Menopause Transition Linked to Increased Headache Risk

Eight percent of the premenopausal group had high frequency of headache compared to 12.2% and 12.0% of the perimenopausal and postmenopausal groups, respectively. The adjusted odds of being in the high frequency headache group during perimenopause was 1.62 (95% CI: 1.23-2.12) and 1.76 (95% CI: 1.23-2.52) during menopause. After adjusting for body mass index, medication overuse, depression, and preventive medications, perimenopause remained significantly associated with high frequency headache. The authors noted that depression (OR 2.15; 95% CI 1.62–2.85) and medication overuse (OR7.07; 95% CI 5.46–9.14) also significantly increased the probability of high frequency headache.

After full adjustment, women in the late stage of perimenopause were found to have a 1.7-fold increased risk for high frequency headache (OR 1.72, 95% CI: 1.19-2.49).

“In the past it was thought that migraines always improve with menopause,” Dr Vincent said. “Our research dispels this myth and suggests that a subgroup of female migraineurs with high frequency headache may actually worsen with menopause.”

The authors suggest this relationship may be related to the hormonal changes associated with each stage of menopause. They further point out the association of potential confounders such as insomnia, smoking, obesity, depression, and medication overuse with headache frequency; however the fully adjusted models in the study accounted for smoking, medication overuse, obesity, and depression.

Reference

Martin VT, Pavlovic J, Fanning KM, Buse DC, Reed ML, Lipton RB. Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine: Results of the American Migraine Prevalence and Prevention Study. Headache. 2016; doi: 10.1111/head.12763.