Migraines and Perimenopause

If you are wondering why your migraines have got worse in the perimenopause, this could be because there is a strong link between migraines and hormone fluctuations. Migraines are three times more common in women than in men, and in the majority of women, migraines are linked to hormones. Migraines are associated with periods in 60% of female migraine sufferers. Since changing hormonal levels become exaggerated during perimenopause its not surprising that this time of life makes migraines worse for up to 45% of women.

Some of the causes of migraines are:

Excessive oestrogen

Hormonal changes during perimenopause such as lack of progesterone

Unstable blood sugars – that’s why its good to avoid alcohol and refined carbs and sugar


Food sensitivities –  caffeine, foods containing tyramine (chocolate, alcohol, sour cream, yoghurt, yeast extracts, aged cheese, soy sauce), red wine, peanuts, foods containing nitrites, monosodium glutamate and aspartame may all worsen migraines.

Hormone replacement therapy can even out the extreme hormone fluctuations associated with perimenopause.

Keep a migraine diary and try excluding potential food allergens. Drink plenty of water and keep blood sugars stable by eating small frequent meals consisting of starchy vegetables, legumes and whole grains. In my experience, some migraine sufferers get relief from just these approaches.

The website www.migrainetrust.org is a good place to read about migraine medications for acute attacks and prevention and botox as a possible option for chronic migraine. Other more natural alternatives which might be worth trying include the use of Cefaly, a plastic headband that works like a TENS machine and stimulates the trigeminal nerve.

The following supplements may be worth trying:

Magnesium 400mg at night- Low magnesium levels have been detected in sufferers of both migraine and tension headaches[1]

Feverfew up to 1200mg/day – Of 270 migraine sufferers who had taken feverfew daily, 70% had a decrease in the frequency and/or intensity of their attacks[2]

Riboflavin – 400mg per day: 49 migraine patients who were treated with 400 mg per day of riboflavin for 3 months had a 68% reduction in symptoms[3]

CoQ10 150mg per day: Thirty-two patients with migraine were treated with CoQ10 at a dose of 150 mg per day in a controlled experiment and 61.3% of the patients treated had a greater than 50% reduction in a number of days with migraine headache.[4]

Butterbur 75mg twice per day: 245 migraine patients were treated for 4 months twice daily with either placebo or 50 mg or 75 mg commercial butterbur. Maximum response was achieved after 3 months resulting in an attack reduction of 58% with a 2×75 mg/day dosing which was statistically significant compared to the placebo response of 28%.[5]

[1] Low brain magnesium in migraine.

[2] Efficacy of feverfew as prophylactic treatment of migraine.

[3] High dose riboflavin as a prophylactic treatment of migraine: Results of an open pilot study. 

[4] Open label trial of coenzyme Q10 as a migraine preventive.

[5] Petasites hybridus root (butterbur) is an effective preventive treatment for migraine.