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[FlowerPot]

Hi ladies, this is my first post and just to say that I've found it so helpful reading about everyone's experiences on here It's a wealth of expertise!

I'm 52 and peri-menopausal, still having fairly regular periods apart from the odd missed one.

I have menstrual migraines which have worsened with peri - they are without aura, just pain but severe enough to put me completely out of action for 2-3 days. In Dec I started having really bad heart palpitations and my migraines worsened further. By Jan, though my heart had calmed down, it got to the point  where nearly every day I either had a full migraine or one hovering. I was miserable and, to be honest, a bit desperate and for the first time considered HRT.

I read everything I could about it and booked an appt with a menopause specialist. She first suggested Mirena which I did not want and we finally decided to try Oestrogel at 1 pump per day and Utrogestan 1x100mg daily with the idea of suppressing my cycle to try to stop the migraines. I take the Utrogestan vaginally.
For the first month I had no migraines, a couple in the second month but this month I feel back to where I was in Jan and have had 8 migraines so far.

The problem is I have no idea whether they are caused by high oestrogen, low oestrogen or just the fluctuation between the two and I can't think of any way of finding that out as I guess an isolated blood test wouldn't really tell me anything.

Does anyone have any experience of HRT and migraines or can think of a way of determining the cause in terms of hormonal balance?

[VanillaLover]

Hi sorry to hear that you are struggling with migraines. That was me a year ago basically. It got to the point where I was having 10 a month. Never really recovering in between. I don’t have pain in general, more nausea/dizziness.

Firstly do you already take prophylactic medication for the migraines? Or triptans for the pain? If not then these are first things to consider. I cannot take any of the first line prophylactics due to other medication and my asthma.

I find that two ibuprofen and a prochlorperazine may abort it 8 times out of ten if I catch it quickly.

I also use a cefaly device which has reduced the frequency a little plus reduced how bad they are.

HOWEVER I started on cyclical HRT around the same time as the migraines got really bad. I had bad peri symptoms too and was suffering a lot of swings. I must say that the HRT made no difference to the migraines. Also I still got my own periods etc so lots of large hormone fluctuations still going on.


In the last four-six months things have calmed down a lot, boobs smaller again, lost a bit of bloating, drier everywhere. Feel more stable in myself. Migraines are now 4-5 a month. I have also swapped onto continuous which although not overriding my own cycle seems to be helping a little too.

In summary, no You can’t rely on HRT to help per se. However time and stabilisation of your hormones should help a lot.

Hope my story helps

Vanilla

[HelloSam666]

The first symptom i had of menopause was debilitating migraines. I started having migraines once a month in my 30s and was told these were hormonal. I took Sumatriptan and that helped enormously.

A year or so ago i started getting them most days and it was awful, they interfered with my daily life and i was guzzling Sumatriptan virtually every day which is not good. The GP prescribed Amitriptyline but they didn't help and i felt awful on them (10mg). What worked for me in the end was progesterone cream, it was a godsend. And i have probably had only a couple of migraines in the last few months.

[FlowerPot]

Thanks for your replies - it really helps to connect with others who have experienced the same.

Hi VanillaLover, conventional pain relief just doesn't touch it.. I take Sumatriptan which gives me a very welcome 4-5hrs relief from the pain but as my migraines last 2-3 days and I have to limit the tablets, it still leaves me with many hours of intense pain. I tried Propanolol as a prophylactic but it didn't help. I've tried acupuncture, straightened my teeth (to even out my bite), eye tests, supplements, Botox and regular massage therapy. While some have helped it's only ever been short-term - Magnesium was my best result with 13 migraine free weeks!

I started an extra half pump of gel a few days ago and was still getting the headaches and feeling generally crap so became despondent about the whole HRT thing which prompted me to post. However I had a completely headache free day yesterday, felt upbeat and back to my old self, and so far so good today - fingers crossed it lasts  Glad to hear things have calmed down for you.

Hi HelloSam666, I ordered some of this online after reading Dr Lara Briden's book but haven't used it as I ended up on the Utrogestan. Great to hear it's worked for you. If I decide to come off the HRT though I will definitely give it a try - how much do you use, is it daily?

[HelloSam666]

Hi Flowerpot,

ahh, i remember those days, waking up without a migraine after being bombarded with them - it felt like all my Christmas's had come at once. My sisters used to suffer badly from them too and was given Propanolol but it made her feel worse than ever. 

I use one pump of the progesterone cream at night. It was nothing short of a miracle for me and made me realise how impactful migraines had on my day to day life. Good luck and enjoy your migraine free day today :-D.

[VanillaLover]

Flowerpot, have you tried a Cefaly at all? I use mine everyday for prevention. Have a look at their website I think you can try it for a couple of months and them get the majority of your money back if it doesn’t work. It does depend on where your pain is etc. Might be worth a punt. I love mine but I know they don’t work for everyone.

They sound dreadful, really sorry you are going through this.

[Mary G]

Flowerpot, sorry to hear you are a fellow migraine sufferer.

I started having silent migraines (aura without headache) when I hit the menopause.  These are quite different to the menstrual, painful migraines without aura that you have but still debilitating and hormonal.

Have you thought about consulting a hormonal migraine specialist?  I think your migraines are caused by the sudden drop in oestrogen but a specialist might be able to help with hormone manipulation and also prescribe a preventative medication.

I'm 61, very post menopause and now on a stable, continuous combined HRT regime but I can no longer control my migraines with hormone manipulation alone and now take amitriptyline (an AD) and propranolol too.

The Cefaly sounds very interesting.

[FlowerPot]

The Cefaly does sound interesting - I've just had a quick look online but will definitely read up about it.

I saw a menopause specialist at a private hospital but I didn't know there was such a thing as a hormonal migraine specialist! I will certainly look into that 

[Mary G]

Yes, there are dedicated hormonal migraine specialists both on the NHS and privately.

I'm reading up on the Cefaly and trying to find out how it will stimulate the vagus nerve and inhibit cortical spreading depression (migraine aura). I know it works on stimulating the trigeminal nerve but I don't yet know how that would affect the vagus nerve.   

[VanillaLover]

I don’t normally get aura (maybe once or twice a year) - but I do get non aura ones approx once a week. If I do get pain it is definitely trigeminal based.

I was also getting a lot of non migraine headaches when I started using it and they did disappear.

From the bumpf it seems to imply that trigeminal nerve sensitivity is one trigger factor that may tip you into migraines (along with hormones, sleep, weather, going on holiday, stress etc) and if you can reduce that then it will reduce migraines frequency by lowering the threshold a little.

I use it every day in prevention mode and I do think there has been a modest reduction in frequency most of the time. Say 8 migraines a month to 6. I love it now and it’s a 20 minute ritual I couldn’t do without. Would I buy a new one if it broke though? I think I would see how things went first but wouldn’t rule it out.

[VanillaLover]

Mary - I think if you don’t get pain then I wouldn’t think cefaly will work for you no.

 Do you get symptoms like a stiff neck or runny nose as part of prodrome? They are trigeminal related in which case you may find it’s worth a try. I think a lot of people don’t find it effective which is why they offer the money back after the trial period.

[Mary G]

Thanks VanillaLover, I think you are right.   I'm pleased the Cefaly has made a difference for you and I think it could help FlowerPot and others who suffer with painful migraines but there is a question mark hanging over it for silent migraines.

I think I might send my migraine specialist an email and ask her if she thinks it will work on the vagus nerve.   

It sounds like a very promising product though.

[KazCham]

I’m 53, peri. I’ve had menstrual migraines for 26 years. They have pretty much stopped after starting continuous 100mg Utrogestan and 50 mg Evorel patch. I understand the patch should be used instead of gel for people with migraine. Appears to work. Maybe you could try this regime. I do however take propranolol as a preventative, last 15 years, but in my opinion it’s the HRT that’s helped the most. Good luck x

[FlowerPot]

Thanks KazCham that's very interesting and great to hear it's worked for you 

I have a GP appt tomorrow to review my HRT so will definitely ask about the patches.

[Madge79]

Hey Flowerpot sorry to hear about your migraines. I’m in a similar position only I have been on HRT for years

Basically I never had a migraine until I was pregnant; then they went away until HRT. I am a serial dose adjuster and I think I created myself so many fluctuations of estrogen that it triggered them.

Since March I have had a daily migraine or some low lingering symptoms at least. I tend to get neck pain, nausea, upset tummy, visual syntoms (not a full on aura just flickery visual snow type stuff and light sensitivity) and sometimes dizziness and head pain. I can’t tell when one migraine ends and the next begins!

I have decided stability of hormones is the key so I have decided to stick on the same dose of HRT for at least 3 months before I decide if it’s working or not.

If you decide to stick with HRT please be patient; you may feel worse before you get better and if you are sensitive like me it may take ages to settle. Don’t do a me 😩