During perimenopause and menopause

Hormone-related migraines may become more frequent and painful during the years leading up to your last period, known as perimenopause. This is because hormone levels rise and fall as you approach your last period. You've reached menopause once you don't get any more periods.

For some people, migraines improve once periods stop. But tension headaches often get worse. If your headaches continue, you likely can stay on your medicines or use other therapies.

Hormone replacement therapy, also known as HRT, is sometimes used to treat perimenopause and menopause. HRT may worsen headaches in some people, and it may improve headaches in others. Or it may cause no changes. If you're taking HRT, your healthcare professional might recommend an estrogen skin patch. The patch provides a low, steady supply of estrogen.

If HRT makes your headaches worse, your healthcare professional might lower the estrogen dose. Or you might try a different form of estrogen or stop the hormone replacement therapy.

Talk with your healthcare professional if you're considering taking HRT and you smoke.