headaches menopause migraine perimenopause women's health May 01, 2024

Are you noticing more frequent migraines or headaches as you navigate through perimenopause? I speak to many women who have been migraine sufferers through other stages of life and are now experiencing an increase in migraines in their 40s and perimenopause. There are also many of you who are completely new to the pain of migraines wondering why this happens and what you can actually do about it.

Come with me on a deep dive into migraines during perimenopause and the underlying hormonal changes that can trigger these painful episodes. Because if you've hung out with me here for a while, you'll know that I always love to get to the bottom of what's driving how you're feeling.

Symptoms like migraines give us lots of clues about what is out of balance in your body. So, if you're tired of relying on paracetamol (or something stronger) to be able to get through the day and you want to understand the root causes of your symptoms, keep reading!


Migraines are often misunderstood as just severe headaches, but they are actually complex neurological conditions that involve much more than just head pain. They are characterised by symptoms that can include nausea, vomiting, sensitivity to light and sound, and visual disturbances known as aura. These symptoms reflect a deeper neurological process that is influenced by a variety of factors.

A migraine can be divided into several phases:

  • Prodrome: Subtle changes that warn of an upcoming migraine, such as mood changes, food cravings, or neck stiffness.
  • Aura: For some people, this phase involves visual disturbances, sensory problems, or speech difficulties. It precedes the headache but does not occur with every migraine. Not everyone has an aura before migrain. I get spots in my field of vision.
  • Headache Phase: The acute, painful phase of the migraine, which can last from hours to days.
  • Postdrome: After the headache resolves, a person may feel drained or washed out, like they have a hungover almost.

Understanding these phases can help identify migraines and differentiate them from other types of headaches, which is crucial for effective management, especially in perimenopause.


While hormonal fluctuations, especially those of perimenopause, are a significant trigger for migraines, there’s many other factors that can also play a role in their onset. Understanding your unique blend of triggers helps when creating an effective management strategy. Personalised plans are where the magic happens!


The primary suspect in perimenopausal migraines is the fluctuation of oestrogen levels. Oestrogen impacts the brain's chemistry, influencing neurotransmitters like serotonin, which regulate pain sensitivity, mood, and sleep. Rapid changes in oestrogen levels, particularly sudden drops, can trigger migraines. This is why you may get migraines in puberty, pregnancy or in the lead-up to your period.


Stress is a well-known trigger for headaches and migraines at any stage of life, but it can be particularly potent during perimenopause. Changes in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress response (and your thyroid, ovaries and kidneys), can exacerbate migraine frequency and severity through its action on compounds like serotonin, histamine, and pro-inflammatory compounds.


  • Histamine and other food sensitivities: Certain foods that are high in the neurotransmitter and immune compound, histamine, or trigger its release in the body - such as aged cheeses, alcohol, and fermented foods - can trigger migraines in sensitive people. Histamine isn’t bad, but sometimes because of gut, liver or immune health issues, it can profoundly impact migraines and other perimenopause symptoms like hot flushes and sweats.
  • Blood Sugar Imbalances: Fluctuations in blood sugar levels can also provoke migraines. Ensuring a balanced diet that prevents spikes and dips in blood sugar can be an effective strategy in managing migraine symptoms.


Tension in the neck and shoulders, or functional issues in the neck or spine, often exacerbated by stress or poor ergonomic setups at work, can also trigger migraines. I make sure my desk is set up ergonomically, alternate between sitting and standing as well, and I regularly see my chiropractor to help avoid these triggers.


Allergies, intolerances, or sensitivities to foods, environmental substances (eg perfumes, strong smells), or changes in weather or barometric pressure can trigger a migraine in susceptible people.


Dealing with perimenopause symptoms requires a nuanced understanding of what triggers them FOR YOU. Standard advice or treatments often fall short, I think, because they aren’t addressing what’s driving the migraines for you, they’re focused on suppressing the symptom (migraine). That’s why adopting a detailed tracking of your migraines is crucial, I think. When done thoroughly, it gives you so much great data to work with, and find out why you’re getting them. When you know why, a solution to the problem is going to be easier to work out.


While you probably are used to juggling a diary for your family, work and social life, a migraine diary goes deep into the nitty gritty of your day-to-day life. You can use your regular phone calendar, or a dedicated notebook to track various aspects of your life, including:

  • Dietary intake, particular note foods that are known to relate to migraines, such as those high in histamine, or histamine-releasing. Rough quantities of the food is a good idea too.
  • Sleep patterns, as lack of quality sleep can trigger migraines.
  • Stress levels, acknowledging both chronic and acute stressors that might influence migraine onset. Don’t forget the physical stressors like high-intensity exercise or lack of sleep!
  • Menstrual cycle phases, particularly important as hormonal fluctuations are significant during the few days before your bleed, and during perimenopause.

By tracking your diet, lifestyle, menstrual cycle, and migraines, you’ll start to see patterns emerge (without having to rely on your memory to put it all together!) For example, migraines that occur during the ovulation phase might be tied to the surge in hormones, and those during menstruation may relate to hormone withdrawal.


Beyond the more recognised triggers, there are environmental and physiological factors that might not be as obvious:

  • Barometric pressure changes: Often overlooked, shifts in weather can prompt migraines. Tracking these alongside your symptoms can reveal correlations you might not have noticed before.
  • Environmental allergens: From pollen to mold, environmental allergens can trigger migraines. Noting days when your symptoms flare up alongside environmental changes can help identify potential allergens affecting you.


Incorporating apps or devices that track sleep, stress, and your menstrual cycle can provide a more detailed picture of your daily health and how it relates to migraines. Please choose carefully though, to make sure the app won’t sell your data.

View tracking not just as a chore, but as data, that is a tool for education and guiding treatment. Trust me, any health professional is going to love that you have all this data available to help understand your body’s responses in real-time. Data allows us to work out what’s driving how you’re feeling, and personalise your management strategies and treatment, to make them more effective.

What this means is that you don’t just need to keep avoiding more and more triggers. It’s about responding to your body’s needs during this transitional time, and helping it adapt better to the changes, so you get less symptoms (like migraines) overall.


Managing migraines in perimenopause isn't just about treating symptoms; it's about understanding and addressing the underlying causes through a holistic approach. Here are some specific strategies that I use with my clients to help manage and prevent migraines effectively:


  • Anti-inflammatory Foods: Incorporate some of my fave functional foods - flaxseeds! Along with flaxseed oil, olives, olive oil, garlic, onions, ginger, rosemary, and decaffeinated green tea. These foods help reduce inflammation and keep blood flowing, which can help prevent migraines.
  • Phytoestrogen-Rich Foods: Foods like alfalfa sprouts, flaxseeds and pulses (lentils, beans) help by reducing the spikes and crashes of oestrogen, and optimising your microbiome. A healthy microbiome is crucial for perimenopausal health as it aids in oestrogen metabolism, neurotransmitter production, and weight management, among other things.
  • Magnesium-Rich Foods: Magnesium is essential for nerve and muscle function. Foods rich in magnesium include leafy greens, nuts, seeds, whole grains, and legumes.
  • Harness the Power of Personalised Nutrition: Use the power of Metabolic Balance personalised nutrition to address underlying issues such as blood sugar balance, insulin, liver function and hormone imbalances - it’s what I use with all my clients!

Traditional and Complementary Therapies:

  • Acupuncture: Particularly effective for pain relief during a migraine, and helping with hormonal health.
  • Herbal Remedies: Herbs like feverfew, ginger, and willow bark can provide relief. Feverfew is known for its properties to reduce migraine frequency (you do need to use it long-term though), ginger can alleviate nausea and inflammation associated with migraines, and willow bark is the original aspirin! (Aspirin is based off an extract of willow bark. Willow bark doesn’t have the negative side effects in your gut that aspirin has though.)
  • Supplements: Magnesium and other essential nutrients can be beneficial, particularly if dietary intake is insufficient. Because deficiencies in essential nutrients can exacerbate migraines, supplementing with the right form of the nutrient and dose—under professional guidance—is crucial.


While many migraine symptoms can be managed with the strategies outlined above, there are certain red flags that require immediate medical attention:

  • Sudden, Severe Onset: A migraine that appears suddenly and with severe intensity, often described as a "thunderclap" headache.
  • Neurological Symptoms: Changes in vision, speech, or balance, or confusion, which could indicate more serious conditions such as stroke.
  • Worsening Pattern: Migraines that progressively worsen or change in frequency and intensity.
  • Associated Symptoms: Symptoms like fever, stiff neck, or rash, which could suggest infections like meningitis.

If you experience any of these symptoms, it’s crucial to seek assessment and care from a healthcare professional immediately. These signs can indicate underlying issues that require more than naturopathic management.


Perimenopause doesn't mean you need to put up with suffering through migraines (or any symptoms)! By understanding the multifaceted triggers—from hormonal fluctuations to your diet and beyond—you can start to gain control over your health again and stop missing out on life because you’re busy lying in the dark trying to get rid of a migraine.

The key is to not just try to treat migraines but work on preventing them by addressing their root causes. Migraines give us valuable clues about what’s happening in our bodies, and where it needs some support and nourishment.

Many clients in the Chaos to Calm Method have successfully overcome migraines. If you're ready to say goodbye to migraines, I'm here to help. Please book a Free Clarity Call and we’ll discuss your specific symptoms and triggers, and explore how a personalised plan can make a significant difference in your life.


Is it perimenopause hormone changes or something else making you cranky, exhausted, overwhelmed, and gaining weight in your 40s?


Don't continue to feel stuck and confused - download The Perimenopause Decoder now and gain clarity on your journey to perimenopause!