Menstrual / Hormonal Migraines and Menopause

Hello all,

I just found this forum and was searching for information with respect to menstrual / hormonal migraines. My wife is 49 and will be 50 this August and is periomenopausal. We do not have children. She has suffered from migraines since she was 37 and they have progressively become worse. The hormonal aspect is a huge component of her headaches, as the headaches become pronounced during these cycles. She has chronic daily head pain and cannot work, she is mostly housebound. As the disease continues, it has changed her, she is weaker, less energy. It actually changes a person, as you so well know, to endure such daily pain.

We have seen all sorts of doctors, chiropractors, alternative, traditional, medications, marjijuana, botox, etc. She eats all the right foods, avoids all the usual triggers. You name it we tried it. Nothing, absolutely nothing works. Our only hope is menopause, and she has told me that if that doesn't work, she is not going to continue to live like this. So menopause is our mantra. It keeps up her optimism. The only thing is, what if it doesn't bring relief?

My heart sank reading through this forum and seeing that for some yes, and for others, it doesn't let up or it even gets worse. Of course, these are individual stories so they are anecdotal. Does anyone know if there have been any actual studies done on menopause and migraines, so I can get a statistical idea? I would really like to know the statistical probability we are looking at. Thanks for you help. Jeff

Hi and welcome,

I am so sorry that your wife has been struggling with this for so long, but she is lucky to have you by her side. I have had chronic intractable migraine/New Daily Persistent Headache since age 17. I am only 3O now, so I can't offer much insight into the menopause angle, but maybe I can in the living with it part.

Migraines and chronic pain in general can certainly change a person. Nothing else saps your energy like pain does. I know she has probably been everywhere and done everything for her migraines. The one this that really helped me the most was radiofrequency to the neck- burning the nerves at C2, and C3. This gave me my first ever period of remission. In 2OO4, I had an occipital nerve stimulator placed- this is kind of like a pacemaker- it sends a false signal to nerves and prevents them from sending the pain signal. I had a great period of remission after it was first implanted. I have broken leads twice and had it repaired- now, it basically allows medications to work- it allows me to function. I'll be happy to write more about it, if you like. I still have daily pain, but it isn't as bad, it can be controlled with pain medication, and medications to break the headache work- this was not the case before.

Have you ever considered pain management? I am sure you have, but if you find a good doctor, it would be worth looking into simply to improve quality of life.

I hope it does go away with menopause. I'm sorry that I can't offer more insight on this topic, but I hope what I have written is of some help to you.

Pain free days,
sailingm

Thanks for the response sailingm. Yes, my wife had tried a version of what you are talking about, occipital nerve blocking shots in the neck. Unfortunately they didn't work and she would be very reluctant to try a more invasive version of it that you went through. I'm glad it worked or is working for you though. She can't handle serious meds, her system is too fragile and they all affect her very bad (and they don't work for her). Unfortunately, a lot of "Pain Management" is simply meds being prescribed. I know, you might say that sure, if it's sooo bad she should be taking meds, but as I say she can't handle them because of the side effects. The meds almost killed her. That's why I am trying to get an idea of what % of people with hormonal based migraines who go through menopause see their conditions improve.

Hi Jeff,

I have gone through menopause and have more experience with hormones than anyone needs.
I will send you a PM and see if I can help.

I'm not able to comment on the menopause topic besides that I found this, where 67% have "improvement" (no breakdown of how much), 9% get worse, and the rest have no change: http://info-med.co.uk/headaches/menopausal-headaches.php

Has she tried hormonal type therapies through a menstrual migraine-competent gyn? I hear of patches being used certain times of the month, etc.

But, I wanted to ask a question about your wife trying pain meds. Was it all with one doctor? If so, do you think she'd be open to trying a more gentle approach with a different doctor with a different med at a lower dose? It would be very rare if every pain med at any dose would have too severe of side effects. For her to have a life-threatening reaction, I would guess that the doctor gave her too much too fast. Some people are very med sensitive, and knowing that, she may want to try a fraction of a dose. I have gone through all the paoin meds now and I know some do nothing while others are extremely helpful, at equivalent doses. Lots of trial and error. In her case, maybe this could be done in a hospital?

There are some newer non-opiate options, and some newer opiate formulations. They even do a pain pump where its 2% of the dose so very very low side effects (they can try it in a hospital before implanting anything). I know sometimes a bad experience can totally turn you off to something though...but thought I'd mention it. Getting multiple opinions from doctors never hurts...it took me over 20 to find a truly helpful one. I, like sailingmuffin, can begin to relate to the daily struggle...I've had a 24/7 headache over 5 years. I think even moderate daily pain is way way worse than acute severe pain (even if its often). Sometimes a medication could even be helpful if its not to treat the head pain, but symptoms of depression, fatigue, trouble sleeping, etc, that commonly go with pain. I've had some recent help from Cymbalta (helps me generally feel more like my old self but didn't help the headache much), but everyone is different. Best wishes.

Jeff

Unfortunately your wife's story is all too familiar here. I never had headaches at all until I was 46 when I got hit with chronic daily migraine. I tried everything ( diet, injections in the neck, preventatives, chiropractic, acupuncture, botox, you name it) to no avail. I had two nuerologists and a pain specialist give up.

I finally found a bioidentical hormone and supplement plan that has worked wonders. It is by a doctor in Texas who claims a 80% success rate for his women patients. I went from 80% headache days down to 2-3 per month. And those have been less severe. It has allowed me to keep my business going and resume a social life and spend normal time with my family again. so while it has not been a total cure for me, it has made a significant difference in my life. I saw an improvement after only a few days trying it.

Details on the plan are at http://www.migraine-headaches-information.com/
Here is what I take:
- 200 mg of bioidentical progesterone (start with 100 and go up if needed)
- 5000 mg of vitamin D
- 400 mg of magnesium
- 12.5 mg of iodide
- 1000 mg of omega3

You can get this online at www.omega-1000.com, or at a local vitamin store.
I honestly think this is worth trying for anyone dealing with peri-menopause, menopause, or hormonal headaches. Dr Jones makes a pretty strong case for the hormonal imbalances that are messing our bodies up and creating much of the migraine problems people are experiencing. The best part is no weird side effects, which so many of the preventatives had.

I hope this helps. Good luck!

Thank you for the replies!
Migrainegirl: yes, my wife tried 4 approaches to Hormone replacement therapy over the last 10 years through different doctors. Creams and pills were administered. The result - it made her headaches worse and also gave her a certain "malaise" feeling when she was undergoing the treatment. Also, she is now against it because of negative long term effects, like cancer. She had a family member pass away after years taking HRT, albeit traditional. Although bio-identical is better than traditional, she is not keen on it. That being said, I looked at the link you said, and it looked rather "info-mercial" to me. Did you go through that site when you described the meds and dosages in your post? Did the $29 e-book give you the information you needed, or did you have to set a consultion with Dr. Jones? I wouldn't be opposed to researching it more if it is perhaps different than what she has done.

tortoisegirl: I looked at the study, but I did not see any sources cited, so I have to take it as an "anecdotal" study. It does seem though according to what they are saying that most do see an improvement, if going through 'natural' menopause (no surgery).
We've tried pain meds from lots of doctors, regular neurologist, primary care doc, and probably 1 dozen ER doctors (when we had to go), each with their own philosophy and drug choice.
She can't handle even the lowest dose, such is her case. A pain pump would be a hard sell given her experience. The other drugs she used for depression and sleep were the worst, the absolute worst in her case - because they altered her mental state and she started not to care about her fate, and that is a road we are not going down again.

Thanks for your responses, I know you suffer from it as well and I am glad you have some sort of coping mechanisms that work to some degree for you.

Hi Jeff,

I feel your pain as well as your wife suffering. Migraine is a debilitating condition and can destroy one's life. It destroyed my mice once when I had it for more than 16 yrs until I discovered a unique approach to overcome my endless distress. When everything else failed, this worked for me. What I want to tell you can't be said in couple words or paragraph; you may want to check it yourself: www.unlockthemysteryofyourmigraines.com

Migrainegirl: yes, my wife tried 4 approaches to Hormone replacement therapy over the last 10 years through different doctors. Creams and pills were administered. The result - it made her headaches worse and also gave her a certain "malaise" feeling when she was undergoing the treatment. Also, she is now against it because of negative long term effects, like cancer. She had a family member pass away after years taking HRT, albeit traditional. Although bio-identical is better than traditional, she is not keen on it. That being said, I looked at the link you said, and it looked rather "info-mercial" to me. Did you go through that site when you described the meds and dosages in your post? Did the $29 e-book give you the information you needed, or did you have to set a consultion with Dr. Jones? I wouldn't be opposed to researching it more if it is perhaps different than what she has done.

Yes I totally agree it is very infomercially sounding, which does it a disservice. I think I paid $12 for the ebook download. Did not know it had gone up. No consultation or other expense was involved. The supplements cost a total of about $80 for a months supply which is less than I was spending on many of the meds I tried.

So what is in the ebook? Mostly a detailed explanation of why hormone treatments (birth control pills or HRT) have messed up our bodies. These pills use progesterone that is chemically different than our bodies. It could not patented if it was identical. The artificial progesterone is produced in horse urine. (This is true.) It has ended up messing up our ability to produce progesterone.

So his plan is based on the finding that many women get relief from migraines when pregnant, when progesterone levels go way up. The book provides a much more detailed explanation of all of this.

He also addresses the questions of HRT and the cancer findings. That study was based on only one HRT which used the artificial horse urine variety. It also was only given to women well past menopause which was also part of the problem. I did later read a independent article in the New York Times that pretty much confirmed this review of that study. (it's a very good article, if you can find it.)

If your wife was on HRT, this may well be part of her problem. I also tried HRT about 6 months before my migraines began, so I now wonder if it was a contributor.

In any case, the real question is does this theory hold up? There are certainly numerous ones out there. I can only say I was rather skeptical myself, but figured I had nothing to lose since nothing else had worked. At least the natural supplements were not likely to harm me, like many of the meds had (longer nightmare stories here that I'll spare you). To me, the proof is in the pudding. I can only say it has made a really big difference for me.

If you want to do the research and review his findings and approach, it's worth reading. If not, you can skip that part and just try the supplements. If it is being used by a younger person who is trying to get pregnant, then she should only take the progesterone for 1/2 of her cycle. If past all that and perimenopausal or menopausal then can take every day, which is much easier.

Migrainegirl,

Thank you for the information on bio-identical hormones. I have had devestating migraines for years and they are very linked to my hormonal levels. I finally was referred to a doctor to start bio-identical hormones. I was familiar with them from hearing Suzanne Somers talk about them with regards to anti-aging and then another migraine sufferer told me they had cured her awful headaches. It is the first glimmer of hope for me. I only get about one per month but they last five days generally. Then the hangover is another day or two. And I can feel them starting to come on a day or two before they start. I am praying they provide a solution. The website looks very interesting. Thanks for some good information!

Wendy, I hope it helps. Here is the link to the article in the New York Times on the use of hormones, and the latest research on effects of HRT.

http://www.nytimes.com/2010/04/18/magazine/18estrogen-t.html

While it doesn't deal with headaches, it does talk about other cognitive effects from declining hormones and gives a good up to date picture of the latest research on HRT.

Thanks Migrainegirl - My wife actually tried bio-identical hormones, not the traditional bad stuff. Her view is the "rule of 3", which you probably benefited from:
The "rule of 3" was told to us by one of the doctors we consulted with with respect to bio-identical HRT.

1/3 experience improvement
1/3 experience no change
1/3 get worse

So in her case, she had tried bio-identical but it did not help.

Thanks again Jeff

Hi Jeff,

Yes it is quite true that what works for one does not work for others, which is pretty weird really, but borne out by experience here. Apparently the combination of supplements (particularly the D and the magnesium) do make a difference.

Hello,

I have suffered with migraine (no aura) for about 7 years now. The pain centers around my left eye (above it in the notch in the orbital bone, below it in my upper cheek and as the migraine progresses in the eye itself) and causes sensitivity to fragrance, light and sometimes sound. It becomes difficult for me to concentrate. Before the attack I get food cravings and feel as though my blood sugar is dropping, but eating does not relieve the feeling. Then with the attack I lose my appetite, get weak and shaky and sometimes get diarrhea. My left eye will feel dry. Very occasionally I'll get nausea. The weak and painful stage can last 1, 2 or 3 days. Afterwards I feel hungover.

I have identified lack of sleep, fragrance, bright light, flickering images and light, sulfites, heat and skipping meals as triggers.

I have tried at least 15 or so different prescription medications (including preventatives like Topomax and rescue meds such as triptans and ergotamines) in addition to over-the-counter medications, supplements, bio-feedback, massage therapy and new eye glasses. I have seen internists, gynecologists, an ENT, an ophthalmologist, neurologists specializing in migraine and an endocrinologist. I have even tried talk therapy (psychology). Two neurologists diagnosed my problem as migraine and another as a type of Trigeminal Autonomic Cephalgia (the class of headaches that include cluster headaches - though mine are not cluster headaches). My current neurologist doesn't think the exact diagnosis really matters as far as treatment goes, though he believes I most likely have migraine.

My attacks began in 2004 during peri-menopause once I stopped birth control pills. In 2005, at the age of 40, I became post-menopausal. The migraines subsided but the hot flashes became so bad I could not sleep - and not sleeping triggers my migraines. So I began hormone replacement therapy (HRT). The hot flashes stopped and I could sleep - but the migraines continued. Since hormones are associated with migraine I tried different kinds and doses of HRT, settling on the lowest dose of an HRT patch (Combi-Patch). The attacks would come and go in their frequency anywhere from 2 or 3 times a month to 2 or 3 times a week. Often I would have mild headache pain without other symptoms for many days. In about '07 or '08 the migraines retreated with attacks happening 1 or 2 times a month. I could live with that. However, in November 2009 they returned with great vigor. I was getting a couple of attacks a week. I saw more doctors and tried more meds and treatments. One medication or treatment after another failed me. Since about January of 2011 I have developed a chronic daily headache with full-body migraine attacks occurring 2 or 3 times a week.

The latest treatment plan is this: Venlafaxine (Effexor) as an alternative to HRT to control the hot flashes. It isn't as good as the HRT. The hot flashes have returned but are not as severe; I do not wake up in a pool of sweat. However, I do wake up some. So my sleep isn't as good as it was on HRT. But the daily headaches aren't as severe and the couple of migraine attacks generally aren't as severe.

This past Thursday I had a Monster attack though. The doc gave me injections of DHE, Torodol (Keterolac), and Decadron (Dexamethasone). The doc has now prescribed Meperidine (Demerol) as a rescue med. I'm to take it at the start of an attack and then once more 4 hours later if the migraine isn't gone. Does anyone else have any knowledge of or experience with meperidine as a rescue med?

You can imagine this is all very disappointing since most migraine information says that menopause should spell the end of migraines for most women. I have read of the other post-menopausal experiences here with interest. If anyone has any helpful suggestions I am open to them.

Thank you for this forum.

Have you tried the bio-identical progesterone? It significantly lowered my frequency of attacks.

I have had demerol once before but it never took the migraine away. I don't understand how those meds by themselves can actually take a migraine away being that they just suppress the pain.

Thank you - I'm wondering the same thing.

The only explanation I ever got on the use of Demorol was that it allows you and your head to disconnect from the pain of the migraine and allows you to relax and possibly sleep to get past the episode. I don't know if that is a good explanation or not but it was better than ' Don't worry about it, it works'. For some it is a viable option, for others just a waste of time.
=Bill

The demerol supressed my pain and made me sleep which I needed because I had really bad m pain for over a month which caused me not to be able to sleep. But when the next day came, the same level of pain was still there before taking the demerol. A Dr had given me a shot of it at the office. Because of the type of med it is, I knew the effect was just temporary.

My migraines are very much related to CHANGING hormone levels, which is why the 100 mg progesterone didn't help me even though I tested low for the hormone, and my pain is worst when the hormone drops every month. I've got a prescription for a patch, from a compounding pharmacy, but most pharmacists have never heard of a patch form, though one MD (I was not his patient) told me they do make them. Anyone used this form of bio-identical progesterone? any luck?

Renee