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Migraine and the menopause.

E Anne MacGregor1

  • 1City of London Migraine Clinic, London, UK. anne.macgregor@bartsandthelondon.nhs.uk

The Journal of the British Menopause Society
|September 7, 2006
PubMed
Summary
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Migraine often improves after menopause. Hormone replacement therapy (HRT) is generally safe for women with migraine, with continuous transdermal estrogen recommended at the lowest effective dose.

Area of Science:

  • Neurology
  • Endocrinology
  • Women's Health

Background:

  • Migraine prevalence peaks in the 40s, often linked to menstruation.
  • Migraine symptoms typically decrease post-menopause.
  • Concerns exist regarding hormone replacement therapy (HRT) potentially worsening migraine or increasing stroke risk.

Purpose of the Study:

  • To review the evidence on the relationship between hormone replacement therapy (HRT) and migraine.
  • To determine if HRT is a contraindication for managing menopausal symptoms in women with a history of migraine.

Main Methods:

  • Evidence-based literature review.
  • Analysis of studies examining HRT effects on migraine and stroke risk.
  • Assessment of menopausal symptom management in relation to migraine.

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Main Results:

  • Migraine is not an absolute contraindication for HRT.
  • Continuous-release transdermal estrogen, at the lowest effective dose, is the preferred HRT regimen.
  • Potential risks of HRT for migraineurs require careful consideration.

Conclusions:

  • HRT can be safely used in most women experiencing migraine.
  • Transdermal estrogen offers a potentially safer route for HRT in migraine patients.
  • Individualized treatment plans are essential for managing menopausal symptoms in women with migraine.