For Many Women, Migraines Worsen During Menopause

Dr. Vincent Martin, MD Professor of Internal Medicine University of Cincinnati College of Medicine Cincinnati OH

Dr. Martin Interview with:
Dr. Vincent Martin, MD
Professor of Internal Medicine
University of Cincinnati College of Medicine
Cincinnati OH

Medical Research: What is the background for this study? What are the main findings?

Dr. Martin: Past studies have found that the perimenopause is associated with an increased prevalence of migraine headache, but there have been no studies to determine if the frequency of migraine attacks is increased during this time period.  In our study we reported that high frequency headache (≥10 days per month with headache) was increased by 62% during perimenopause (irregular menstrual cycles) as compared to premenopause (regular menstrual cycles).  We later divided the perimenopause into early and late stages.  During the early perimenopause women experience irregular menstrual bleeding while during the late perimenopause women begin skipping menstrual periods for 2-11 months.  Of the two stages the late perimenopause in particular had the greatest likelihood for high frequency headache increasing its risk by 86%.  This could suggest that low estrogen and progesterone levels, which occur when menstrual periods are skipped, might account for the increased probability of headache attacks in women with migraine.

The common belief in the medical field is that migraine attacks improve in women during menopause.  To the contrary we found that high frequency migraine increased by 76% during menopause compared to premenopause.  This indicates that a subgroup of women with frequent headaches tend to worsen with menopause.  The increased probability of high frequency headache appeared to be secondary to an increased intake of pain medications occurring during this time period, which could result in “rebound headaches”.  Rebound headaches occur from overuse of pain medications.

Medical Research: What should clinicians and patients take away from your report?

Dr. Martin: Subgroups of women with more frequent attacks for migraine headache may worsen during perimenopause and menopause, but for different reasons. Hormonal changes that occur during the perimenopause likely account for the worsening during perimenopause while medication overuse might explain the increase during menopause.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Martin: Future research could entail using hormonal and non-hormonal therapies to treat women during the perimenopause and menopause in an effort to prevent migraine attacks during these time periods. Knowledge of the factors contributing to such an increase in frequency will enable us to tailor therapies for women during this turbulent time period.       

Medical Research: Is there anything else you would like to add?

Dr. Martin: Research such as ours and others should offer new hope for female migraine sufferers during the menopausal transition.


Headache. 2016 Jan 21. doi: 10.1111/head.12763. [Epub ahead of print]

Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine: Results of the American Migraine Prevalence and Prevention Study.

Martin VT1, Pavlovic J2, Fanning KM3, Buse DC2, Reed ML3, Lipton RB2,4.

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Dr. Vincent Martin, MD (2016). For Many Women, Migraines Worsen During Menopause