Can Menopause Cause Headaches?

Menopause and headaches are often intertwined. For some women, menopause marks the end of monthly hormonal headaches. But, the transition into menopause can trigger more frequent headaches and migraines.

This article discusses menopause and headaches. It also explains how shifting hormones cause different types of headaches related to menopause. This article also provides ways to find relief from hormonal headaches and possibly even prevent headaches and migraines during menopause.

Language Considerations

The words "female" and "women" are used here to refer to people who identify as women and have the typical reproductive organs of a cisgender female. We recognize that some people who identify as women do not have the same anatomy as that depicted in this article.

Woman suffering from insomnia and headache

Prostock - Studio / Getty Images

What Is Perimenopause?

Menopause occurs when a woman's menstrual cycle (period) permanently stops for 12 months in a row. Perimenopause is the time leading up to menopause. Though different for every woman, it typically begins in your 40s and takes an average of four or five years.

Symptoms of Menopausal Headaches

Headaches associated with menopause are known as hormonal headaches. Migraines and tension headaches are the most common types of hormone-related headaches.

A tension headache can feel like:

  • A persistent "rubber-band around the head" sensation
  • Often start at the forehead and radiate around to the back of the head
  • A dull tightening or pressure on both sides of the head
  • Muscle tension in the neck and shoulders
  • The discomfort lasts a few hours to a few days

Migraines can feel like:

  • A gradual progression of head pain to a moderate or severe throbbing headache
  • The pain is often constant
  • May include nausea
  • Activity, light, or loud noises can make it worse
  • Commonly last for a few days and can be followed by exhaustion or brain fog

Hormonal headaches typically occur up to two days before your period and can last up to three days after your period starts.

Menopause and Headache Statistics

The following are statistics related to women, menopause, and headaches:

  • Women are three times more likely to experience a migraine than men.
  • 12% of menopausal women have high-frequency headaches (10 or more per month).
  • For 24.4% of menopausal women, their headaches improved with menopause.
  • For 35.7% of menopausal women, their headaches worsened with menopause. 
  • Women who experience early menopause are at a higher risk of migraines.
  • Migraines may wake you up at night or early morning hours.

Causes of Menopausal Headaches

Hormones cause menopausal headaches. A drop in levels of estrogen—the primary sex hormone in cisgender females—is to blame. Commonly known as menstrual migraines, they strike a day or two before your period starts. 

In the years leading up to menopause, your menstrual cycle changes. Periods come more frequently, causing an uptick in hormonal headaches. Hot flashes and night sweats—two common menopause symptoms—can also trigger migraines during perimenopause and menopause.

Many women find monthly hormonal migraines and headaches resolve after menopause. However, some women experience an increase in hormonal headaches as estrogen levels plummet even further. Many women experience more frequent tension headaches in the post-menopausal years.

Tension headaches, the most common type of headaches, are also caused by stress and muscle tension. Common triggers include a lack of sleep, dehydration, hunger, uncorrected vision problems, dental problems, alcohol, and certain climates. 

What Menopause Medications Can Cause Headaches?

Medications used to treat menopause symptoms can sometimes contribute to headaches. This includes hormone replacement therapy (HRT), such as estradiol and progesterone.

While often helpful in relieving hot flashes and other uncomfortable symptoms of menopause, HRT can trigger headaches in some women. If you suspect HRT is causing headaches, talk to your healthcare provider about adjusting the dose.

Herbal remedies used to balance hormones and relieve menopause symptoms may also cause headaches. These include:

  • Black cohosh
  • Evening primrose oil
  • Gingko biloba
  • Ginseng
  • Red clover
  • St. John's wort

Caffeine in Medications

Many forms of Excedrin include caffeine which often relieves headaches. However, caffeine can be a headache trigger for some people. 

How to Treat Menopausal Headaches

A two-pronged approach of prevention and treatment is recommended for menopausal headache relief. Over-the-counter and prescription medications help relieve the symptoms. Lifestyle changes, hormone therapy, and prophylactic (preventive) medications can help to reduce headache frequency.

Treating Menopausal Migraines

Some migraines respond well to over-the-counter medications. According to research, combination of 500 mg acetaminophen, 500 mg aspirin, and 130 mg caffeine—or two Excedrine tablets—is often highly effective. You may need to to take two tables every six hours until the migraine resolves (typically three days).

For migraine associated nausea, Benadryl (diphenhydramine), Dramamine (dimenhydrinate), or Bonine (meclizine) can help. However, these OTC medicine can make you drowsy, so use caution.

Prescription medications used to treat migraine pain and other symptoms include:

  • Triptans like Imitrex (sumatriptan), Relpax (eletriptan), and Zomig (zolmitriptan)
  • Butalbital, a barbiturate, in combination with acetaminophen (Fioricet) or aspirin (Fiorinal) and caffeine) 
  • Ergots such as dihydroergotamine and Cafergot (ergotamine)
  • Oral steroids like prednisone and dexamethasone for migraines that last more than three days
  • Anti-nausea medicine such as Reglan (metoclopramide) or Zofran (ondaseteron)

Non-drug treatments for migraine include lying down in a dark and quiet area. A cool rag on your forehead, the back of your neck, and over your eyes can help decrease swelling, block out light, and reduce nausea.

Treating Menopausal Tension Headaches

Tension headaches are often treated with OTC headache medicines. These include:

  • Tylenol (acetaminophen)
  • Advil or Motrin (ibuprofen)
  • Aleve (naproxen)
  • Ecotrin, Bufferin, or Ascriptin (aspirin
  • Excedrin (acetaminophen, aspirin, caffeine)

Non-drug treatments for tension headaches include drinking more water, getting enough sleep, relieving stress levels, neck and shoulder massage, ice packs, and physical therapy to relieve muscle tension.

How to Prevent Menopausal Headaches

Recurring headaches during menopause are often treated with prophylactic (preventive) medications, HRT, and lifestyle changes. A doctor can prescribe preventive medications for headaches that occur twice a week or more.

Hormone Replacement Therapy

The most commonly prescribed treatment for menopause symptoms is HRT. HRT—an umbrella term for medications that replace low estrogen and progesterone levels—has mixed results as a treatment for menopausal headaches. If used for headache prevention, steady, continuous doses of hormones are recommended.

HRT comes in several different formulations with various concentrations of hormones. In addition to pills, hormones are delivered through the skin in transdermal patches, topical creams and sprays, or intra-vaginally with rings, suppositories, and creams.

Common HRT medications include: 

  • Oral (pills):  Bijuva (estradiol and progesterone), Activella (estradiol and norethindrone), FemHRT (Ethinyl estradiol and norethindrone), Jintei (Ethinyl estradiol and norethindrone), and Prempro (conjugated estrogens and medroxyprogesterone)
  • Transdermal patch: Alora, Climara, Estraderm, and Vivelle-Dot (all estradiol transdermal systems)
  • Topical cream: Estrogel (estradiol gel)
  • Topical spray: Evamist (estradiol transdermal spray)
  • Vaginal ring: Estring (estradiol vaginal ring)
  • Vaginal suppository: Imvexxy (estradiol vaginal suppository)
  • Vaginal creams: Premarin vaginal cream (conjugated estrogens)

HRT—in particular progesterone replacement—can also contribute to hormonal headaches. Talk to your healthcare provider if you are still experiencing hormonal headaches on HRT. They may be able to prescribe a different formula.

Non-Hormonal Medicine

Depending on your symptoms, your healthcare provider may prescribe non-hormonal medicines to prevent and treat recurring migraines. These include antidepressants and anticonvulsants.

Antidepressants used to prevent migraines include:

  • Effexor (venlafaxine)
  • Paxil (paroxetine)
  • Lexapro (escitalopram)

Elavil (amitriptyline) is used to prevent chronic tension headaches. Gralise (gabapentin), an anticonvulsant (anti-seizure medication), is effective in preventing menopausal migraines and tension headaches. 

Lifestyle Changes

Lifestyle techniques to help prevent migraines and tension headaches caused by menopause include:

  • Maintain a healthy lifestyle: Adopting healthy lifestyle changes such as eating well, exercising, stress management, and getting enough sleep can help prevent headaches.
  • Hydrate (drink water): Decreased hormone levels make it more difficult for your body to replenish fluids. This can cause dehydration, which can lead to headaches. Drinking water helps your body replace the fluid it loses.
  • Avoid triggers: It can be helpful to identify and avoid food or environmental triggers such as alcohol, dairy, gluten, monosodium glutamate (MSG), strong smells, or bright lights.
  • Alternative therapies: Some people use natural supplements such as B vitamins, coenzyme Q10, magnesium, black cohosh, and butterbur to prevent migraines. Acupuncture, massage, and essential oils are also alternative methods that may help. Talk with your healthcare provider to see which are an option for you.

Are There Tests to Diagnose the Cause of Menopausal Headaches?

Blood tests that measure hormone levels are sometimes used to diagnose menopause and related symptoms, including menopausal headaches. These include:

However, healthcare providers often diagnose menopause based on a woman's age and the presence of other menopause symptoms. Hormone level testing is more common when early menopause is suspected in women in their 30s.

Your healthcare provider may run additional labs and imaging studies to rule out other potential causes for headaches. These can include blood and urine tests, an electroencephalogram (EEG), computed tomography (CT) scan, or magnetic resonance imaging (MRI).

When to See a Healthcare Provider

For women in their 40s or 50s, menopause is one of many potential causes of headaches. If you experience frequent headaches or migraines, talk with your healthcare provider.

You should also seek medical care for any of the following symptoms:

  • A sudden, severe headache 
  • A headache that wakes you 
  • A headache that occurs with a high fever or rash
  • A headache combined with dizziness or weakness 
  • Headaches combined with unexplained weight loss
  • Headaches that are getting worse or feel different than before
  • Headaches that occur frequently and aren't relieved with OTC medication

Summary

Hormonal headaches like migraine and tension headaches can become more frequent during perimenopause. Menopause sometimes relieves menstrual migraines but may trigger tension headaches.

Medications and lifestyle changes can help to relieve menopausal headaches. While at-home remedies can help, it’s best to see your healthcare provider for frequent or severe headaches. 

Prescription medications can treat and prevent hormonal headaches. HRT, pain relievers, antidepressants, and anticonvulsants can help ease symptoms and reduce headache frequency.

A Word From Verywell

Recurring headaches can hinder your quality of life. For women in their 40s and 50s, frequent headaches may be caused by hormone fluctuations from menopause and perimenopause. Menopause symptoms vary for every woman and can change as you move through the transition. Talk to your healthcare provider if menopause symptoms affect your activities of daily living. They may want to rule out other underlying conditions or prescribe medications. 

Frequently Asked Questions

  • What age does menopause start?

    Perimenopause usually begins when a woman is in her 40s or 50s, with the average age of menopause being 52 years old.

  • How long does menopause last?

    Menopause occurs in three stages. Perimenopause, the time leading up to menopause, can take two to eight years. Once you’ve reached menopause (no periods for 12 months in a row), postmenopausal hot flashes can last another four to 10 years.

  • How early does menopause start?

    The average age a woman reaches natural menopause is 51 or 52. Menopause is considered premature when it occurs before age 40.

  • Can menopause cause dizziness?

    Yes, dizziness can be a symptom of menopause. However, it’s important to talk with your healthcare provider to rule out other health concerns that may be causing dizziness, such as anemia, diabetes, or thyroid disease.

  • What are other symptoms of menopause?

    In addition to headaches, other menopause symptoms include:

    • Changes in periods
    • Hot flashes
    • Night sweats
    • Vaginal dryness
    • Dry skin 
    • Forgetfulness
    • Mood swings
    • Low sex drive
    • Trouble sleeping 
    • Urinary incontinence (leakage)


29 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Department of Health and Human Services: Office on Women’s Health. Menopause basics.

  2. Johns Hopkins Medicine. Headaches and women: what do hormones have to do with it?

  3. Johns Hopkins Medicine. Tension headache.

  4. U.S. National Library of Medicine: MedlinePlus. Migraine.

  5. Martin V, Pavlovic J, Fanning K, Buse D, Reed M, Lipton R. Perimenopause and menopause are associated with high-frequency headache in women with migraine: results of the American migraine prevalence and prevention study. Headache. 2016;56(2):292-305. doi:10.1111/head.12763.

  6. American Headache Society. Understanding and treating headache related to menopause.

  7. Van Oosterhout W, Van Someren E, Schoonman G, et al. Chronotypes and circadian timing in migraine. Cephalalgia. 2017;38(4):617–25. doi:10.1177/0333102417698953.

  8. UpToDate. Estrogen-associated migraine.

  9. The North American Menopause Society (NAMS). Women's health and menopause: headaches.

  10. MacGregor EA. Migraine, menopause and hormone replacement therapy. Post Reprod Health. 2018;24(1):11-18. doi:10.1177/2053369117731172

  11. U.S. National Library of Medicine: MedlinePlus. Tension headache.

  12. National Center for Complementary and Integrative Health. Black cohosh.

  13. National Center for Complementary and Integrative Health. Evening primrose oil.

  14. National Center for Complementary and Integrative Health. Gingko.

  15. National Center for Complementary and Integrative Health. Asian ginseng.

  16. National Center for Complementary and Integrative Health. Red clover.

  17. National Center for Complementary and Integrative Health. St. John’s wort.

  18. Diener HC, Gaul C, Lehmacher W, Weiser T. Aspirin, paracetamol (acetaminophen) and caffeine for the treatment of acute migraine attacks: A systemic review and meta-analysis of randomized placebo-controlled trials. Eur J Neurol. 2022;29(1):350-357. doi:10.1111/ene.15103

  19. MedlinePlus. Diphenhydramine.

  20. Cleveland Clinic. Menstrual migraine.

  21. Lauritsen CG, Chua AL, Nahas SJ. Current treatment options: Headache related to menopause—diagnosis and management. Curr Treat Options Neurol. 2018;20(4):7. doi:10.1007/s11940-018-0492-7

  22. Food and Drug Administration. Menopause: medicines to help you.

  23. Scripter C. Headache: tension-type headache. FP Essent. 2018;473:17-20.

  24. Stachenfeld N. Hormonal changes during menopause and the impact on fluid regulation. Reprod Sci. 2014;21(5):555-561. doi:10.1177/1933719113518992.

  25. National Headache Foundation. Headaches and dehydration.

  26. Johns Hopkins Medicine Health Wellness and Prevention. Did I just have a hot flash? I’m 44?

  27. Johns Hopkins Medicine. Introduction to menopause.

  28. Terauchi M, Odai T, Hirose A, et al. Dizziness in peri- and postmenopausal women is associated with anxiety: a cross-sectional study. Biopsychosoc Med. 2018;12:21. doi:10.1186/s13030-018-0140-1

  29. Takahashi T, Johnson K. Menopause. Medical Clinics of North America. 2015;99(3):521-534. doi:10.1016/j.mcna.2015.01.006.

By Brandi Jones, MSN-ED RN-BC
Brandi is a nurse and the owner of Brandi Jones LLC. She specializes in health and wellness writing including blogs, articles, and education.