Migranes in follicular phase perimenapause

[sjlee000]

I love progesterone & it had really helped my migranes just before my period started. Then I started getting awful migranes from day 4 to day 12. Progesterone didn´t help. I started a low dose estrogen patch (25ug/24hrs) from day 2 to day 14 and the migranes are much reduced & I feel so much better. I am reluctant to take estrogen whilst I am still cycling but my life is severely distrupted with these migranes. I´m 50 years old.

Problem is my periods are now coming from 32-38 days to 17 to 21 days! Not as heavy as I am used to though.

Do you have any thoughts on this? I recently had bloodwork done on Day 9 of my cycle without taking any estrogen.

Iron 42ng/ml
Serrum Iron 131 ug/dl
FSH 63 mui/ml
LH 36.5 mui/ml
Estrogen 45 pg/ml
Progesteone 0.51 ng/ml

Does anything jump out to anyone?

Many thanks

[Lara]

At this later stage of perimenopause (age 50), it's fine to take estrogen while you're still cycling. Especially if it's relieving the migraines.
Thanks for being one of the first comments in my new forum!

[sjlee000]

Thanks for reply & for setting up the forum. I hope it takes off, there are plenty of us hormonally challenged females with lots of experience to share!

[JenDroge]

Thank you for commenting on this as I am in exactly the same place. I went from having migraines a couple days before my period, like clockwork, in pre-menopause, to having migraines at ovulation and period during perimenopause, and now, with my FSH and LH in high thirties at 53 years old, I'm getting migraines at ovulation and period, plus on day 5. My iron is perfectly normal.

Any thoughts on what this might be, because it's agonizing dealing with these migraines. Is it because my estrogen is falling really low (although I had a test done on what I thought was day 21 - it was 197). Is it the massive fluctuations of perimenopause or estrogen dipping to a level that triggers the migraine?

I find when I skip a period now, which I do every two or three periods, I have a great month, hardly any headaches. When I have two together (eg: 21 days apart), I am awful. Progesterone has really helped, (oral micronized) just as you commented, and just as Dr Briden recommends, but now the follicular phase is awful. Any thoughts on what to do? My specialist is recommending starting low dose estrogen patch or cream, which I'd really like to do, because my hot flashes are just about every night now (luteal phase through day 5 or so) and my concentration and mood is really low. But I'm not sure which delivery system or timing to do? And afraid it will make the migraines worse. But I have read that if you had relief from migraine during pregnancy when progesterone and estrogen are high, a steady rate of both hormones might help me?

I did find, the one time I tried the patch, (but this was before my FSH and estrogen dropped) the patch seemed to increase my insomnia in the first few days. Could that be because of the 24-hour delivery system and perhaps a cream in the morning is better? But the creams don't have the same systemic effect from what I've read, (as the patch). Perhaps I was just having a bad streak.

Help, Dr. Briden. This is starting to get unbearable. Your book, Hormone Repair Manual, has been invaluable to me. Thank you!

[chaarlie_mulcahy]

I wonder if taking Melatonin can help; it is mentioned in relation to migraines a couple of time in the book; I've been taking it as a sleep-aid for a few weeks now and it has helped massively, but I'm also prone to migraines and haven't had any since I started taking the Melatonin (3mg every night)

[JenDroge]

Thanks Chaarlie! I would really like to try Melatonin but it can interfere with my blood pressure med. So glad it's working for you though! That's fabulous.

[sjlee000]

Hi Jen,

My migranes are pretty much the same as yours. 5-6 years ago at 45 years old I started progesterone utrogestan 2 weeks of the month which helped my migranes in the later stage of my cycle. I thought I had cracked it!!

About 1 year ago I started with the day 4/8 & day 10-12 migranes that are terrible. I now feel awful or the first 2 weeks after my period (which vary from 17 to 41 days!) if I´m not getting migranes I am foggy headed & suffer from insomnia. No real sweats yet.

I tried month long utrogestan (1 pill every night instead of just for 2 weeks) but it didn´t help, so i´m back to 2 weeks of progesterone. I´ve tried magnesium, taurine, seratonin & melatonin but no joy at all. I had some success with omega 3 but not for all the migranes.

My doc is lovely but doesn´t says if I still have a period my estrogen levels are still good enough BUT she did prescribe a low dose 25 mg estrogen patch for me to try. I use it from day 2 to day 14 which is longer than i intended BUT it does seem to help the migranes & I feel much better. On the actual day of the migrane I also apply estriol cream to my temples but this month I slapped on an extra 25mg patch which stopped the headache completely.

The only downside so far is my periods are coming closer together & was enjoying the 40 days apart.

I started getting headaches day 21 too, a small amount of estriol cream eliminated those. The progesterone helps the migranes I used to get before my period.

I hope this helps. Sam

[JenDroge]

Thanks Sam! We are in such similar places! My estrogen and progesterone have really dropped again. I really appreciate the sharing of experience How do you time your progesterone with the varying cycle lengths? That's my challenge. My doc said to go 5 days a week on and 2 days off if I'm not sure. Also, you don't find applying the estriol cream or patch for 'spot' treatment aggravates the migraine with the drop after? Doesn't sound like it. I might try it! Also, did you find your migraines were a bit increased when you started the patch? Maybe I just need to time it better.

[sjlee000]

Hi Jen,

I´ve only started the estrogen the last couple of months but at the moment I´m using the patch for 14 days to cover the follicular phase and then progesterone for 14 days....if my period doesn´t come I´ll use the progesterone for a little longer say another 4-7 days but 1 pill per night. If my period comes early then I´ll stop the progesterone and start counting again from Day 1.

I suffer "drop off" estrogen migranes at ovulation and day 21 & this is when a patch plus some estrogen cream really helps.....I can literally feel the migranes tail off. If you suffer a worsening migrane then perhaps something else is amiss. I think the migranes day 4-8 are due to lower estrogen than my body likes or FSH or LH going crazy and causing the migrane, I´m not really sure. I had a blood test day 9 when I had a migrane and my FHS level was super high. Trying to get my poor ovaries to work when they need to retire!

My best advice, especially as you are starting to skip periods (lucky you!!) is to use the patch and progesterone as your doc suggested and see how you feel. There are options for progesterone use - 1 pill everyday (with a 5 day break) as Lara suggested to me on one of my posts to help keep my progesterone level even to avoid any migrane trigger OR cyclical for 2 weeks.

The 5 days on 2 off sounds quite good....I might try that if my periods get too heavy using the estrogen for migrane control or to help me sleep better.

I´ve put a couple of links below that I´ve found really useful. The book gave me the confidence to trust myself. I also keep a hormonal spreadsheet - length of cycle, day of migrane, severity of migrane, what I was using and how it helped, days of insomnia & a note of any other issues! I can then look back and determine patterns etc.

I´ve written an essay and I´m obviously not a doc. At the end of the day, you know your body well, you´ll get an idea of how you feel with the treatments & your doc seems helpful. My doc is lovely but not helpful for perimenapause which is why I´m always asking Lara questions!

Good Luck!

https://www.amazon.co.uk/Natural-Hormon ... 296&sr=8-2

https://withalva.com/menopause/cyclical ... nt-therapy

[sjlee000]

"you don't find applying the estriol cream or patch for 'spot' treatment aggravates the migraine with the drop after? " - Ah - I see what you mean - I have no idea why my head isn´t screaming with the subsequent drop!!

"Also, did you find your migraines were a bit increased when you started the patch?" No, not for me.