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[Megamind]

Yours sound very similar to mine Hurdity. Mine are mostly on the right side but do sometimes get them on the left but more around and over my eye. I would say they started getting worse about six months ago. I noticed the pattern that it was on the lead up to a period and the headache will last 3-4 days then two months ago, I got the headache AFTER my period and it lasted a good 5 days. For me, ibupofren and paracetomol don't always have an effect but I still take them and it eases slightly. I don't particularly get numbness in my cheek or side of my face but it feels like numbness but if I touch it,  I haven't lost feeling. I also get tingling in my face. I get a lot of eye pain and sometimes very painful earache but the earache is only ever in my left side. Also pain in back of neck, side of skull and scalp painful to touch.

I'm not on HRT but after discussing peri with a friend, she got diagnosed with peri after going to the Dr after suddenly starting with migraines and then she was told she couldn't have HRT because of her migraines?

[Hurdity]

Poor you Megamind - they are horrible aren't they? Not sure why you would get them after a period though - but this can only be answered if you knew what your hormones were doing at that point  oestrogen should be rising and progesterone at its lowest - but in peri-menopause the pattern can vary due to anovulatory cycles). Migraines are not a contra-indication to HRT though. This is what it say on this website:

https://www.menopausematters.co.uk/atoz.php#GlossM

Migraine
Migraine is often triggered by hormonal fluctuations and therefore may occur around the time of a period. Such migraine may improve at the time of the menopause. Some women find that migraine may be triggered by the daily hormone fluctuations which can occur with oral (tablet) HRT so the transdermal (patch or gel) route is usually preferred with a history of migraine.

Can't say it any plainer than that. I mean also I started HRT without even knowing I suffered from migraines. I think the contra-indication is advised for those who wish to take the combined contraceptive pill because the oestrogens used in these are the very strong synthetic type, and as far as I understand this is confined only to migraines with aura.

As you can see from the info above, if the migraines are hormonal, they may well be lessened as a result of HRT - but on the other hand they may worsen - depending on the dose/delivery method (as I found - when the progesterone withdrawal would still give me a monthly migraine - although it doesn't now!).

Hurdity x

[Elizabethrose]

I'm sorry Megamind, they certainly seem to be setting in now for you. I'd definitely say mine increased in frequency and intensity the further into peri I moved. I'm afraid that the hormonal movement up or downwards is enough to trigger them which seems to be what you are now experiencing.

The facial numbness and tingling is a common aura symptom. When I got that particular aura it was always a warning to me that I had a monster on the way so I would hunker down. Such a pain!

Have you discussed the migs with your docs? Maybe if they are happening on a regular basis it's time to request some specific migraine meds. Profs Anne MacGregor and Peter Goadsby dictate that Frovatriptan works particularly well with hormone related migraine, which are prone to rebound, as it has a long half life. I combine that with Diclofenac suppositories (or tabs when out and about!). If you can abort the things early it does go some way to prevent rebound.

I have never had any side effects with Frovatriptan, though I have with some other Triptans none of which worked for me. You are restricted in how many med days you can have a month and they are contraindicated for some conditions but maybe they are worth a try. Have a chat with your doc. Take in a diary showing when the migraines are occurring in relation to your cycle and suggest Frovatriptan and Diclofenac.

I took part in a trial of using Frovatriptan as a prophylactic in the 6 days running up to a bleed. There was some success but sadly not for me. Have a read of this.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039425/

HRT is not contraindicated for migraine, these profs use it frequently to try to manage migraine, it just doesn't work for everyone, certainly not me!

Good luck Megamind, I can't remember where you are in peri but don't let them build too much before you take action, it's horrible to regularly lose a slice of your life!! xx

[Megamind]

Thanks for the advice Elizabethrose. I think we have disccussed before that my teenage daughter gets bad headaches before her period so I think I'll make an appt for both of us with the GP.

I'm not sure where I am in peri...still having monthly periods but they started coming closer together, got heavier and more painful whereas I never really had painful periods. Now they are getting a little further apart and not always as heavy and only last a few days.

[Elizabethrose]

Classic peri signals then Megamind!

I know it sounds like my mantra but if you don't already, chart! All of the specialists demand it as it helps them identify why, when and how you're reacting. It's then much easier to tailor make meds/a solution to suit you. Also easier to convince GPs to take you seriously if the evidence is laid out in front of them. Our daughters' hormonal experiences seem similar, I remember we talked about it before re the period pains. Poor darlings they've got all of this to come. Hopefully by then menopause will be better understood, taken seriously and solutions will have been found to help those struggling. x

[Megamind]

Up to now I have just been marking when I have the headache on my period app and I do see the pattern. I realised I said to Hurdity that two months ago I had a migraine 'after' my period but checking my app, it was actually during my period rather than the norm which is before it.

[Elizabethrose]

Anything -2 +3 is pure menstrual migraine if you don't get them at any other time. A day or two extra is not unusual either. These are tricky migraines to treat as they rebound so easily, much more so than other types.

[Hurdity]

Thanks for the advice Elizabethrose. I think we have disccussed before that my teenage daughter gets bad headaches before her period so I think I'll make an appt for both of us with the GP.

I'm not sure where I am in peri...still having monthly periods but they started coming closer together, got heavier and more painful whereas I never really had painful periods. Now they are getting a little further apart and not always as heavy and only last a few days.

Sounds like the standard (average) pattern of the late reproductive stage according to the STRAW criteria - for reproductive ageing. For the majority of women cycles begin to shorten in this late stage when you are still ovulating regularly, and the following stage as peri-menopause begins - is that they get longer and increasingly erratic as your ovaries begin to function less well and begin to fail.

If you can cope with your headaches with normal painkillers and as they are the classic type ( ie without aura) and are pre-menstrual like mine, then I'm not sure you need to see a doctor about them - only if normal painkillers do not work I presume (or if you need to get a diagnosis?)? I never did - except about a year ago ( about 15 years after I started getting them) when the doc said they were migraines! With me, normal painkillers do mostly work, although sometimes one of the nights of the 2/3 these headaches usually last - they don't - so I have a disturbed night - but have managed to cope so far. As your cycle weakens and the interval becomes longer, then hopefully they should become less frequent. Annoyingly in my case what were hormonal migraines became a general propensity to get them from all sorts of different reasons, as I mentioned earlier in this thread.

Hurdity x

[Elizabethrose]

Am I right in remembering that you felt you were having symptoms of aura Megamind, seem to remember from our previous discussions re silent migraine? If so note those down too to show the doc. The more info the better. If the OTC meds aren't working for you i.e. removing the headache completely, then the doc should be able to prescribe proper migraine meds which should remove pain completely.

Good luck xx

[Lizab]

Maybe you all can help me. My headaches have been increasing in frequency also. Thinking back, I remember keeping ibuprofen in my desk at work in my 20s and using it often, but those were simple headaches which may or may not have been related to my cycle. Later, when I had Mirena I developed terriflying ocular migraines without any significant pain. I could always tell one was coming on if other cars' headlights had a funny look to them. Upon removal of the Mirena, the headaches disappeared for several years. Then, when I was still cycling, I began to get these 3 day headaches which would have been mid to late cycle. At that point my cycle was short so while they definitely weren't the day or two before my period they must have been after ovulation. Now with no cycle, I'm getting migraines any time, sometimes with flicker lights or visual problem aura, always with a prodrome uneasy feeling, and often with a postdrome hungover feeling. The actual headache responds well to ibuprofen, but as Hurdity described, returns after the med wears off. I usually get by with only taking a small 200mg of ibuprofen at the beginning of the pain, then once or twice more over the course of the 3 days. I consider this very manageable, but the prodromal and postdromal stages and lately the auras really bother me. I've never discussed with my doctor since the ibuprofen covers the ache. Do you all know if there is anything to be done for the pro- and postdrome and auras? The only thing HRT seemed to do for it was possibly made it more cyclical but more intense.

[Megamind]

Yes i do seem to get aura. I also just read on another thread about the blurry vision and glasses not working as well. I've had that as well. For me, ibupofren or paracetomol don't seem to work. I think I've said before I used to assume they were sinus headaches so I always siff my olbas oil. That doesn't seem to be working as well now either.

[Elizabethrose]

I thought so Megamind, not completely losing my marbles!

Yep the visual disturbance as in blurriness is also a common aura symptom that can be tricky as if it starts when you're out, you can't get home and have to wait it out, like the visual aura. Two of my specialists commented that migraine are very commonly incorrectly diagnosed as sinus headaches. The trigeminal nerve is involved in the migraine process often resulting in earache, sinus pain, jaw ache, tooth ache along with the headache and pain in the eye sockets. As if you haven't enough to contend with!

You don't need to put up with all this: as I remember your GP is open minded and willing to listen to you. Have a chat with them, you have nothing to lose. They may say that the triptans should be prescribed after other meds have been tried first but explain that the Frovatriptan and diclofenac are well considered for pure menstrual migraine and take the paper in that I posted if nec to show them. (Do read it, it's not just about Frova being used as a prophylactic which isn't appropriate here). x

Actually just to remind you, the triptans can't be used if you suffer with certain conditions but your doc will have your medical history x

[Elizabethrose]

Lizab I know we've spoken before but I can't remember how far post meno you are. Are you still feeling your hormones fluctuating?

Whilst the ibuprofen is helping reduce the headache pain, the aura prodrome and postdrome is very much part of the migraine and may only respond to migraine meds. It may be that a specifically designed migraine med like a triptan will abort the thing completely. However, triptans can only be taken at the start of the headache not in the aura or prodrome phase, those stages have to be managed. I don't think triptans can therefore be used to treat silent migraine (all the stages except the headache).

I think you're in the US is that right? If you are able to take aspirin, have you tried an effervescent dissolvable one, or taking aspirin with a fizzy GLUCOSE drink? Anne MacGregor a UK prof suggests this as a first point of call. You could try taking the aspirin at the first sign of aura or prodrome. My mother experienced silent migraine post meno for a couple of years and used to take something called Asproclear which was a dissolvable effervescent aspirin which was absorbed quickly straight from the stomach. It worked for her every time. Obviously, you will know whether you are able to take aspirin, some people can't.

Might I suggest you PM Mary G. She is a lovely lady who suffered terribly with silent migraine, she may be able to offer some hot tips to you. I know she'd be delighted to help.

There are drugs used as migraine prophylactics so you'd take them constantly but most have side effects which you'd have to weigh up against the symptoms of aura and prodrome you're experiencing.

I'm afraid HRT only exacerbated the migraines for me too, they became a virtual constant. It was nightmarish to try to manage it.

Have a read through the linked threads that I posted on my response to LesleyA. You may get some hot tips there too. x

[Lizab]

Thank you Elizabethrose, I'll have a look at those. I do think I'm still fluctuating but have no idea where I am. My last natural period after months of nothing was a month before I started hrt. I've now been off the hrt four months and no period yet, but that's not to say one couldn't show. Can you believe I am 40 years old and have never tried aspirin? I remember having baby chewable aspirin as a child until doctors advised against giving aspirin to children. I remember liking the taste! I do keep aspirin on hand for my dog so I'll give it a try.

I was always sympathetic to my friends with migraines and so thankful I didn't have them. Little did I know my "regular" sinus headaches would morph into full migraines. I'm on day 3 now of what started out as pressure center of my forehead and behind both eyes. I was even sneezing! Perhaps the sinuses kicked it off before it migrated to the right side to settle in a for a few days. Who knows?

[Elizabethrose]

Lizab, if you're trying the aspirin do take it with a fizzy glucose drink, it apparently aids the drug's absorption in the stomach. In migraine the gut is usually in stasis which prevents absorption of meds (and everything else) thus the nausea.

Too many sinus headaches are actually migraine. That's exactly how mine started out and was only recognised when I saw a wonderful GP whose mother had suffered in exactly the same way as me with pure menstrual migraine.

I too haven't taken aspirin since a child. I seem to remember that Prof MacGregor advised Mary G to take daily aspirin as a prophylactic but I may be wrong. Do PM her, she is always really delighted to help.

Good luck, hope you find a solution x