If a woman has a difficult time during perimenopause, does that mean she will also have a difficult time during menopause?


Having a difficult time through perimenopause does not necessarily mean menopause will be equally difficult. In two-thirds of women, migraine attacks often decrease or disappear completely during menopause.


“Absolutely not. In fact, probably the worse a woman is during perimenopause — I'm excited — because that means there's a strong hormonal connection. So the women that have a strong hormonal connection to their migraines are probably going to do much better during menopause. So when you look at statistics, if a woman goes into menopause spontaneously — meaning she hasn't had her uterus and ovaries removed, it's just her own ovaries slowing down — two-thirds of women going into menopause, their migraines will go away or get better. Two-thirds. If that woman is thrown into menopause surgically, let's say she has a complete hysterectomy, she does not do as well, because that's somewhat of an abrupt change to her body. So I guess the nice thing is, while I am struggling with a woman who is perimenopausal who is frustrated, I can tell them, ‘Look there is light at the end of the tunnel. There's hope. There's an excellent chance you're going to be a lot better.’ And I'm an example of that. My headaches were really bad when I was perimenopausal. And I am completely menopausal now, so mine are infrequent and very episodic.”


If a woman has a difficult time with migraine attacks during perimenopause, she actually might have an easier time during menopause. In two-thirds of women, migraine attacks decrease or go away completely during spontaneous menopause. A woman who goes into surgical menopause, however, does not fare as well due to the abrupt change to her body.

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Susan Hutchinson, MD

Author - The Women's Guide to Managing Migraine
Orange County Migraine & Headache Center

Dr. Susan Hutchinson is a headache specialist and board-certified family practice physician. In February 2007, she founded Orange County Migraine & Headache Center, dedicated to serving patients with headache and mood disorders. Although she is not a psychiatrist, she has developed a special interest in treating mood disorders as well as headache. The mood disorders she treats include depression; anxiety; bipolar disorder; ADHD; and panic attacks. Dr. Hutchinson suffers from migraine headaches which gives her an empathy with her patients.

She felt such a calling to help patients with headache and mood disorders that she decided to specialize and devote her career to alleviating the suffering caused by both headaches and mood disorders. She lectures nationally on the subject of headache; has written dozens of articles for medical journals; participated in headache research projects and is very active in numerous professional organizations such as the American Headache Society and the National Headache Foundation.

She is the immediate post-chair of the Women’s Issues section of the American Headache Society after serving in the chair position for 5 years. Dr. Hutchinson is a dynamic and sought-after speaker. She speaks for community groups as well as professional groups. In 2010 she became the President of The Orange County Chapter of the California Academy of Family Physicians.