You may need hormone medicine, such as the Pill, IVF or menopausal hormone therapy (MHT) at different times in your life. But if you have migraine that’s triggered by hormone changes, it can be hard to find a treatment plan that works for you.
On this page, you’ll find information about how hormone medicines can affect migraine and when to see your doctor.
Hormone contraceptives might help reduce symptoms of migraine.
If you have menstrually-related migraine, the oral contraceptive pill (the Pill) or injection could help to reduce attacks.
Ask your doctor about taking the Pill without the 7-day break if you find you get migraine attacks during this time. You could also take low-dose oestrogen or oestrogen patches on the pill-free days.
If you have migraine with aura, your doctor may not recommend the Pill due to the small increased risk of stroke. You could try a progestogen-only contraceptive, such as pills, injections, an implant or an IUD instead.
After the age of 35, when cardiovascular health risks increase due to age, your doctor may recommend a different kind of contraception, for example, a progestogen-only option.
Emergency contraception (known as the ‘morning after pill’) is progestogen-only, so it doesn’t usually increase the risk of migraine attack.
If you prefer to use a non-hormone contraceptive, ask your doctor about different options. For example, condoms or a diaphragm.
If you have migraine and symptoms of menopause, ask your doctor about using menopausal hormone therapy (MHT).
Everyone’s experience of MHT is different. It may improve or worsen your migraine symptoms, or you may not notice any changes.
When you see your doctor, they will ask about your medical history, your experience of migraine and other risk factors to work out the best MHT treatment.
Your doctor will recommend a treatment that keeps your hormone levels as steady as possible, to reduce the risk of migraine attacks.
Depending on your situation, they may recommend different types of MHT, including patches, pills or implants under the skin. They will also consider which doses may work best for you.
If you haven’t had a hysterectomy, you’ll need combined oestrogen and progesterone therapy to reduce the risk of endometrial cancer (cancer of the uterus).
An IUD with lower progestin (a synthetic type of progesterone) may be a good option if progestin triggers migraine attacks.
Talk to your doctor about the benefits and risks of taking hormone medicines for fertility treatment, health conditions, such as endometriosis, or gender-affirming therapy. If you try a new hormone medicine and notice changes in your migraine patterns, see your doctor.
Some women experience migraine attacks when they use IVF to conceive. This is because the process to encourage ovulation makes hormone levels go up and down. If you notice changes in your migraine patterns, talk to your doctor.
Gonadotrophin-releasing hormone (GnRH) injections can be used to help manage certain health conditions, including:
GnRH injections stop your ovaries from making the hormones oestrogen and progesterone.
Some studies suggest GnRH injections can trigger migraine attacks in some women, as oestrogen hormone levels rise in the first 2 weeks and then drop again. But others find the medicine improves their migraine. Talk to your doctor about the best treatment for you.
There’s not much evidence about how gender-affirming hormone therapy affects migraine. Some studies suggest that trans women taking oestrogen may get migraine attacks more often, or get migraine with aura for the first time. Studies also suggest that trans men taking testosterone may get fewer migraine attacks.
This information was developed in partnership with Migraine & Headache Australia.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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