Top 75 Migraine and Headache Questions, #47

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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 HRT 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.
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    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.


    Dear Ann;

    Regretfully, there isn't a particular HRT regimen that's better tolerated by women with Migraines. Some women need higher hormone replacement levels to avoid triggering Migraines; some need lower. The best suggestion we can offer is to work with specialists on both the HRT and your Migraines and have them consult and work together.

    Good luck,
    John Claude Krusz and Teri Robert

    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert. If you have a question for this section of our site, please click HERE. Accepted questions will be answered by publishing the answers here. No questions will be answered privately.

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Published On: April 08, 2007