8/13/07 #3 - Menopausal and Migraines have become unbearable. HRT Combination?

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  • Full Question:
    I am a female 54 years of age and menopausal. I have a 30 year history of migraines, but the past 6 months they have become unbearable. I have been on HRT for about 2 1/2 years. I took Prempro for about 2 years with no increase of migraines other than the normal 6 or so a month that I usually get. Last April I began to get them daily. The doctor put me on Topamax and by July I felt better, but by August they were coming daily again. My HTR was changed to 1 mg oral estradiol and 100 mg prometrium in October and I had only 2 migraines until the end of December, then they started to come daily again. I began the Topamax again, but this time it did not stop them. Nothing but Zomig or Imitrex almost daily would work. The middle of January the doctor put me on a Climara Pro patch, the headaches have worsened even more. We are now trying a new preventative--Lamictal. It's not helping yet. Are you aware of any HRT combination that seems to work better than others for women with a history of migraine? Don't suggest I use nothing. I've tried than route. Not only do I have daily headaches, but I can't sleep more than about 3 hours a night, I have a continuous hot sweat, I feel like I have constant PMS, and I have confusion and no memory. HELP! Ann.

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    Dear Ann;

    I wouldn't suggest you use nothing! If I were a woman, I would be on the side of the fence in favor of hormonal supplementation. Often, testosterone is overlooked in its association with headaches and I have been (pleasantly) surprised on many occasions when testosterone is added to the regimen for a woman. In fact, about 50% of night sweats have nothing to do with estrogen. They have to do with testosterone. The way to check is to get a free testosterone level (drawn between eight and 10 a.m.) and if this is on the low side of the range, to supplement. I feel for your continuing increased headache pattern, but if it is a hormonal, I would not ignore testosterone.

    Good luck,
    John Claude Krusz and Teri Robert

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Published On: August 13, 2007