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Audrey Halpern, MD, Board-Certified in Headache Medicine by the United Council for Neurologic Subspecialties, Board-Certified in Neurology by the American Board of Psychiatry and Neurology and Clinical Assistant Professor of Neurology at New York University School of Medicine, is Executive Director of The Manhattan Center for Headache & Neurology.
Managing Migraine During Menopause
By Audrey L. Halpern, MD
Migraines tend to worsen in severity and length with menopause, making it critical to understand and reduce exposure to triggers, whether food and beverage-based (see www.audreyhalpernmd.com for a list of little-known triggers) or related to heightened stress levels, changes in sleep patterns, caffeine intake or skipped meals. Keeping a healthy diet, plenty of exercise and good sleep habits at the core of your daily regimen will provide physical and emotional benefits. For migraineurs who have struggled for years with debilitating pain, combining traditional (proper diagnosis, medicine, weight loss, Botox injections, nerve blocks) and complementary (natural remedies, supplements, yoga, biofeedback) medicine with stress reducers (body and scalp massage, facials) is helpful. This is the time to invest in yourself and your well-being since doing so will not only contribute to fewer headache and migraine occurrences, it will also contribute to greater longevity.
Along with managing triggers, avoiding medication overuse (i.e., analgesics or pain medications should not be used more than 2-3 days per week, on average) is essential for minimizing migraine occurrence. As with any time in your life, but particularly during menopause, paying attention to things such as depression, sleep changes and weight fluctuations is essential to improving the quality of your life and reducing the frequency and severity of migraine. The good news? After enduring months or years of hormonal fluctuations that are part of menopause, often migraine sufferers emerge from this life cycle with lower frequencies of migraine.
Peppermint, lavender and eucalyptus essential oil scents are helpful in minimizing headaches and can also be used in massages to relieve migraines. Botox injections for migraine can be tremendously helpful to sufferers. These injections may be given under the skin in the forehead, around the eyes, on the sides of the head and back of the head, as well as in the neck. The specific location of head pain and factors such as the presence of neck pain influence injection locations. Injections are usually performed every 3 months or so, (although this can vary by patient), and may be given for years at a time, until the migraines start to improve.
Tracking headache and migraine will help illuminate triggers. Biofeedback and deep breathing are also effective in the treatment and management of migraine. Sharing headache and migraine onset and tracking calendars with your doctor, along with how medication has alleviated pain, will help you create a roadmap to avoiding migraines while grappling with the physical and emotional challenges of menopause.