GP 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 Replacement Therapy (HRT), 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:
Oestrogen 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 oestrogen 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:
- Monosodium glutamate (MSG)
- Citrus fruits
- Spicy foods
It is important to drink plenty of water and keep well hydrated – you should aim to drink around 1.2 litres (six to eight glasses) of water 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 GP’s guide to Stress, anxiety, and brain fog.
What treatments are available?
Hormone Replacement Therapy (HRT)
If you’re experiencing migraines associated with your periods then you may benefit from oestrogen replacement around this time. It is important you discuss this with your GP as some hormone therapies can trigger migraines or may even be unsafe. You can read more about oestrogen therapy in this GP’s guide to HRT
Continuous contraceptive pills
For some women who are taking the contraceptive pill with oestrogen, you may find headaches on the days you are not taking the pills. This is due to the drop in oestrogen 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 oestrogen levels. It is important to discuss with your GP 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 GP to check there is nothing else going on.
About Dr Shilpa McQuillan MRCGP MRCOG DFSRH
Dr Shilpa McQuillan is a GP 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.