Hormonal manipulation strategies in the management of menstrual migraine and other hormonally related headaches

Lynne T. Shuster, Stephanie S. Faubion, Richa Sood, Petra M. Casey

Research output: Contribution to journalReview article

20 Scopus citations


Menstrual migraine and other hormonally related headaches are common in women. Falling estrogen levels or estrogen withdrawal after periods of sustained higher levels can trigger migraine. It makes sense to target this trigger for management of hormonally related headaches, particularly when nonhormonal strategies have been unsuccessful. Decision making regarding the use of hormonal contraception and menopausal hormone therapy is complex and commonly driven by other factors, but hormonal manipulation can potentially improve the course of migraine. Providers caring for migraineurs are appropriately concerned about stroke risk. Estrogen-containing hormonal contraceptives are relatively contraindicated for women who have migraine with aura. Postmenopausal hormone therapy is acceptable for women with a history of migraine. For these women, transdermal estradiol is recommended. Estrogen replacement is important for women who undergo an early menopause, whether natural or induced. Practical strategies for hormonal manipulation in the management of migraine and other hormonally related headaches are presented.

Original languageEnglish (US)
Pages (from-to)131-138
Number of pages8
JournalCurrent neurology and neuroscience reports
Issue number2
StatePublished - Apr 1 2011



  • Bilateral oophorectomy
  • Estrogen
  • Estrogen withdrawal
  • Headache
  • Hormonal fluctuations
  • Hormonally related headaches
  • Ischemic stroke
  • Menopausal hormone therapy
  • Menopause
  • Menstrual migraine
  • Migraine
  • Oral contraceptives
  • Ovarian insufficiency
  • Perimenopause
  • Progesterone
  • Progestogen
  • Stroke
  • Surgical menopause
  • Transdermal estrogen

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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