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[Selina]

Hi everyone. I was prescribed HRT on Monday this week. Was very excited! Took my first dose of Oestrogel on Tues morning. Floored by major migraine on Weds!! I have been plagued by migraines all my life so this was always a possibility but has anyone any one else had this? What did you do?? Have contacted GP for advice but would like to be armed! TIAx

[Mary G]

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

You say you have had migraines for years, are they with or without aura/pain?   Do you know if they are menstrual type migraines?   This would make a difference.

Unfortunately it's not at all surprising that you would get a migraine from starting the Oestrogel because you have introduced a hormonal change.   It depends on what happens once your body has got used to having oestrogen again and whether your migraines are hormonal and which hormone triggers them.   What type of progesterone will you be taking?

If you have migraines, it's best to use transdermal HRT and to avoid a cycle.

[Selina]

Thanks so much for taking the time to reply Mary. I really appreciate it.

I don’t have aura migraine but I have pain and vomit a lot (nice I know!) and yes, migraines are hormonal and also stress related for me. I was prescribed the gel and utrogestan as my progesterone. Did you mean to suggest taking this every day rather than for 2 weeks a month? I raise it with the GP and suggest trying one pump not two to start with.

Was hoping for a miracle…seems it’s not to be!! 😔

[Mary G]

Selina, I have migraine aura without headache which are caused by low oestrogen, high progesterone, a cycle and hormone instability which in turn causes low levels of serotonin.

As far as I know, menstrual migraines are caused by the drop in oestrogen and rise in progesterone just before a period but it's far from simple unfortunately.

For all types of hormonal migraine, it's best to have a stable delivery of hormones and to avoid a cycle so it would be better to have a continuous combined regime.   If you are going to use Utrogestan every day (vaginally is better) I would use two pumps of gel otherwise you might drown out the oestrogen with the progesterone and will not get symptom relief.   You might want to consider a Mirena coil for the progesterone component as long as you don't have a history of PMS and progesterone intolerance.

I'm afraid it's far from easy and quite a challenge to find the right HRT regime if you have migraines.

Have you ever tried migraine preventative medication?   I'm taking amitriptyline (an AD) and it's really helped so it might be worth speaking to the doctor about that.

I hope that helps.