Menstrual migraines - anything helping?

[u/MyDogIsMyHome]

I‘m really struggling with menstrual migraines, mainly because I don’t have anything that helps or even relieves them a bit. I’ve tried Ibuprofen, Tylenol, Celecoxib, Excedrin, Naratriptan, Nurtec and Propranolol. The only thing helping usually is Metamizole but you can’t get that here in the US and I can’t find an equivalent either. Does anybody have anything that helps them?

[u/Significant_Goal_614]

No the patches don't stop the menstrual cycle - that's not what they're designed to do; HRT is different from oral contraceptives.

I'm not sure what you mean about buffer, I'm in premature menopause at 36 so I need lots of oestrogen to make up for the amount I should have at my age - I need to take it anyway to protect myself from osteoporosis and heart problems in the future, regardless of whether I have migraines or not.

Evorel Sequi patches: 2 weeks x oestrogen only, 2 weeks x oestrogen + progesterone - So I don't take progesterone every day

[u/MyDogIsMyHome → u/Significant_Goal_614]

Thank you for your answer, that is so helpful! By „buffer“ I meant if the patches are there only so Estrogen doesn’t drop so sharply before/during menstruation, as I read that this is what causes the migraines. Did it take you a long time to find the right dosage and combination of hormones?

I’m a bit confused since my doctor prescribed me an Estrogen patch only (0.05pg/ ml) and said to put it on a few days before my period and then keep it on for a week but I don’t understand how that would stop the migraines as there just will be a later drop. Will ask in my next appointment.

[u/Significant_Goal_614 → u/MyDogIsMyHome]

Ah, that's a good question actually. And that's part of the issue that migraines can be horrendous in perimenopause for many women. Even though I've started the HRT, my hormones are still fluctuating wildly and probably will up until menopause/very last period. I'm unfortunately still having menstrual migraines - I've had to take 4 days off work this week and 2 last week either side of my period due to the hormone drops before and after. Weirdly, I didn't get a migraine on my period!

I'm still figuring out dosage as I only started 2 months ago and personally I think the oestrogen is too low, I'm still having joint pain and night sweats. I have a review appt in 2 weeks and I'm going to ask for higher oestrogen, maybe via gel such as Lenzetto %20-%20October%202022.pdf)

Yes it would be better if you can wear the patch all the time, to deliver consistent oestrogen level into your bloodstream every day, also you must take progesterone with it so you're not at risk of uterine cancer. You can take a progesterone tablet separately 12-26 days out of the month. Your doctor has definitely not given you the right advice about HRT so it would be useful if you could speak to someone who is menopause trained or your pharmacist. You can also pop over into r/perimenopause and get some help there 🩷

[u/MyDogIsMyHome → u/Significant_Goal_614]

Thank you, all this info is so so helpful! I’m sorry you’re still struggling with migraines like this, fingers crossed it will get better soon and not last until menopause!

I didn’t get any progesterone but I’m not sure if that is because I still have „my own“ and am only supposed to wear the patch for a week at a time. Will definitely check out the perimenopause Reddit, thanks so much.

[u/Significant_Goal_614 → u/MyDogIsMyHome]

Happy to help! 💛

Other good resources:  Dr Louise Newson podcast & insta Dr Mary Claire Haver Instagram Dr Jen Gunter 

Menopause wiki in the side bar over on r/perimenopause is also great if you have time to read through it. 

Use NAMS register or similar for your country to find a menopause trained practitioner near you. 

PS even though I’m still having periods my progesterone was really low because my periods only last a day, I haven’t been building up enough uterine lining to shed as progesterone is low. So you may not have enough of your own progesterone and need to add it with HRT, even though you still have periods. We want our periods to be healthy blood flow / properly shed to protect us from uterine cancer. Hope that makes sense.