Menopause, Perimenopause & Migraine

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Key Questions
  • What is the difference between perimenopause and menopause?
  • What changes to their migraine patterns can women expect during menopause?
  • Can migraine occur for the first time during perimenopause or menopause?
  • How does a migraine attack change during perimenopause and menopause?
  • When is it appropriate for someone to return to their doctor to reassess their treatment plan?
  • What medications and other treatment options can be used during perimenopause or menopause?
  • What lifestyle changes can reduce the frequency and severity of migraine during perimenopause and menopause?
  • How important is it to get your hormones tested?
  • Could the use of birth control pills or other contraceptive methods that reduce the frequency of menstrual cycles have a positive impact on migraine?
  • Are there any predictors of whether someone is likely to experience a decrease in attack frequency after menopause?
Interview Notes
Treatments Mentioned
  • CGRP small-molecule receptor antagonists (gepants)
  • Gabapentin
  • Hormone replacement therapy (HRT)
  • Monophasic birth control
  • Neuromodulation therapy
  • NSAIDs
  • Oral contraceptives
  • Triptans
  • Venlafaxine (Effexor)

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.


Christine Lay, MD, FAHS

Professor of Neurology, Deborah Ivy Christiani Brill Chair
University of Toronto

Dr. Christine Lay is a professor of neurology and the founding director of the headache program at the University of Toronto, where she holds the Deborah Ivy Christiani Brill chair for neurology research. She completed her residency at the Mayo Clinic and her headache fellowship at Albert Einstein College of Medicine in New York.

In addition to directing and growing the headache program at the University of Toronto and heading a very busy patient practice, she is actively involved in research and teaching. She directs the Canadian Headache Society fellowship program in Toronto; she is actively engaged in advocacy and education, serving as the chair of the American Migraine Foundation; and she is a board member of the American Headache Society and the Canadian Headache Society.

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