Perimenopause & Headaches

3 minute read

By: Sharon D. Malone, MD|Last updated: December 6, 2022
Black woman sitting on the floor at laptop with hand to forehead in discomfort. AW502

When it comes to headaches during perimenopause and menopause, there is good news and bad news. First, the bad news: Many people report that their headaches are worse during perimenopause, and this includes migraine sufferers as well as those who have no history of headaches. The reason for this is not entirely clear, but it appears that the fluctuation in hormone levels, which is characteristic of perimenopause, is a trigger. Now, the good news: Once you are menopausal (you haven’t gotten a period in a year), the headaches tend to improve.

So, what can you do about it? Start by keeping a symptom diary. Use it to try to figure out what your headache triggers are. We do know that disrupted sleep, stress, dehydration, and alcohol use exacerbate not only the severity of the symptoms but also the frequency of headaches.

Next, consider treatment. See if there is a relationship between the onset of your period and the onset of headaches. If so, the use of low dose contraceptives or supplemental estrogen might be beneficial. And for those of you with a history of migraines, depending on the severity and frequency, you may benefit from a consultation with your doctor to consider switching from episodic treatment (only when you have a migraine) to a prophylactic regimen (taking medication daily to prevent them).

The key is to understand what is happening, what you can do 
about it, and when to go for help. Perimenopause: It’s the gift that keeps on giving.

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