If you’re now suffering from more intense and more frequent headaches, it could be a sign that you're in the early stages of menopause. “Heal the Pain” Okay, George Michael was singing about a broken heart, but for us it’s the pain of a hormone-induced headache!

There’s a link between your periods, fluctuating hormones and the frequency and intensity of headaches. Approaching menopause, oestrogen supplies can be as inconsistent as a British summer, so it’s no surprise that women may experience more frequent and severe headaches around this time, even if they weren’t previous headache sufferers. Hormonal headaches are most likely to develop in the two days leading up to a period, or within the first three days of a period. 
And the good news is…. The severity of migraines may decrease during perimenopause, and they may stop altogether after menopause, as your hormones stabilise. 

The best ways to prevent menopause headaches Manage headaches and migraines with diet changes, relaxation, stress-busting techniques and keeping on top of your sleep. Medication helps, too!

What to eat to help with headaches  

Food to fight headaches? Skipping meals may trigger a migraine; eating small snacks regularly should help to keep your blood sugar levels stable. Eating the right foods may help to control your headaches: Magnesium - studies show low levels during migraine attacks. Eat more: legumes, nuts, whole grains, seeds, green leafy vegetables, soy products, bananas, dried apricots and avocados. (This mineral is also found in water in hard water areas). 
Phytoestrogens – these plant based chemicals that boost oestrogen may help restore hormone balance. Eat more: soy based foods, miso, wholegrain rice, alfalfa, cherries and apples. 
CoQ10 - a vitamin-like substance recommended by The Migraine Trust. Found naturally in oily fish, legumes and whole grains. 
Vitamin B2 has an antioxidant effect helping absorb damaging free radicals that can trigger migraine. Eat more: leafy vegetables, nuts, legumes, eggs. 
Stay hydrated Mild dehydration is one of the most common causes of headaches. Hot flushes and night sweats, contribute to water loss. Drink between 6-8 glasses of water, herbal teas or caffeine-free drinks each day. 

What to avoid to help with headaches 

There are plenty of old wives’ tales about food including chocolate, acting as a trigger for migraines and headaches. There’s no evidence that it triggers a migraine, more that you may crave it during times of stress or hormonal changes, or as a migraine comes on. If you’re prone to headaches, you may choose to avoid foods containing: 
Monosodium glutamate (MSG) a flavour enhancer and preservative that may trigger headaches, if you’re sensitive to it: found in Chinese food, pre-prepared foods, soy sauce, bottled sauces, and flavoured crisps 
Tyramine found in fermented and aged foods such as strong, aged cheeses can be a migraine trigger. Nitrates used as a food preservative, found in hot dogs and bacon, may trigger headaches in some people but studies are inconclusive. 
Caffeine and cola According to Migraine Action these are serious headache and migraine triggers. If you drink lots, then wean yourself off gradually as it’s a stimulant and the lack of it may cause headaches. Switch to decaf teas and coffee instead. 
Smoking Smokers tend to have more migraines, and smoking more than five cigarettes a day may trigger a migraine according to the Journal of Headache and Pain. 
Alcohol Alcohol causes dehydration, a recognised headache trigger. Drink plenty of water alongside alcohol. Some of us are particularly sensitive to wine and its various additives, which can cause severe hangovers and headaches. Certain red wines contain more of these chemicals. 

Lifestyle & wellbeing to help with headaches 

Dear diary… To get a clearer picture of what may be causing your headaches, keep a diary. Record when headaches strike. Note down what you’ve had to eat, drink, how much sleep you’ve had, what you were doing (working on computer, watching TV) and what the weather was like. Keep a record of when you have a period to see if there’s a link between headaches, your cycle and your hormones. 
The Goldilocks approach to sleep Develop a regular sleep pattern. Avoid too much or too little sleep, get it just right; aim for 7-8 hours a night. Try our relaxation yoga stretching exercises before bed to help you sleep. Check out our YouTube vlog Yoga with Annie – Relaxation & Breathing Exercises 
Stress and exercise Migraine and stress are linked. Attacks can develop as stress flip flops, increasing and decreasing. However it happens for you, regular, gentle exercise helps relieve stress, helps with sleep and improves the working of the heart. Simple stretching exercises help you with strength and flexibility. Watch our YouTube vlog Yoga with Annie – Basic Stretching Exercises 
Treatment of Hormonal Headaches There are two approaches to the treatment of menopause headaches. 
Talk to your doctor about how to prevent headaches with magnesium, aspirin and HRT. 
Treat headache symptoms when they happen – with non-steroidal anti-inflammatory drugs (NSAIDs). They can be bought over the counter and others are available on prescription. NHS Choices say they’re not suitable for everyone so DO check with the pharmacist or your GP.

Supplements worth trying for headaches 

Magnesium supplements, take either in capsules or a powder. 
Feverfew as a tincture, dried or fresh leaf or capsule taken every day may prevent migraines in menopause, although trials into its effectiveness have had mixed results. During a migraine take as a tea to help deal with nausea and relieve symptoms. 
Vitamin B2 the Migraine Trust say that taking as a supplement may help. 
Agnus Castus or Chasteberry may help settle hormone fluctuations. *Whilst these are natural products, herbal supplements can have side effects and interact with other medications. Check with your GP if they’re safe for you.

Alternative help for headaches 

Acupuncture Acupuncture may prevent headaches. The National Institute for Health and Care Excellence (NICE) headache guidelines, updated in 2015, say that a course of up to 10 acupuncture sessions may be offered where medication hasn’t worked, (be aware that there is no obligation for health professionals to prescribe this). 

When to see your doctor about headaches 

The website NHS Choices says your doctor can prescribe anti-migraine medicines to take around the time of your period such as called triptans and a type of painkiller called mefenamic acid.These don’t contain hormones, but they can help stop the headaches developing. 

And then there’s always HRT… 
Whilst the Migraine Trust say ‘There is little research evidence to be found on the effects of HRT on migraine in women. It can help some women but may aggravate it for others.’ NHS Choices says it is an option for headache treatment. 
HRT Patches or gels may be best as they keep your hormone levels more constant than tablet form, they don’t pass through the live and are less likely to trigger migraines. 
The usual caveat here, that HRT is something to be discussed with your doctor. There are pros and cons to taking it. See our vlog, What is HRT? We don’t take a view. It’s for you to decide whether it’s for you or not. 

And we can help 
Your Fbl Team x