Menopausal Migraines

Hello,

I have suffered with migraine (no aura) for about 7 years now. The pain centers around my left eye (above it in the notch in the orbital bone, below it in my upper cheek and as the migraine progresses in the eye itself) and causes sensitivity to fragrance, light and sometimes sound. It becomes difficult for me to concentrate. Before the attack I get food cravings and feel as though my blood sugar is dropping, but eating does not relieve the sensation. Then with the attack I lose my appetite, get weak and shaky and sometimes get diarrhea. My left eye will feel dry. Very occasionally I'll get nausea. The weak and painful stage can last 1, 2 or 3 days. Afterwards I feel hungover.

I have identified lack of sleep, fragrance, bright light, flickering images (like some of those moving emoticons on this page), red wine, heat and hunger as triggers.

I have tried at least 15 or so different prescription medications (including preventatives like Topomax and rescue meds such as triptans and ergotamines) in addition to over-the-counter medications, supplements, bio-feedback, massage therapy and new eye glasses. I have seen internists, gynecologists, an ENT, an ophthalmologist, neurologists specializing in migraine and an endocrinologist. I have even tried talk therapy (psychology). Two neurologists diagnosed my problem as migraine and another as a type of Trigeminal Autonomic Cephalgia (the class of headaches that include cluster headaches - though mine are not cluster headaches). My current neurologist doesn't think the exact diagnosis really matters as far as treatment goes, though he believes I most likely have migraine.

My story began in 2004 during peri-menopause once I stopped birth control pills. (Prior to that I had been on birth-control pills for most of my adult life.) In 2005, at the age of 40, I became post-menopausal. The migraines subsided but the hot flashes became so bad I could not sleep - and not sleeping triggers my migraines. So I began hormone replacement therapy (HRT). The hot flashes stopped and I could sleep - but the migraines continued. Since hormones are associated with migraine I tried different kinds and doses of HRT settling on the lowest dose of an HRT patch (Combi-Patch). The attacks would come and go in their frequency anywhere from 2 or 3 times a month to 2 or 3 times a week. Often I would have mild headache pain without other symptoms for many days. In about '07 or '08 the migraines retreated with attacks happening 1 or 2 times a month. I could live with that. However, in November 2009 they returned with great vigor. I was getting a couple of attacks a week. I saw more doctors and tried more meds and treatments. One medication or treatment after another failed me. Since about January of this year I have developed a chronic daily headache with full-body migraine attacks occurring 2 or 3 times a week.

The latest treatment plan is this (begun very recently): I began Effexor as an alternative to HRT to control the hot flashes. It isn't as good as the HRT. The hot flashes have returned but are not as severe. I do not wake up in a pool of sweat. However, I do wake up some. So my sleep isn't as good as it was on HRT. But the daily headaches aren't as severe and the couple of migraine attacks I've had this week have seemed to respond better to rescue treatment. I've read that Effexor can interfere with sleep, so I'm hoping that is the reason my sleep is disturbed and that after a month or so on the medication that my body will adapt and my sleep will improve.

I am so exhausted. Here's hoping that Effexor will be my answer. If this doesn't work then my neurologist has referred me to another doctor that does Botox.

You can imagine this is all very disappointing since most migraine information says that menopause should spell the end of migraines for most women. If anyone else has migraines post menopause, I am interested in learning about your experience.

Thank you for this forum.

Welcome to the forum! I recently joined myself, and let me tell you, these ladies (and probably some gentlemen, too) are very supportive & understanding. It really is great to have the support.
I'm not menopausal yet, so I can't empathize there. I do have the chronic migraines (w/o aura), as well as daily headache and tension headaches. Tee and I both get Botox, and have some pretty positive results (I'm still undecided about this last round, however).

I,too, have heard that most migraines improve after menopause. I am holding out hope that mine will improve then.

Again, welcome. I hope you have a restful night.

Andrea

Hi Lib and welcome

I am so sorry to read your story and the pattern of them getting worse, with nothing helping. You are not alone and amongst friends here

Hormone triggers are the worse kind, you just cannot avoid them. I am not there yet, but not far off and was told it will probably get worse during the change but better after - maybe you will see an improvement once this settles. I remember my mum having a lot of hot flushes and she used soya products and this seemed to work - I do not have any experience of this, but I will have a look and see if I can find anything that explains why soya helps.

I can highly recommend the Botox, it is the only thing that has given me a break in 5 yrs of daily migs. The other one I would suggest is Fluarazine - that is a calcium channel blocker and has shown to have, statistically, the best results with migraines. It certainly helped mine - but sadly made me very sleepy.

I do not know a lot about Effexor, other than it is from the anti D family and you have to go carefully what other medds you take with it - but I am sure your doc went through that with you. How long will it take to kick it?

Do let us know how you get on.

tee

Hi there

These might help?

http://www.ehow.com/about_5468667_soya-menopause.html

http://www.soya.be/soy-news.php?news=soy-menopause

http://www.dailymail.co.uk/health/article-33079/Can-soya-beat-heart-disease-menopause.html

http://www.timesonline.co.uk/tol/life_and_style/health/article2673595.ece

Hi and welcome. So sorry to hear that you've been on such a hormonal rollercoaster. I can certainly sympathise with that, although I am still getting the dreaded monthlies and pinning all my hopes on an improvement after menopause!!

I'm not so sure soya is a great thing hormonally, to be honest... It is full of phytoestrogens, but it interferes with the thyroid. It's a confusing business, isn't it?

Thank you all for taking the time to read my post and for your your replies. I just needed to vent to some folks who might understand. It is confusing business. I'm sure you all have had your share of confusion regarding treating your migraines as well. I've tried soy and black cohosh for hot flashes in the past without any success. I'm glad to hear about your good results with Botox though. I tried Verapamil, another calcium channel blocker, once. It dropped my blood pressure so low I could hardly get off the couch! I understand your comment about becoming sleepy. Actually, I've had to stop other meds as well because they made me so sleepy - and interfered with cognitive function.

Thanks again for your kind replies.

I was reading yesterday (prompted by something Tee posted about vitamin B12), that vitamin B12 has a role to play in hormone regulation too. That I didn't know. I've started taking sublingual B12 again (since I get plenty of B12 in my diet naturally anyway, so if I'm deficient, it's likely to be an absorption problem).

An update. Since quitting the hormone replacement therapy (HRT) my migraines are not nearly as severe - though I still get them. I've had a couple of really bad ones, but not the regular weekly full-blown attacks I was experiencing.

The hot flashes are still happening, but not nearly as bad as without any medical intervention.

I still have problems sleeping. I think part of that is a return of anxiety. I was on Wellbutrin for that. But the doc said to stop the Wellbutrin since the Effexor is an SSRI. I'm wondering though if the medication switch is the cause - or if it is a symptom of adjusting to finishing graduate school. I was so focused on that for so long. But even when I am dealing with a lack of sleep (a dependable trigger for me) the migraines attacks are much milder.

However - and this may be TMI - without the HRT I've noticed that my bladder control is failing a little. Nothing major, but I've noticed. Kinda sucks. But if I have to choose, I'll choose milder migraines.

Anyway - just sharing in case it is helpful information for anyone else.

Thanks for the update - so pleased cutting the HRT has helped