Evidence suggests that migraine activity is influenced by hormonal factors, and particularly by estrogen levels, but relatively few studies have investigated the prevalence and characteristics of migraine according to the menopausal status.
Overall, population-based studies have shown an improvement of migraine after menopause, with a possible increase in perimenopause. On the contrary, the studies performed on patients referring to headache centers have shown no improvement or even worsening of migraine.
Menopause etiology may play a role in migraine evolution during the menopausal period, with migraine improvement more likely occurring after spontaneous rather than after surgical menopause.
Postmenopausal hormone replacement therapy has been found to be associated with migraine worsening in observational, population-based studies. The effects of several therapeutic regimens on migraine have also been investigated, leading to non-conclusive results.
To date, no specific preventive measures are recommended for menopausal women with migraine. Hormonal manipulation for the treatment of refractory postmenopausal migraine is still a matter of debate.
Ripa P, Ornello R, Degan D, Tiseo C, Stewart J, Pistoia F, Carolei A, Sacco S. Migraine in menopausal women: a systematic review. Int J Womens Health. 2015 Aug 20;7:773-82. doi: 10.2147/IJWH.S70073. eCollection 2015.
Content updated 15 December 2015