Hormonal Havoc: Navigating Migraines in Perimenopause

Maya has had the best life, fulfilling all her roles as a thriving professional, a loving wife and a doting mother with skill and grace. She has always been well-respected and admired by all for her boundless energy and zest for life. 

But now, in her 40s, her life seems to have changed very quickly, with the onset of migraines. The episodes were occasional at first, and she would think stress or lack of sleep was to blame. But, with time, they have become more frequent and more intense, breaking her confidence and making her feel incapable. Maya, who was once a force to reckon with, now finds herself struggling even to get through the day. 

Can you relate to this story? Have you experienced something similar? Before you feel disheartened, know that Maya hasn’t given up. She has decided to reset her lifestyle and manage her migraines rather than fight them. She is also enlisted in support groups, which provide much-needed comfort and encouragement. You can follow in Maya’s footsteps too. And we at Miyara, are here to support and empower you.

Perimenopause, the transitional phase leading up to menopause, is marked by hormonal fluctuations that can significantly impact physical, mental, emotional and social health (relationships and adaptability). One of the common and often debilitating symptoms experienced during this time is an increase in migraine frequency and severity. Migraines are different from regular headaches.

While there is no direct cure yet, several strategies can help improve the quality of life during this time.

• OTC or prescription medication: This includes non-steroidal anti-inflammatory drugs (NSAIDs), dietary supplements like Mg, riboflavin and Co-Q10, triptans as well as antidepressants, anticonvulsants, or beta-blockers in cases of severe headaches.

• Hormone Replacement Therapy (HRT): HRT may be helpful but it has pros and cons in migraine management. Talk to your doctor about its potential risks and benefits.

• Behavioral therapy is an umbrella term for practices to relax the mind and body consciously. It includes mental and muscle relaxation techniques. In some cases, Biofeedback therapy is advised. This involves learning to control physiological responses like heart rate, muscle tension, and skin temperature, which can help manage stress and reduce migraine frequency. It should only be done under the supervision of skilled professionals.

• Neuromodulation devices: Prescription-based devices (headband or armband electrodes) and implantables have shown promising effects in migraine management. These work by delivering electrical currents to stimulate or modulate nervous system responses. However, these devices are still in their early stages of development.

  

• Regular, restful sleep: This is undoubtedly the most helpful intervention for managing migraines. Aim for 7-8 hours of uninterrupted sleep each night to regulate your body’s internal clock and reduce stress.

• Combating stress: Relaxation techniques, meditation, deep breathing or progressive muscle relaxation can also prevent migraine triggers.

• Regular exercise: Moderate-intensity physical activity most days of the week can improve overall health and reduce stress. It is ok to listen to your body and skip exercise during a menses or migraine episode if you don’t feel up to it. 

• Prioritising vitamins and minerals: Anti-inflammatory foods like ginger and turmeric, green leafy vegetables, nuts and seeds, whole grains and legumes rich in vitamins and minerals (especially folate, riboflavin and magnesium) can help.

• Hydrating well: Drink enough fluids to prevent dehydration, which can initiate headaches.

• Limiting known triggers: Identify and avoid potential migraine triggers, such as certain foods, drinks, strong odors, loud noises or bright lights.

  

Remember, early diagnosis and appropriate treatment can help improve the quality of life for women experiencing this challenging phase of life. Talk to your healthcare provider for personalised treatment approach if your condition is particularly debilitating or difficult to manage.

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Kanchana is a Lifestyle Consultant & Weight Management Specialist. After a Masters degree in Molecular Biology from the USA, she ventured into the field of Nutrition and is certified in General Nutrition, Sports Nutrition, and Weight Management. Her own successful weight loss journey inspired her to help people of all age groups and health conditions via Calorie Culture, which she founded in 2012. She is also an avid dancer, mini marathoner, and sports enthusiast. She strongly advocates sustainable lifestyle changes as a means to long-term health benefits and optimal weight.