Women going through perimenopause are at higher risk for frequent, severe headaches. Here’s why—and how to find relief.
Women going through perimenopause are at higher risk for frequent, severe headaches. Here’s why—and how to find relief.
Hormones causing headaches? For many women, this unfortunately might be a familiar phenomenon.
Menstrual-related headaches often happen right after ovulation when estrogen levels drop. During perimenopause, when estrogen levels are declining, headaches are common, too.
So, what are perimenopause headaches and how do they differ from other headaches? How can you find relief? Here’s what you need to know.
What is a perimenopause headache?
A perimenopause headache is a headache that occurs as you’re going through the menopausal transition. During perimenopause, estrogen levels start to drop, and as estrogen declines, headaches can arise.
Estrogen does much more than just regulate the reproductive system. There are a few different reasons why drops in estrogen can cause perimenopause headaches:
- Neurotransmitter regulation: Neurotransmitters are the chemical messengers that transmit signals between nerve cells. They include serotonin, a neurotransmitter associated with mood and pain perception. When estrogen levels fluctuate, they can influence neurotransmitter activity, disrupting the balance of neurotransmitters like serotonin and leading to headaches.
- Vasodilation and vasoconstriction: Estrogen impacts blood vessels by influencing their ability to dilate and constrict. When estrogen levels decline, this can lead to fluctuations in blood vessel size, affecting blood flow to the brain and potentially triggering headaches.
- Hormone changes: Migraines are closely linked to hormonal changes. When estrogen decreases during perimenopause, the hormonal imbalance can trigger a migraine.
What does a perimenopause headache feel like?
A perimenopause headache is often described as similar to migraines or tension headaches. Some women report a throbbing, pulsating sensation, while others might feel a persistent, dull ache.
Other symptoms of perimenopause headaches include:
- Nausea
- Sensitivity to light (photophobia)
- Sensitivity to sound (phonophobia)
- Aura
- Changes in vision
- Irritability and mood changes
- Fatigue
- Difficulty concentrating
The intensity and unpredictability of perimenopausal headaches can have a significant impact on daily life. Women may find themselves navigating work, family responsibilities, and social activities while contending with the discomfort and potential debilitation caused by these headaches.
How long do perimenopause headaches last?
Perimenopausal headaches vary in frequency and duration, sometimes even between one headache to the next. Some women may experience occasional headaches, while others may find themselves dealing with them more regularly. The duration of perimenopausal headaches can range from a few hours to several days.
Headaches triggered specifically from the hormonal fluctuations of perimenopause often subside once you’ve reached menopause. Studies have shown that perimenopausal women are particularly susceptible to high frequency headaches—compared to postmenopausal women, who are much less susceptible.
Perimenopause headache relief
Perimenopause headache relief involves addressing both the underlying hormonal changes and specific triggers contributing to headache episodes.
Hormone therapy
Because perimenopausal headaches are often triggered by decline in estrogen levels, hormone therapy can help with hormonal balance. Estrogen replacement can help stabilize hormonal levels and reduce the frequency and severity of headaches. However, the decision to pursue hormone therapy should be made in consultation with a healthcare professional, weighing potential benefits against associated risks.
Pain management medications
Over-the-counter pain medication like Tylonel or Ibuprofen can help with temporary relief from headaches. For more severe headaches, prescription medications may be recommended. It's important to use these medications as directed and under the guidance of a healthcare provider.
Diet changes
Specific foods or additives, like caffeine, chocolate, or processed foods can trigger headaches. Keeping a food diary and avoiding potential triggers can help you identify what might trigger you and guide diet adjustments.
Hydration
Dehydration can contribute to headaches, so staying well-hydrated is essential. Aim to drink an adequate amount of water throughout the day, and limit the consumption of beverages that may contribute to dehydration, such as caffeinated or alcoholic drinks.
Adequate sleep
Lack of sleep can contribute to headaches, so establishing and maintaining regular sleep patterns can be crucial for perimenopausal headache relief. Ensure a comfortable sleep environment, practice good sleep hygiene, and aim for a consistent sleep schedule to promote quality rest.
Symptom and hormone tracking
For some women, perimenopausal headaches may be linked to their menstrual cycle. The hormone fluctuations that come with your cycle and interact with the hormonal changes of perimenopause, intensifying headache symptoms. Tracking your cycle—and specifically your hormone levels—can you give you better insight into what’s going on in your body so you can take proactive and preventative action.
Perimenopause headaches: the bottom line
Perimenopause headaches may feel different from person to person, and even different for one person one week to the next. Yet recognizing that these headaches, no matter how variant they are, are triggered by perimenopause—and potentially other lifestyle factors—is a crucial first step toward symptom management. While perimenopause headaches can be painful and even debilitating, there are tons of strategies to manage them and find relief.
About the author
Sources
- Barth, C., Villringer, A., & Sacher, J. (2015). Sex hormones affect neurotransmitters and shape the adult female brain during hormonal transition periods.
- Martin, V. T., Pavlovic, J., Fanning, K. M., Buse, D. C., Reed, M. L., & Lipton, R. B. (2016). Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine: Results of the American Migraine Prevalence and Prevention Study.
- Moy, G., & Gupta, V. (2021). Menstrual Related Headache.
- Sacco, S., Ricci, S., Degan, D., & Carolei, A. (2012). Migraine in women: the role of hormones and their impact on vascular diseases.
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