Compared with premenopausal women, the adjusted odds of having high frequency headaches was 1.62 (95% CI = 1.23, 2.12) for perimenopausal women and 1.76 (95% CI = 1.23, 2.52) for postmenopausal women. The odds ratio decreased but remained significant in the perimenopausal group (1.42 [95% CI 1.03–1.94]) after adjustment for BMI, current migraine preventive use, medication overuse, and depression. After adjustment, the odds ratio remained increased but was not significant in the menopausal group.

“The fact that the increased risk of high frequency headache was not statistically significant for menopause in the fully adjusted models suggests that different mechanisms might account for the increased risk for this stage of the menopausal transition,” the authors wrote.

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“Women as they get older develop lots of aches and pains, joints and back pain and it is possible their overuse of pain medications for headache and other conditions might actually drive an increase in headaches for the menopause group,” said Dr Martin.

For women who are approaching menopause and who suffer from migraines, there is help, according to Jelena Pavlovic, MD, PhD, attending physician in neurology, Montefiore and assistant professor of The Saul R. Korey Department of Neurology, Einstein.

“Physicians can prescribe hormonal therapies that level out these changes that occur during the perimenopause and menopause time periods,” said Dr Pavlovic. “If the patient is in early perimenopause, you can give birth control pills that level things out. If they are in the late perimenopause and they start skipping periods, they can be put on estrogen patches.”

Reference

Martin VT, Pavlovic J, Fanning KM, Buse DC, Reed ML, Lipton RB. Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine: Results of the American Migraine Prevalence and Prevention Study. Headache. 2016; doi:10.1111/head.12763.