Migraine after the menopause: When does it stop?


With the menopause the migraine stops? Not with author Jessica Fehyman. Now she’s on her way to finally get over the plague – after all, there are new treatment approaches.

When friends tell me with a smile that they have not had a headache for a while, I do not think it’s that good. Why she and me do not? After menopause, as I had hoped, my headaches would slowly but surely disappear. My life would be a long, calm river, with no painkillers and trigger points.

Help, a headache! Still …

But nothing there! It has even gotten worse, sometimes up to five pain attacks per month. As I write these lines, it pulls in the back left corner. I’m watching this closely, because it can always cause a migraine attack. At the same time, I try not to hang signs and triggers too high. Yes, not too much attention, to make the pain not the main actor of my life – that has been my motto for a long time.

I have had migraines since I was twelve. At that time she was still called a headache and caused my mother to go with me to the neurologist. Make an EEG? Completely superfluous. One would only have to look around in the family. The father, teacher: headache. The grandmother, farmer’s wife: the same. In fact, migraine is related to hereditary factors. The mechanisms leading to the pain are also well studied today. It is believed that overly active neurons, nerve cells, provoke inflammation of the blood vessels of pain-sensitive meninges in the brain. This happens against the background of a very easily irritable brain. True, I can only say, because I actually hear the fleas cough – sometimes they cough even from distant rooms. Also that migraine is an inflammatory process, I can feel it myself when I touch my temple, my ear and my neck. During an attack, the blood is throbbing hot there.

Many suffer from vision problems, some with speech disorders before the pain comes. With my neck hurts, but only on the side, where then later the migraine pain sits. Previously, the attack announced by bad mood and depression. Sometimes I’m relieved when it hurts, because then I know: After all, it’s not depression, just migraine. Only migraine? These headaches are among the worst pain ever, it is said. If you’ve ever ripped off your hair to distract yourself from it, you know the dimension.

There are now many medications for acute seizures

Most of the pain occurs only on one side of the skull (“hemicrania“, in English: half skull, hence the term of migraine), sometimes they migrate in the course of the other side. Their side effects such as nausea , burning eyes, dizziness , hypersensitivity to light, smells and sounds are also very, very annoying. The worst, however, is in my opinion the feeling of absolute misery that always accompanies a seizure. That’s why you can not help but retire completely when it’s time again. This is the most important thing for the stressed brain.

Do you have to stand this idle? Definitely not. There are many strategies against it. Not only to prevent the attacks of widespread disease. Since 1993, special drugs for the treatment of acute seizures have been on the market. Triptans stop the inflammatory process in the head. Without them, many women – who suffer about twice as much recurrent pain as men – would be much worse off. Me too.

I’ve always tried to give my migraines what keeps them in check – but not a tad more. Wrote with her for the place she occupies in my life. Even now that I have decided to take her seriously again, I find it difficult to talk about her. Because I am so reluctant to think about them, the conscientious logging in the migraine calendar is a bit reluctant. I have been watching this for many, many years, why should I write down the degree of pain, localization, medication and the duration of the pain?

I know that there are so many triggers – and then again no real: red wine, quarrel, sleep-out … Some triggers are not at all, but first signs of the attack. Migraine Apps? Also not for me. Because these are in principle electronic migraine calendars with additional function. Have I recently enjoyed delicious on the side of the app “M-Sense”. One of the users writes, “Having survived almost all year without migraines, and now she suddenly jumps on an ass-bomb, has suitcases with her, it drills and pounds, seems like a longer stay.” I like that. Humor is the best way to enjoy life anyway.

Do Menopause Affect Migraine?

But again, back to the original question. Is it normal to suffer like this during menopause and after that? Dr. Stefanie Förderreuther, Munich headache expert, knows many women who like me. It is responsible for the hormonal fluctuations during the change, which indeed extend into the period after the last bleeding. But why is it getting better with so many women – in exactly this time? “Those are the ones whose migraine is cycle-dependent and benefit enormously from menopause and menopause,” Dr. Katja Heinze-Kuhn from the Pain Clinic Kiel. It never was my headache. Most women would not get rid of their migraines until they were six years old, says Ms. Förderreuther. At that age you are simply more relaxed.

So there are a few more years left for misery. Years in which I continue to practice yoga (relaxation prevents attacks) and go jogging (endurance sports as well). But in which I can also try, which I have not tested. For example, a stay at the Pain Clinic Kiel, which offers inpatient treatment for migraine sufferers. Or the new migraine prophylactic, of which one now reads so much: The drug “CGRP antibodies” inhibits the eponymous inflammatory messenger in the brain and has not only helped chronically migraineurs in studies very well, but also low side effects.

I ask my neurologist. With an average of four attacks a month for more than two years, I’m the perfect patient for the new drug, right? “Well, yes,” she says. “The health insurance companies only cover the costs if at least three proven prophylactic options are exhausted. Beta blockers and antidepressants – both did not help me. And what about the vitamin-mineral combination (vitamin B2 with magnesium and coenzyme Q10), the manual methods such as chiropractic, osteopathy or acupuncture, which have brought a great deal with my girlfriends? I have tried all, but without lasting effect. The current migraine guideline also recommends the antiepileptic topiramate for prophylaxis, which suppresses the overactivity of nerve cells and has an antispasmodic effect. As side effects tingling, numbness and weight loss are listed – unfavorable, if you are anyway a thin shirt like me.

“If it gets better, I have to give the disease more room in my life”

“Botox”, the nerve agent botulinum toxin A, would be the appropriate third prophylactic for me, my neurologist advises. “Always here with it!”, I call relatively enthusiastically. And learn that in order to get the prescription, you first have to prove how much you suffer – of course with a migraine calendar. In addition, my eyelid could hang after the injection. That would pass, but the positive effect of Botox as well. And all this just to get the CGRP inhibitors afterwards? Yes, explains the doctor. Because the antibody syringes are immensely more expensive than all previously available funds. A three-pack costs about 2000 euros and is enough for three months. Lots of money for a disease that is one of the most common and most debilitating diseases worldwide, but not deadly. Hm.

Do I want to go that way? Maybe I belong exactly to the third patient who does not respond to the antibody. And the migraine is gone after the syringes not – only for the time of treatment, one may hope for fewer attacks. But it does not help anything: If it gets better, I have to give the disease more room in my life. I could learn biofeedback or book an MBSR course that teaches mindfulness-based stress reduction. Both are absolutely promising, as studies show. I decide to sit down and start a migraine calendar.

TRIPTANE: The Most Important Info The

  • If you access triptans as early as possible at the beginning of a migraine attack, they work best.
  • Do not take on more than ten days a month, otherwise a drug-induced headache threatens. Means: You get a headache from the headache remedies.
  • Triptans have side effects and must not be taken in cardiovascular diseases.
  • They only work for migraine and not for tension and other headaches.
  • Some medications may be over-the-counter, but only with a previous diagnosis.
  • The combination of a triptan (Sumatriptan) with the long-acting painkiller Naproxen (it may belong to the so-called NSAIDs, such as Ibuprofen) can prevent the recurrence of migraine attacks.