The Independent Pharmacy

Migraines And Menopause: Are They Linked?

Andy Boysan
Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 12 Sep 2023

Many women going through menopause experience headaches — it’s a common menopause symptom caused by changing hormone levels. But if you suffer from migraines, you might want to know whether migraines and menopause are linked as well.

Migraine is a common condition that affects lots of people. It’s a type of severe headache that comprises of symptoms such as a throbbing head, light and sound sensitivity, nausea, and vomiting, among others. For some people, migraine attacks can be extremely painful and debilitating — stopping them from going about their daily lives and having a huge impact on their health.

For some migraine sufferers, this condition can get worse during menopause.

In this article, we’re going to be talking about the link between migraines and menopause, symptoms to look out for, when menopause migraines generally strike, and treatment options. We’ll also be taking a look at the connection between HRT and migraine, and asking whether hormone replacement therapy helps or hinders menopausal migraines.

Read on to find out more.

If you would like to find out more about menopause, you can visit the menopause & HRT guides section of our website. If you want to read more about migraines, we also have a dedicated migraine guide section too.

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Is there a link between migraines and menopause?

The short answer is yes — there is a link between migraines and menopause.

Although we don’t know exactly what causes migraines, we do know that hormones, and fluctuating hormone levels, can be a trigger for migraine attacks.

During and leading up to menopause, there is a big change in the hormone levels in the body. The transition to menopause and the changing levels of oestrogen in the body that happen at this time can lead to more frequent migraines and headaches.

As a result, some people who experience migraines may find that their migraines get worse, last longer, or become more frequent while they are going through menopause.

However, others may notice the opposite — that migraines ease during menopause. Some people might find that there are no changes at all in how they experience migraines.

Although lots of people who suffer from migraines will notice they get worse before and during menopause, many women do notice that their migraines improve once their hormone levels have settled and menopause is over. If your migraines are caused by other factors rather than hormonal triggers, then they will probably still continue post-menopause.

Hormonal headaches in perimenopause

“Perimenopause” refers to the time period during which the body naturally makes the transition to menopause.

Women can start perimenopause at different ages, though it generally occurs in the late forties and early fifties. Perimenopause can last anywhere from a few months to years and is generally marked by a changing and irregular menstrual cycle, as well as other menopause symptoms. The perimenopause phase is over once you have gone a year without a natural period (which is when you have reached menopause).

During perimenopause, migraines and headaches can worsen. This is due to disruption of the menstrual cycle and fluctuating hormone levels in the body.

In particular, the natural drop in oestrogen levels during this time can cause headaches and migraines to increase, and become more severe. Irregular and more frequent menstrual periods can also cause migraines to become more frequent.

If you get migraines and you tend to notice that your migraine attacks happen just before or around the time of your period, you suffer from what are called “menstrual migraines”. The drop in oestrogen around this time can set off migraines. These affect more than half of women who get migraines. Women with a history of menstrual migraines are more likely to experience frequent migraines and hormonal headaches in perimenopause.

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Menopause and migraine with aura

Migraine with aura is a specific type of migraine. Migraine with aura is also known as a “classic aura”, and is a less common type of migraine (compared to migraine without aura, which affects around 70-90% of sufferers).

Typical symptoms of migraine with aura include visual symptoms such as seeing flashing lights, tunnel vision, blind spots, coloured spots in vision, shimmering spots, stars or sparkles, zigzag lines across vision, and temporary loss of vision. Other symptoms of migraine with aura can include dizziness, a tingling sensation, or numbness.

Menopause and migraine with aura are thought to be connected, though there isn’t a lot of clinical research into this.

High levels of the sex hormone oestrogen are thought to trigger migraines with aura. This is why some women who experience migraines with aura will get them in the middle of their cycle (leading up to ovulation), or during pregnancy (when hormone levels are high).

If you experience migraines with aura during or before menopause, it may be because of the oestrogen levels in your body swinging up and down suddenly. You may find that your migraines become more unpredictable, or you may notice that they become less intense and less frequent as menopause continues.

Often, migraines with aura will improve after menopause once the oestrogen levels in the body are lower and more consistent.

Ocular migraine and menopause

Ocular migraine (also known as retinal migraine) is a condition that can cause temporary changes in vision such as partial vision loss, blindness in one eye, blurred vision, dimming vision, scotomas (blank spots in your field of vision that can flicker and waver, making mosaic-like patterns) or flashing lights. These visual symptoms may be accompanied by a headache before, during or after the attack.

Although they share the same name as migraine and some similar symptoms, ocular migraines are a separate condition. They are not the same as migraines or migraines with aura (which normally affects the vision in both eyes, compared with retinal migraine, which tends to affect one eye).

Ocular migraines can be frightening and interfere with certain activities (such as driving or reading), but they are usually harmless and not serious.

Women are more likely to experience ocular migraines than men are, as are people with a history or family history of migraines.

Retinal or ocular migraine is thought to be triggered by a number of different factors such as stress, smoking or high blood pressure. It has also been linked to the oral contraceptive pill. However, there isn’t currently a proven link between ocular migraine and menopause.

If you are experiencing problems with your vision or sudden loss of sight, speak to your GP. They should be able to diagnose your condition and suggest an appropriate course of action, but in some cases, they may refer you to an eye specialist for further investigation and testing.

HRT and migraine: can hormone replacement therapy affect migraines?

HRT — hormone replacement therapy — is a type of treatment used to ease menopausal symptoms. It works by replacing the hormones that are lost during menopause, helping to get the body’s hormone levels back to normal and effectively relieving symptoms as a result.

If you think that your migraines are caused by dropping hormone levels, you might find that using HRT helps to reduce the likelihood and frequency of your migraine attacks, or makes them less severe.

However, some people find that if they have hormonal headaches and migraines, using HRT may make these worse. HRTs can cause hormone fluctuations, triggering migraines.

If you suffer from migraines, your doctor might suggest using a transdermal version of the medication, such as patches or gel. HRTs that come in this form and are administered through the skin rather than taken orally are more likely to keep your hormone levels stable than tablets, which means they are less likely to trigger migraine attacks.

Lowering the dose of HRT, or using a continuous combined HRT rather than a cyclical (or sequential) HRT treatment is also less likely to trigger headaches and migraines.

Everyone is different, so it’s important to find a treatment option that works for you during menopause. If you aren’t sure what is best, speaking to your GP or one of the qualified pharmacists in our team at The Independent Pharmacy can help. They will be able to point you in the right direction.

Menopausal migraine treatment

If you suffer from hormonal headaches or migraines during menopause, there are a few different treatment options for you.

Migraine treatments

Your doctor may prescribe anti-migraine medications or painkillers for you to help with your migraines.

There are lots of different medicines that can help with migraines, such as Rizatriptan, a tablet that melts in the saliva on your tongue. Rizatriptan contains a triptan, a type of drug that helps to reverse some of the changes that happen in the brain to trigger a migraine and relieve the symptoms of migraine.

Almotriptan and sumatriptan are other types of triptan which are used to relieve the symptoms of migraine headaches.

There are many types of migraine medications and pain relief available. You can find more migraine treatments as well as information about each over on our migraine treatment page, which contains advice and information about the condition as well as the different medications and treatments available.


Hormone replacement therapy (HRT) can be used to effectively alleviate symptoms of menopause, including headaches.

However, as we have mentioned in the section above, if you suffer from migraines, you may be recommended a transdermal HRT — a type administered through the skin, such as a patch or gel.

Transdermal HRT currently available from The Independent Pharmacy include:

We also offer a range of HRT tablets.

The type of HRT most suitable for you will depend on a number of factors.

It is best to speak to your GP or one of our qualified pharmacists for guidance first. Once you have a prescription for the best HRT for you, you can complete an online consultation with us and we can get your treatment delivered to you as soon as the next day.

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