Perimenopause and Migraines

Now that I'm 50+, I've been getting severe headaches with my periods, and it also seems like my nasal allergy symptoms are worse at those times. Is this just a coincidence, or is this associated with perimenopause?

Yes. Your symptoms could well be associated with perimenopause.

The World Health Organization has defined perimenopause as the time period two to eight years prior to menopause, as well as the year after cessation of menses.

Research found that the urinary estrogen metabolites were higher and progesterone metabolites were lower throughout the menstrual cycle in perimenopausal women than in younger women. Many of the symptoms of perimenopause are thought to be due to this phenomenon known as "estrogen dominance."

• Change in menstrual cycle - You may experience variable lengths of menstrual cycles, heavier menstrual bleeding, and intermittent amenorrhea during this time.
• Tension or migraine headaches - You may have started getting more headaches or perhaps you never had headaches before and now you do. Hormone-induced migraines can flare up at the time of perimenopause. Tension headaches may become more common because of the everyday stress women may face or because a woman is dealing with the realities of entering into menopause.
• Vasomotor - Nasal congestion and rhinorrhea (runny nose) could be induced through vasomotor instability. It occurs less often compared to other symptoms such as hot flashes and sweating.

Treatment includes symptomatic management, relaxation and life style modification, and hormone replacement therapy (HRT). Discuss with your doctor the risks and benefits of HRT.