Question: Hormonal Migraines and estrogen replacement?
Answer: Full Question:
I am hoping you can give me some advice about my hormonal migraines. My grandmother had them, but no longer had them by her 60's so I don't know details. Originally, I had two in my twenties, with different pregnancies. In my late thirties (I am now 50) I began to have one migraine a month, around ovulation. I would drink a coke and it would subside. I also developed severe PMS and then perimenopause over the years. (haywire hormones basically) I developed problems sleeping and other hormonal problems helped by Estrogen, but my migraines increased to several a month over the past 3-4 years. I have had a normal MRI. I had a complete hysterectomy a month ago and hoped that would help but I have had a terrible time this month. I have taken Zoloft and Effexor in the past and they didn't help me. I am trying Topamax now. I use Imitrex, Maxalt and Pamelor. I don't know what to do, if I should try to stop Estrogen completely or what? I have done lots of research and I take feverfew, melatonin, and other natural methods also. Are some women's migraines made worse because of estrogen (I now use estrogel, an estradiol gel) because most of the articles say the opposite? Also, I have only taken the topcoat for three days, maybe I need to give it more time? Are there neurologists who specialize in hormonal migraines or does that matter? And how would I find one? I use a family practitioner who has tried different things and been responsive so far and I have also worked with a gynecologist. Leigh Ann
Answer:
Dear Leigh Ann;
Estrogens cut both ways: they can increase Migraines in some women; but they are just as likely to decrease them (in several weeks usually). Taking Topamax for several days only is short-sighted as it often takes well over a month to get the person to a playing field dose. Most headache specialists are quite aware of hormonal headaches but everyone has their favorite approach. Seeking out a local headache expert would be a great idea. There's a link below to our directory of recommended specialists.
Good luck,
Teri Robert and John Claude Krusz
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Published April 9, 2006
