When a women stops menstruating for more than 12 months she is said to have attained menopause. Menopause could be natural or surgically induced when the ovaries are removed. The period preceding menopause is called the perimenopausal period where women experience a variety of vasomotor and psychological symptoms. Depression, hot flashes, mood swings, vaginal dryness, insomnia etc are some of the common complaints by women in the menopausal age group.
Migraine is an acute form of headache affecting more women than men. In some women suffering from migraine, the cyclic ovarian sex steroids may worsen the attacks during menses. Studies have also shown that these women improve with pregnancy when the menstrual cycle ceases.
Experimental studies have observed that estrogen withdrawal at the time of menses aggravates migraine and it can be reduced by supplementation of estrogen. Supplementation with progesterone does not show a similar effect. A study conducted by Lichen and colleagues also supports the role of estrogen withdrawal to be a trigger for worsening migraine in postmenopausal women. This is attributed to the down regulation of anti-inflammatory genes with decreasing estrogen concentration thereby increasing the neuronal excitability in women prone to migraine.