How Women’s Hormones Affect Migraine

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Key Questions
  • Are hormones the reason why more women than men have migraine?
  • Why do many women with migraine see an increase in attacks with their menstrual cycle?
  • Are there risk factors that make some women more susceptible to menstrual migraine than others?
  • What is menstrually related migraine versus pure menstrual migraine?
  • What is the best approach to treating menstrually related migraine?
  • Should menstrually related migraine be treated any differently than regular migraine?
  • When does menstrually related migraine require a preventive approach?
  • Why is hormonal migraine seemingly harder to manage than other types of migraine?
  • What kinds of providers should treat hormonally related migraine?
  • What is the best way to get multiple providers to work together for you?
  • What is the difference between premenopause and perimenopause?
  • Is it common for menopause or perimenopause to trigger new-onset migraine?
  • Does migraine typically get better or worse during the later years of a woman’s life?
  • Can hormone therapy help with migraine?
  • Are there any reasons women with migraine should avoid hormone therapy?
  • How is migraine in menopause best treated?
Interview Notes

Find more about Jelena Pavlovic, MD, PhD and her work here:

Treatments Mentioned
  • Behavioral therapy (biofeedback)
  • Diary/calendar
  • Gepants (ubrogepant, rimegepant)
  • Meditation/mindfulness
  • Mini-prevention
  • Neuromodulation devices
  • NSAIDs (naproxen, diclofenac, nabumetone, ibuprofen)
  • Triptans (naratriptan and frovatriptan)

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.

Jelena Pavlović, MD, PhD

Associate Professor
Montefiore Headache Center

Dr. Jelena Pavlović is an associate professor of neurology at Albert Einstein College of Medicine and attending neurologist at the Montefiore Headache Center. In addition to being a practicing neurologist, she holds a PhD in molecular biology. Her research interests broadly focus on the hormonal regulation of migraine in women. Specifically, she aims to answer how hormonal fluctuations affect migraine symptoms during the menstrual cycle and across the transition to menopause.

Dr. Pavlović is board certified by the American Board of Psychiatry and Neurology. She is a member of the American Academy of Neurology (AAN), the American Headache Society (AHS), and the International Headache Society (IHS). She has published extensively on migraine in women and is funded by the National Institutes of Health/National Institute of Aging (NIH/NIA) to conduct research on this topic. In recognition of her outstanding achievements in headache/facial pain, she has been awarded the Harold Wolff-John Graham Award in Headache/Facial Pain Research by the AAN and is the recipient of the 2021 Women’s Health Science Award from the American Headache Society.

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