Myths about Migraines and Menopause Hormone Therapy

Navigating Migraines and Menopause: Debunking Myths About Hormone Therapy

Among the many symptoms of menopause, migraines can be particularly challenging for those who experience them. Managing migraines during menopause can be complex, and one common concern is whether menopause hormone therapy (MHT) is a safe option for women who have a history of migraines, especially if they were previously on contraceptive pills. In this blog post, we will explore this issue and clarify why some doctors may hesitate to prescribe hormone therapy, but also why it might still be a suitable treatment option for many women.

Understanding Migraines and Hormones

Migraines are severe headaches often accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound. They can be triggered or exacerbated by hormonal fluctuations, making menopause a critical period for women prone to migraines.

Oestrogen, a key female hormone, plays a significant role in migraine development. Many women who experience migraines notice that their headache patterns are influenced by fluctuations in oestrogen levels, which occur during their menstrual cycle, pregnancy, and menopause. Some women find relief from migraines during pregnancy, when oestrogen levels are higher and more stable, while others may experience worsening migraines during menopause when oestrogen levels decline.

The Myth About Menopause Hormone Therapy and Migraines

A common misconception is that menopause hormone therapy for menopause (MHT) is not advisable for women with a history of migraines. This belief often stems from concerns about the oestrogen component in hormone therapy and its potential to trigger migraines. However, it’s important to distinguish between the type of oestrogen used in contraceptives and the oestrogen used in MHT.

Dr. Joanne Hobson, Clinical Lead Director of The Menopause Consortium and a respected British Menopause Society Accredited Menopause Specialist, clarifies this issue: “The oestrogen found in menopause hormone therapy is from a different set of oestrogen hormones than those in contraceptives. While some women may have experienced migraines with contraceptive use, it doesn’t necessarily mean they will have the same reaction to MHT.”

Understanding the Difference in Oestrogen Types

The oestrogen found in contraceptive pills is synthetic and often ethinyl oestradiol, which may have a different impact on the body than the regulated bioidentical also known as Body identical oestrogen used in MHT. Please refer to a previous blog regarding regulated bio identical/body identical hormones v’s compounded bio identical hormones:

Regulated bioidentical/body identical hormones are chemically identical to the hormones naturally produced by the human body. These hormones are typically derived from plant sources such as soy or yam and are processed to match the molecular structure of human hormones.

Regulated bioidentical/body identical oestrogen used in MHT is available in various forms, including pills, patches, creams, and gels. Unlike synthetic hormones, bioidentical hormones are believed to be better tolerated by the body and may not have the same migraine-triggering effect as synthetic 0estrogen.

The Decision to Use MHT for Migraines

The decision to use MHT for managing menopausal symptoms in women with a history of migraines should be made on a case-by-case basis. It’s important for women to consult with a menopause specialist who can assess their individual medical history, migraine patterns, and overall health.

As Dr. Joanne Hobson advises, “In the hands of a skilled menopause specialist, menopause hormone therapy can be a safe and effective option for many women experiencing troublesome menopausal symptoms, even those with a history of migraines. Remember, managing migraines during menopause is not a one-size-fits-all journey. Seek guidance from healthcare professionals who specialize in menopause to create a personalized treatment plan that addresses your unique needs and concerns.”


Migraines during menopause can be challenging, but they should not automatically disqualify women from considering hormone therapy as a treatment option. The key is to consult with a knowledgeable healthcare provider who can assess individual risk factors, medical history, and symptoms. Understanding that the oestrogen used in MHT is different from that in contraceptives is crucial, as it helps debunk the myth that MHT is contraindicated for women with migraines.