Menopause Int. 2009 Jun;15(2):82-6.
Hormonal management of migraine at menopause.
Nappi RE, Sances G, Detaddei S, Ornati A, Chiovato L, Polatti F.
Research Center of Reproductive Medicine, Unit of Gynecological Endocrinology
and Menopause, IRCCS Maugeri Foundation, University of Pavia, Via Ferrata 8,
27100 Pavia, Italy. renappi@tin.it.
In this review, we underline the importance of linking migraine to reproductive
stages for optimal management of such a common disease across the lifespan of
women. Menopause has a variable effect on migraine depending on individual
vulnerability to neuroendocrine changes induced by estrogen fluctuations and on
the length of menopausal transition. Indeed, an association between estrogen
'milieu' and attacks of migraine is strongly supported by several lines of
evidence. During the perimenopause, it is likely to observe a worsening of
migraine, and a tailored hormonal replacement therapy (HRT) to minimize estrogen/progesterone
imbalance may be effective. In the natural menopause, women experience a more
favourable course of migraine in comparison with those who have surgical
menopause. When severe climacteric symptoms are present, postmenopausal women
may be treated with continuous HRT. Even tibolone may be useful when analgesic
overuse is documented. However, the transdermal route of oestradiol
administration in the lowest effective dose should be preferred to avoid
potential vascular risk.
Please click on the required question.
- 1 HRT help me with the psychological difficulties that I am experiencing around?
- 2 HRT help my mental ability?
- 3 Can HRT reduce my chance of developing heart disease?
- 4 How does HRT protect against coronary heart disease?
- 5 If I am at particular risk of heart disease, can HRT still help?
- 6 Do progestogens taken in combination with oestrogen replacement therapy have an adverse effect on heart protection?
- 7 How long should HRT be taken to reduce the risk of heart disease?
- 8 Is there any evidence that HRT will protect my bones?
- 9 Would the dose (strength) of my HRT influence its ability to protect my bones?
- 10 Are there other treatments apart from HRT for osteoporosis?
- 11 Would HRT help my skin?
- 12 Can hormone replacement therapy cure all my menopausal symptoms?
- 13 How prevalent is cancer of the breast?
- 14 What factors influence the chance of breast cancer developing?
- 15 What is the relationship between HRT and breast cancer?
- 16 I have benign breast disease. Can I take HRT?
- 17 Does a history of breast cancer mean that HRT is absolutely contraindicated?
- 18 If I started HRT early (aged 30 to 45), does this influence my chance of developing breast cancer?
- 19 Does hormone replacement therapy increase the risks of cancer of the womb?
- 20 I have had endometrial cancer and now have menopausal problems. Can I take HRT?
- 21 Does HRT have a relationship to ovarian cancer?
- 22 How does HRT relate to a blood clot (DVT - deep venous thrombosis or pulmonary embolism)?
- 23 I have varicose veins. Can I take HRT?
- 24 Should HRT be discontinued before I have a major operation or leg surgery?
- 25 Does HRT increase life-expectancy?
- 26 I am still seeing periods. Could HRT have any benefits for me?
- 27 I have been told that I have fibroids. Can I take HRT?
- 28 What happens if I decide not to take HRT?
- 29 Doctors seem to promote HRT but the media cause me anxiety. Who is right?
- 30 Support Groups.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
