Migraine in perimenopausal women

Area of Science:

• Reproductive Endocrinology
• Neurology
• Women's Health

Background:

• Hormonal fluctuations during the reproductive cycle influence migraine patterns.
• Many women experience or have worsening migraines during perimenopause, a phase often overlooked in climacteric syndrome discussions.
• Premenstrual syndrome (PMS) history is linked to increased migraine prevalence during late menopausal transition.

Purpose of the Study:

• To investigate the relationship between hormonal changes, menopause, and migraine.
• To explore the role and optimal administration of hormone replacement therapy (HRT) in managing perimenopausal migraines.
• To compare migraine incidence in natural versus surgical menopause.

Main Methods:

• Review of existing literature on hormonal changes, menopause, and migraine.
• Analysis of the effects of hormone replacement therapy (HRT) on migraine occurrence.
• Comparison of migraine incidence between natural and surgical menopause.

Main Results:

• Migraine attacks often intensify during menopausal transition; initial onset is rare.
• Continuous HRT, particularly transdermal estradiol, is recommended to prevent estrogen withdrawal migraines.
• Natural menopause shows a lower migraine incidence than surgical menopause, though hysterectomy's specific role is unclear.

Conclusions:

• Migraine management during perimenopause requires attention to hormonal shifts.
• Continuous HRT is crucial for preventing hormone-induced migraines, with transdermal routes preferred.
• Further research is needed to clarify the impact of hysterectomy on migraine occurrence.