Balancing Hormones for Migraine Management

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Key Questions
  • What role do hormones play in migraine?
  • Why does migraine worsen for some women as they approach perimenopause?
  • What does “balancing hormones” actually mean?
  • Is hormone replacement therapy (HRT) safe?
  • What are some of the risks that come with HRT?
  • What’s the distinction between hormones for contraception and hormones for replacement therapy?
  • Why is it important to know if you have migraine with aura?
  • How do you determine what type of hormonal approach is best for each individual woman as she approaches the later stages of her reproductive life?
  • Is there an upper age limit for women to safely take HRT?
  • Are there any indications that might help a woman predict whether migraine will improve or not after menopause?
  • Are there any herbal treatments that have been shown to help with hormonal balance and associated migraine?
  • What type of practitioner is most suitable for managing hormonal migraine?
  • Why is advocacy so important to improvement and advances in treating hormonal migraine?
Interview Notes
Treatments Mentioned
  • Bioidentical estrogen
  • Bioidentical progesterone
  • Chasteberry (Vitex agnus castus)
  • Contraceptive hormones
  • Hormone replacement therapy (HRT)
  • Menopausal replacement therapy (MHT)
  • St. John’s wort (Hypericum perforatum)
  • Synthetic estrogen (ethinyl estradiol)
  • Synthetic progestogen

Please note: The Migraine World Summit’s aim is to bring you a variety of perspectives and expertise, independent of bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan.

Anne MacGregor, MD

Centre for Reproductive Medicine, St Bartholomew’s Hospital, London, UK

Dr. Anne MacGregor is a world leader in studying the link between the menstrual cycle and migraine. She holds a doctorate in medicine from the University of London and a master’s in medical education from the Royal College of Physicians and University College London. Dr. MacGregor is an honorary professor at the Blizard Centre for Neuroscience, Surgery and Trauma; the Blizard Institute of Cell and Molecular Science; and Barts and The London School of Medicine and Dentistry. She has published more than 200 research papers, authored five books, co-authored an additional five books, and co-edited three books.

Dr. MacGregor has carried out extensive research into drug treatments for migraine and cluster headache, including significant research into menstrual migraine. Her doctoral thesis explored the role of estrogen in migraine, which led to the development of research criteria for menstrual migraine that were adopted by the International Headache Society in 2004. She has been awarded the Elizabeth Garrett Anderson Award for her extraordinary contribution to relieving those affected by the burden of headache and has received the Special Recognition Award and Honorary Life Membership from the International Headache Society. Dr. MacGregor regularly contributes to media discussions on the topic of migraine, particularly menstrual migraine.

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