Headaches and menopause: What's the connection?

Briefly defined, menopause is the time when a woman stops menstruating. As her ovaries will stop producing new eggs, a woman will experience hormonal changes that can lead to other symptoms as the body adjusts. Menopause also marks the time in a woman’s life when she can no longer get pregnant.

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Most women go through menopause between the ages of 40 and 58. The average age a woman has her last menstrual period can vary depending on a number of factors. In developed countries, the average age a woman stops menstruating is 51.4.

Factors like a woman’s race or ethnicity, health history, and lifestyle also play a role.

A 2011 article published in Obstetrics and Gynecological Clinics of North America notes that some studies show that African-American and Latina women experience natural menopause about 2 years earlier than white women. Asian women tend to go through menopause at similar ages to Caucasian women.

The same article also mentions that social and economic factors can affect when a woman enters menopause. Numerous studies have found that lower social class is linked to an earlier age for natural menopause.

One common mistake people make about menopause is that it happens as one clearly defined event. Menopause usually happens in three transitional periods, usually over multiple years. These stages and what to expect during them are as follows:

1. Perimenopause

This is the stage of menopause when a woman first begins to experience changes. Perimenopause can begin 8 to 10 years before a woman’s last menstrual period. It will last for about 4 years, according to the Cleveland Clinic.

Perimenopause usually begins when a woman is in her 40s. Menstruation is still ongoing but may become irregular. It’s important to remember that women can still get pregnant during perimenopause.

During this time, the body’s production of estrogen and progesterone begins to change, which can lead to experiencing menopausal symptoms, such as:

• Breast tenderness
• Worsening of premenstrual syndrome
• Heavier or lighter than usual periods
• Headaches

2. Menopause

This is the stage when a woman completely stops menstruating. The ovaries are no longer producing eggs, and the body is producing less estrogen and progesterone.

This is the stage most often associated with menopause. It’s common to experience a number of symptoms, such as:

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• Hot flashes
• Night sweats
• Cold flashes
• Vaginal dryness
• Pain or discomfort during sex
• Difficulty sleeping
• The need to urinate more frequently or urgently and urine leakage
• Mood swings, anxiety, or depression
• Joint aches and pains
• Headaches
• Skin flushing
• Weight gain or loss

3. Postmenopause

This is the stage after a woman has stopped having her period for at least 1 year and can no longer get pregnant. The years after are called postmenopause.

Some symptoms, like hot flashes, should get better during this time. This is also when a woman’s risk for health issues like brittle bones and heart disease increases because of the lower amounts of estrogen in her body.

Medication or lifestyle changes can help to reduce this risk, so it’s important to speak to a doctor.

Although headaches aren’t usually the first symptom one might associate with menopause, women have often reported them during this time.

A 2014 study from the University of Cincinnati’s Headache and Facial Program confirmed that women tend to experience more migraine headaches in the early years of menopause due to the fluctuating hormone levels.

“In the past physicians had not really recognized the effect of hormones on migraines,” Dr. Vincent Martin, co-director of the program and lead author of the study was quoted saying in a Los Angeles Times article:

“Headaches do increase during this time period. It’s what women have been telling us for years. Perimenopause and early menopause are very turbulent times for women with migraines.”

For some women, migraines will get better once their periods stop, but tension headaches will get worse. Women who are taking hormonal replacement therapy during perimenopause or menopause may find that their migraines get better or worse. Some will not feel any different.

Given the recent research linking headaches and menopause, headaches could signal early menopause for older women who don’t usually suffer from them. As only 10 percent of headaches have a known cause, however, it’s difficult to say that they are a clear sign of menopause.

When to see a doctor

Most headaches can be treated with over-the-counter pain relievers. If the pain persists or worsens, it’s a good idea for people to see a doctor. If headaches disrupt someone’s ability to do everyday activities, they should seek medical attention.

Headaches can also be a sign of another, more serious issue. If someone notices any of the other following warning signs, they should see a doctor immediately:

• Headaches after they’ve hit or injured their head
• Headaches paired with a painful red eye
• Headaches that get worse with coughing or movement
• Headaches that are paired with fever, stiff neck, confusion, decreased alertness or memory
• Headaches that are paired with nerve-related symptoms such as vision changes, slurred speech, weakness, numbness, or seizures
• Headaches after receiving hormonal therapy treatments
• Headaches that come on severely and abruptly

Treatment and prevention

Acetaminophen, aspirin, ibuprofen, and naproxen are commonly used nonprescription pain relievers that help with headaches.

Stress-relieving activities like yoga and meditation can also work. For some, a cool washcloth or an ice pack are effective in relieving the pain. Other people simply need to eat or properly rehydrate.

A doctor may prescribe medication for persistent or worsening headaches that don’t get better with these forms of treatment.

For women taking hormonal treatment therapy, their doctor may reduce the estrogen dose or switch them to an estrogen skin patch with a lesser dose.

A headache is defined as any pain in the head. The pain can be on one or both sides of the head, be in one place only, or even move from one place to another.

The types of pain people experience with headaches also vary, and sometimes because of what is causing them. Some headaches may be paired with sharp pains, some may have dull pains, and others may come with throbbing pains.

The National Headache Foundation list more than 15 different types of headaches. These range from allergy headaches and menstrual migraines to hangover headaches and sinus headaches.

Some headaches are caused by internal factors, like with changing hormone levels during menstruation and menopause. Others are the results of external factors, like eyestrain or bright sunlight.

What headaches are most common?

About 95 percent of headaches are caused by things people deal with every day, according to Harvard Health Publications. These include things like stress, tiredness, weather changes, and caffeine withdrawal.

The most common headaches are:

• Tension headaches
• Sinus headaches
• Migraines

The symptoms, severity, risk factors, and complications can vary for each type of headache. Some can be prevented with lifestyle changes or medication, while others cannot be prevented as simply.