]

I had zoladex after my second operation to remove endometriosis - it was supposed to solve everything!

I have amitriptyline and find this just makes my headaches worse.

My last lot of bloods showed low TSH, low vitamin D, and high Plasma C.  GP didn’t see the point of doing hormones tests as they aren’t accurate (apparently).

Last time I had them done they were all normal.

My gynaecologist suggested I tried a continuous regime as when I do have a period they are horrendous (pain and clots) worse than before zoladex and HRT.

I’m tempted to stop the lot as at present I feel hormonally unstable, with frequent crying and feeling hopeless.

[Mary G]

BoingBoing, perhaps you need to try the contraceptive pill to override your cycle so that you don't ovulate.   This would effectively remove your menstrual cycle altogether and bring an end to the painful periods which make migraines even worse.   

If you still have migraines you might need both the pill and amitriptyline or something similar like venlafaxine.

How old are you and where are you in the menopause? 

[BoingBoing]

I’m 42 and was put into medically induced menopause but since stopping zoladex I should have returned to my normal cycle - this doesn’t appear to have happened.

I can’t really take the pill for several reasons:-
1) I have a history of blood clots so can’t take Estrogen by mouth
2) I have a progesterone intolerance so the pill affects my mood
3) can’t have the Mirina coil as this sent me mad/loopy when I had it

[Mary G]

BoingBoing, it sounds like you are going to need some specialist help on this.   Poppytoast mentioned Tibolone and that could be an option for you as you are only 42 so it might be worth a try.

Have you thought about having a private consultation with a menopause specialist, funds permitting of course?   Most will agree to a telephone appointment which avoids the need to travel.