Migraine headaches are frequent among women, but they can be difficult to cure in the elderly due to a variety of health hazards. While hormone therapy has been shown to help with a variety of menopause symptoms, its safety in women suffering from migraines has yet to be established.
Its safety for this demographic is demonstrated in a new study based on data from the Women’s Health Initiative (WHI). The findings of the study will be presented at the North American Menopause Society (NAMS) Annual Meeting, which will be held in Philadelphia from October 11 to 14.
“Hormone therapy use has been on the decline since the WHI clinical trials. Newer data has brought further clarity to its safe use, especially in younger women (age < 60) who are closer to the time of menopause (within 10 years of menopause),” says Dr. Peter F. Schnatz, immediate past president of NAMS and one of the study’s authors.
“Based on this newer data, hormones still have a major role in treating menopause symptoms and preventing bone loss. A number of these women will have migraines. Hence, knowing the risk/benefit profile of hormone therapy in these women is critically important.”
There have been few studies that show how hormone therapy affects migraines and, as a result, cardiovascular disease. Because of the link between exogenous estrogen use and an increased risk of stroke in women with migraines, hormones are rarely given for migraine sufferers.
Hormone therapy use has been on the decline since the WHI clinical trials. Newer data has brought further clarity to its safe use, especially in younger women (age < 60) who are closer to the time of menopause (within 10 years of menopause).
Dr. Peter F. Schnatz
This led to the suggestion that in women with a history of migraines, combination oral contraceptives (also known as birth control pills) be used with caution or avoided altogether, depending on whether or not the headaches were accompanied by an aura.
The data from 67,903 WHI clinical trial participants was analyzed to learn more about the link between migraines and cardiovascular disease events, as well as their interaction with hormone treatment use.
It was revealed that migraine sufferers drank and exercised less than non-migraine sufferers and consumed more vitamin D and calcium. Night sweats and hot flushes were also more common in migraine sufferers.
Importantly, the researchers found no link between a history of migraines and a higher risk of cardiovascular disease events. Most importantly, there was no effect of hormone therapy on this relationship in terms of treatment safety.
“Since migraines affect one in every four women and women with migraines are often advised to avoid hormone therapy, these findings may have significant public health implications,” says Dr. Jelena Pavlovic, lead author of the study from Albert Einstein College of Medicine in the Bronx.
“We know that changes in estrogen lead to migraines for many women. Yet, there has been very little research focused on migraines through the menopause transition when estrogen levels can fluctuate greatly,” says Dr. JoAnn Pinkerton, NAMS executive director. “This study clearly demonstrates the need for more research in this area so symptomatic women can benefit from proven therapies.”
Drs. Pavlovic, Pinkerton, and Schnatz are available for interviews before the presentation at the Annual Meeting.
