Understand The Triggers And Find Relief
Menopause Headaches & Migraine

For many women, peri-menopause feels like the body has started changing the rules without telling you. Headaches and migraines can creep in more often, or feel more intense than they used to. Knowing what’s happening physiologically can help you feel less in the dark – and more in control.

Knowing the difference: headaches vs migraines

• Tension headaches often cause a steady, band-like pressure around the head. They can be annoying but are usually manageable with rest or over-the-counter relief.

• Migraines are more complex – often one-sided, throbbing, and accompanied by symptoms like nausea, light sensitivity, or visual disturbances (known as aura).

• Some women notice their migraines change in pattern or severity during perimenopause – for example, becoming more frequent right before a skipped period.

How hormonal shifts play a role

• Oestrogen and progesterone levels fluctuate more unpredictably during perimenopause.

• Sudden drops in oestrogen can affect neurotransmitters like serotonin, which influence how the brain processes pain.

• If you’ve ever experienced menstrual migraines, you may be more likely to notice changes now.

Imagine a simple line graph: in your 20s, your hormonal cycle looked like smooth rolling hills; in perimenopause, it’s more like a jagged mountain range. Those sudden drops and spikes can be a key migraine trigger.

Understanding what type of headache you’re experiencing – and how it links to hormonal changes – is the first step to finding effective relief. You’re not imagining it, and you’re not alone in noticing these changes.

Menopause is not a one-size-fits-all experience – and migraines prove it. For some women, they fade away almost entirely after periods stop. For others, they seem to turn up more often, or with a new intensity that feels unfair after decades of managing them.

Hormonal triggers you can't see but can feel

• Oestrogen plays a key role in regulating serotonin, a brain chemical that influences mood and pain perception.

• When oestrogen levels drop sharply, serotonin can dip too, which may make you more sensitive to pain signals.

• If your migraines have always been linked to your menstrual cycle, these hormonal changes can either disrupt or intensify that pattern.

Other contributors beyond hormones

• Sleep disruption: Perimenopause can bring more nights of tossing and turning, and lack of restorative sleep is a well-known migraine trigger.

• Stress: Emotional stress and daily life pressures can combine with hormonal shifts, amplifying the likelihood of an attack.

• Dietary changes: Some women find their food sensitivities shift during this time – red wine, aged cheese, or processed meats might suddenly set off headaches that never used to be a problem.

Picture this: in your 30s, you might have had a glass of Merlot at dinner without thinking twice. Now, one glass plus a late night and a stressful workday might leave you reaching for the ice pack by morning.

The relationship between menopause and migraines isn’t straightforward – but spotting patterns can help you understand which changes are driven by hormones and which by lifestyle factors. That awareness is the first step toward targeted relief.

Migraines during menopause can feel unpredictable – one week you're fine, the next you're cancelling plans and lying in a dark room. But often there is a pattern hiding in plain sight. Learning to recognise yours can be the difference between feeling at the mercy of headaches and feeling a step ahead.

Keeping a detailed migraine diary

• Record the date, time, and duration of each headache or migraine.

• Note any symptoms – aura, nausea, light sensitivity, or mood changes.

• Include possible triggers in the 48 hours beforehand – what you ate, sleep quality, stress levels, weather changes.

• Tracking for at least two to three months can help reveal recurring patterns.

A patient once told me she discovered that three of her migraines in one month occurred after Friday evening takeaway and a late bedtime – something she’d never connected before writing it down.

Spotting trigger combinations

• Migraine triggers often stack up: a single glass of wine might be fine, but wine plus poor sleep plus hormonal change can tip the balance.

• Seasonal changes, travel, or a run of stressful days can quietly add to your trigger load.

• Looking for overlaps in your diary can help you anticipate high-risk days and take preventive steps.

Patterns aren’t always obvious day to day, but when you look at them in black and white, they often start to make sense. The more you know about your triggers, the more you can plan around them.

Once you’ve identified your migraine patterns, the next step is finding treatment that works for you. For many women, relief comes from a combination of medical support and lifestyle adjustments – especially when hormonal changes are part of the picture.

Hormone Replacement Therapy (HRT) for migraine stability

• HRT can help smooth out the hormone fluctuations that often trigger migraines during perimenopause.

• Transdermal options (patches, gels) provide steadier oestrogen levels than oral tablets, which may be better tolerated by migraine sufferers.

• HRT isn’t suitable for everyone – your GP or menopause specialist will assess your medical history and risk factors.

Some women describe the effect as “turning the volume down” on their headaches, making them less frequent and less severe.

Acute migraine treatments for fast relief

• Triptans can be effective if taken early in a migraine attack.

• Over-the-counter pain relief (e.g., ibuprofen, aspirin) may help for milder episodes.

• Anti-nausea medication can be useful if sickness is a major symptom.

Preventive medications to reduce frequency

• Beta-blockers, certain antidepressants, or anticonvulsants can be prescribed to prevent migraines if they occur frequently.

• These are generally considered when headaches impact daily life despite lifestyle changes.

Your best treatment plan may involve a mix of approaches – stabilising hormones, addressing triggers, and using medication when needed. The key is personalisation, guided by a healthcare professional who understands the interplay between menopause and migraines.

While medical treatments have their place, many women find that simple, consistent lifestyle shifts can make migraines less disruptive. The key is stacking small changes that support your body through hormonal transitions.

Eat and hydrate to support your brain

• Keep blood sugar steady with balanced meals – protein, healthy fats, and complex carbs.

• Limit known dietary triggers like aged cheeses, red wine, and heavily processed meats if they appear in your migraine diary.

• Aim for 1.5–2 litres of water a day – dehydration can magnify headache severity, especially during hot weather or after exercise.

A client once joked that buying a glass water bottle she actually liked looking at was the only thing that made her drink more – small changes matter.

Protect your sleep and lower stress

• Create a wind-down routine: dim lighting, reading, or gentle stretching.

• Keep a consistent sleep schedule, even at weekends.

• Try mindfulness, meditation apps, or short breathing exercises to manage daily tension.

Move regularly but gently

• Low-impact exercise like walking, swimming, or yoga can improve circulation and reduce stress-related headaches.

• Avoid sudden bursts of high-intensity workouts if they seem to trigger migraines – gradual progression is safer.

Lifestyle changes won’t erase every migraine, but they can tip the balance towards fewer and milder episodes. Think of them as part of your overall menopause toolkit, working alongside any medical treatments.

Most menopause-related headaches aren’t dangerous, but there are times when prompt medical attention is essential. Knowing the warning signs can give you peace of mind and ensure serious issues aren’t overlooked.

Recognising red flag symptoms

• A sudden, severe headache – often described as “the worst headache of my life.”

• Headache accompanied by blurred or double vision, weakness, or confusion.

• Persistent headache after a head injury.

• Headache with fever, stiff neck, or rash.

These symptoms may signal conditions unrelated to menopause, such as stroke, meningitis, or other neurological emergencies – all of which require urgent care.

When to see your GP

• Migraines are increasing in frequency or changing in nature.

• Over-the-counter medicines are no longer helping.

• Headaches are interfering with your ability to work or carry out daily activities.

If in doubt, it’s always better to check. One patient put it perfectly: “I’d rather feel silly for coming in than regret not coming in soon enough.”

Headaches during menopause are often a normal part of the hormonal rollercoaster, but they should never be dismissed without thought. Early medical input can rule out serious issues and give you more options for relief.

Migraines might feel like yet another unwelcome addition to your menopause checklist, but they don’t have to define this stage of life. With the right mix of medical support, self-care, and realistic expectations, it’s possible to feel more in control and less at the mercy of your headaches.

Building your personalised migraine toolkit

• Combine medical treatments (such as HRT or preventive medication) with lifestyle habits that work for you.

• Keep your migraine diary going, even after symptoms improve – patterns can change over time.

• Have a “migraine plan” ready: preferred medication, hydration, quiet space, and someone who knows how to help you if needed.

Reclaiming quality of life

• Schedule important activities for times of day or month when you’re less likely to experience migraines.

• Make room for enjoyable, stress-reducing hobbies – gardening, swimming, or even just sitting in a café with a good book.

• Accept that occasional setbacks are normal, and focus on progress rather than perfection.

One woman I spoke to described it as “learning to live in partnership with my body, instead of fighting it every day.” That shift in mindset can make a bigger difference than you might expect.

Menopause is a transition, not a permanent state of chaos. By understanding your migraine triggers, seeking the right help, and supporting yourself daily, you can create a new normal that feels steady and liveable.

Migraines and headaches during menopause can feel like yet another hurdle in an already shifting landscape, but they don’t have to be something you simply endure. Understanding how hormonal changes affect your body, spotting your unique trigger patterns, and knowing the range of evidence-based treatments available can help you move from reacting to anticipating – and in many cases, reducing the impact these episodes have on your life.

It’s worth remembering that there’s no single “right” approach. For some, medical support such as HRT or targeted migraine medication can be transformative; for others, consistent lifestyle changes make the biggest difference. Most often, it’s a blend of both, refined over time as your needs evolve. What matters most is finding a plan that feels sustainable, realistic, and guided by professionals who understand the nuances of this life stage.

If your symptoms are affecting your day-to-day life, consider speaking with a GP or menopause specialist to explore your options. And if you’re looking to take the first, low-pressure step, start with a simple migraine diary – you might be surprised by what it reveals. This stage of life is about adaptation, but also about reclaiming comfort and confidence in your body. The right support can make that entirely possible.