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Migraine, menopause and hormone replacement therapy.
Post Reprod Health. 2018 Mar; 24(1):11-18.PR

Abstract

Perimenopause marks a period of increased migraine prevalence in women and many women also report troublesome vasomotor symptoms. Migraine is affected by fluctuating estrogen levels with evidence to support estrogen 'withdrawal' as a trigger of menstrual attacks of migraine without aura, while high estrogen levels can trigger migraine aura. Maintaining a stable estrogen environment with estrogen replacement can benefit estrogen-withdrawal migraine particularly in women who would also benefit from relief of vasomotor symptoms. In contrast to contraceptive doses of ethinylestradiol, migraine aura does not contraindicate use of physiological doses of natural estrogen. In women with migraine with or without aura, using only the lowest doses of transdermal estrogen necessary to control vasomotor symptoms minimizes the risk of unwanted side effects. Cyclical progestogens can have an adverse effect on migraine so continuous progestogens, as provided by the levonorgestrel intrauterine system or in continuous combined transdermal preparation, are preferred. There are no data on the effect of micronized progesterone on migraine, either cyclical or continuous. Non-hormonal options for both conditions are limited but there is evidence of efficacy for escitalopram and venflaxine.

Authors+Show Affiliations

Barts Sexual Health Centre, London, UK.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28994639

Citation

MacGregor, E Anne. "Migraine, Menopause and Hormone Replacement Therapy." Post Reproductive Health, vol. 24, no. 1, 2018, pp. 11-18.
MacGregor EA. Migraine, menopause and hormone replacement therapy. Post Reprod Health. 2018;24(1):11-18.
MacGregor, E. A. (2018). Migraine, menopause and hormone replacement therapy. Post Reproductive Health, 24(1), 11-18. https://doi.org/10.1177/2053369117731172
MacGregor EA. Migraine, Menopause and Hormone Replacement Therapy. Post Reprod Health. 2018;24(1):11-18. PubMed PMID: 28994639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Migraine, menopause and hormone replacement therapy. A1 - MacGregor,E Anne, Y1 - 2017/10/10/ PY - 2017/10/11/pubmed PY - 2018/9/21/medline PY - 2017/10/11/entrez KW - Estrogen KW - hormone replacement therapy KW - menopause KW - migraine KW - vasomotor symptoms SP - 11 EP - 18 JF - Post reproductive health JO - Post Reprod Health VL - 24 IS - 1 N2 - Perimenopause marks a period of increased migraine prevalence in women and many women also report troublesome vasomotor symptoms. Migraine is affected by fluctuating estrogen levels with evidence to support estrogen 'withdrawal' as a trigger of menstrual attacks of migraine without aura, while high estrogen levels can trigger migraine aura. Maintaining a stable estrogen environment with estrogen replacement can benefit estrogen-withdrawal migraine particularly in women who would also benefit from relief of vasomotor symptoms. In contrast to contraceptive doses of ethinylestradiol, migraine aura does not contraindicate use of physiological doses of natural estrogen. In women with migraine with or without aura, using only the lowest doses of transdermal estrogen necessary to control vasomotor symptoms minimizes the risk of unwanted side effects. Cyclical progestogens can have an adverse effect on migraine so continuous progestogens, as provided by the levonorgestrel intrauterine system or in continuous combined transdermal preparation, are preferred. There are no data on the effect of micronized progesterone on migraine, either cyclical or continuous. Non-hormonal options for both conditions are limited but there is evidence of efficacy for escitalopram and venflaxine. SN - 2053-3705 UR - https://www.unboundmedicine.com/medline/citation/28994639/Migraine_menopause_and_hormone_replacement_therapy_ L2 - https://journals.sagepub.com/doi/10.1177/2053369117731172?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -