Menopause and Headaches – A Doctor’s overview

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Dr Shilpa McQuillan discusses headaches at menopause. Why do they happen, and how can you reduce the impact they’re having on your life. From lifestyle changes to Hormone Therapy (HT), there’s a lot you can do to reduce menopause-related headaches.

Why do some women get headaches that occur around menopause?

There are a few of reasons women experience headaches around menopause. Here are some common reasons that may be contributing to your symptoms:


Estrogen causes the blood vessels to expand and progesterone causes them to tighten. Around menopause there is fluctuation and imbalance of these hormones causing the blood vessels to keep expanding and contracting. This can lead to a build-up of pressure in the head resulting in pain – what’s commonly called a ‘pressure headache’.

Some women experience migraines for a few days around their periods. This is due to the natural drop in estrogen levels. As you approach the menopause, some women can experience more regular periods and therefore experience these headaches more often.

Tiredness and stress

There are many causes of sleep problems and stress around the menopause. This can lead to tension headaches, with a feeling of tightness around the forehead and back of the head and neck.

How can you manage and reduce headaches?

Headaches are a common menopause symptom, but thankfully, there’s a lot you can do to reduce and manage them. The first set of actions you can take are lifestyle-focused:

Consider your diet

Some people find that certain foods and drink trigger headaches, in particular migraines. It may be worth keeping a diary to see if there are any triggers, and try removing these from your diet. Common triggers include:

    • Caffeine
    • Alcohol
    • Monosodium glutamate (MSG)
    • Cheese
    • Citrus fruits
    • Chocolate
    • Spicy foods

Be drink-aware

It is important to drink plenty of water and keep well hydrated – you should aim to drink around 1/2-1 gallon of water a day to keep well hydrated.

It is also important to limit caffeine and alcohol intake as these can cause or worsen headaches. You might find some improvement in your symptoms by swapping to de-caffeinated teas and coffees. In addition, there is an ever growing choice of non-alcoholic beverages available in shops and restaurants. These can be a great alternative, just be mindful of the high sugar content that some of these contain.

Reduce stress and improve sleep

Lack of sleep and stress may be contributing to your headaches and this can become a vicious cycle. By addressing this aspect of your life, you may notice an improvement in your symptoms. Find more in my doctor’s guide to Stress, anxiety, and brain fog.

What treatments are available?

Hormone Therapy (HT)

If you’re experiencing migraines associated with your periods then you may benefit from estrogen replacement around this time. It is important you discuss this with your doctor as some hormone therapies can trigger migraines or may even be unsafe. You can read more about estrogen therapy in this Doctor’s guide to HT

Continuous contraceptive pills

For some women who are taking the contraceptive pill with estrogen, you may find headaches on the days you are not taking the pills. This is due to the drop in estrogen levels around this time. You may benefit from taking several of these pill packets without a break ‘back to back’ to avoid this sudden fall in estrogen levels. It is important to discuss with your doctor what options are available and safe for you.

Anti-migraine tablets and pain relief

Medications are available ‘over the counter’ in most local pharmacies and range from simple pain relief to anti-migraine tablets. They are used only as short term option for headaches. If your symptoms persist, you should see your healthcare provider to check there is nothing else going on.

About Dr Shilpa McQuillan MRCGP MRCOG DFSRH

Dr Shilpa McQuillan is a with a difference; she brings a wealth of specialist knowledge when it comes to women’s health. Previously a Hospital Registrar in Obstetrics and Gynaecology, Shilpa now works in general practice, providing patients with resident expertise and knowledge on women’s health concerns.

Read Shilpa’s full biography here.

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Headaches during menopause – does diet make a difference?

Dr Shilpa McQuillan

Dr Shilpa McQuillan

General Practitioner

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