New Discoveries Highlight the Efficacy of Preventive Measures in Managing Menopause-related Migraines

Migraines

Middle-aged women experiencing migraines, hot flashes, and night sweats may also harbor concerns about potential cardiovascular risks such as heart attacks or strokes. Previous research indicating a possible connection between these symptoms and cardiovascular crises during and after menopause has garnered considerable attention.

However, two recent studies published in the journal Menopause indicate that many of these women may not need to be as concerned, particularly if they do not experience both migraines and persistent hot flashes and night sweats. Instead, they should prioritize addressing other factors that could elevate their cardiovascular risk. This includes prioritizing adequate sleep, engaging in regular exercise, consuming a healthy diet, quitting tobacco use, and effectively managing their blood pressure, blood sugar levels, cholesterol, and weight.

For women who have endured both migraines and hot flashes or night sweats for an extended period, one of the recent studies does indicate an additional level of cardiovascular risk. Study leader Catherine Kim, M.D., M.P.H., from the University of Michigan, emphasizes the heightened importance of heart disease and stroke prevention in this particular group.

Furthermore, for women currently in their 20s and 30s experiencing migraines, the new findings suggest that they may be predisposed to a higher risk of experiencing long-term menopause-related symptoms as they age.

Kim and her colleagues at Michigan Medicine, the academic medical center of the University of Michigan (U-M), recently published two new studies. These studies were based on a comprehensive analysis of data collected from a long-term study involving over 1,900 women. These women volunteered to undergo regular physical examinations, blood tests, and annual health surveys when they were in their late teens to early 30s. Now in their 50s and 60s, these women have provided researchers with invaluable insights into the factors influencing health during the pre-menopausal years and beyond, thanks to their ongoing participation in the CARDIA study.

“The anxiety and concern experienced by women dealing with migraines and menopausal symptoms regarding cardiovascular risk is valid. However, these findings imply that prioritizing prevention and addressing unhealthy habits and risk factors could benefit the majority of women,” stated Kim, an associate professor of internal medicine at U-M and a primary care physician.

She further emphasizes, “For the subgroup experiencing both migraines and persistent hot flashes and night sweats early on, as well as for those currently experiencing migraines during early adulthood, these findings underscore the importance of controlling risks and addressing symptoms promptly.”

In the study, slightly over 30% of middle-aged women reported experiencing persistent hot flashes and night sweats, collectively referred to as vasomotor symptoms (VMS) due to their association with changes in blood vessel diameter. Among these women, 23% also reported having migraines. Interestingly, this was the sole group in which Kim and her colleagues observed an additional risk of stroke, heart attack, or other cardiovascular events that couldn’t be accounted for by other well-established risk factors associated with cardiovascular issues.

Apart from those who reported persistent vasomotor symptoms beginning in their 40s or earlier, 43% of the women in the study experienced minimal levels of such symptoms in their 50s, while 27% observed an escalation in vasomotor symptoms as they progressed into their 50s and early 60s.

Interestingly, neither of the latter two groups demonstrated any surplus cardiovascular risk once their other risk factors were considered, regardless of whether they experienced migraines. Furthermore, the utilization of hormone-based birth control and estrogen therapy for medical purposes did not impact this risk.

In the 1980s, our understanding of blood vessel biology, particularly at the cellular and molecular levels, was significantly less advanced compared to today. Both vasomotor symptoms during menopause and migraines are linked to the contraction and dilation of blood vessels. However, decades of research have unveiled the microscopic effects of smoking, poor sleep, unhealthy eating habits, lack of physical activity, genetic predispositions, life experiences, and hormonal factors on blood vessels.

In recent years, newer injectable migraine medications known as calcitonin gene-related peptide (CGRP) antagonists have emerged on the market. These medications, utilizing monoclonal antibodies, target a crucial receptor on the surface of blood vessel cells to prevent migraines and cluster headaches. Despite their efficacy, they are often expensive and may not be covered by insurance for all individuals affected by migraines.

Although the new study’s data predates the availability of these medications, Kim suggests them to her patients dealing with persistent migraines. She also collaborates with them to identify migraine triggers and utilizes other medications such as pain relievers and antiseizure medications for prevention.

Furthermore, Kim highlights the paper’s reflection on the increasing use of antidepressant medications to alleviate the effects of persistent hot flashes and night sweats during menopause.

Kim further emphasizes the mounting evidence supporting the significance of healthy sleep habits in alleviating hot flashes. Additionally, she highlights the short-term utilization of estradiol-based hormone therapy patches, which have not been associated with increased cardiovascular risk.

Moreover, Kim underscores that research has yet to demonstrate the effectiveness of over-the-counter supplements or herbal remedies. She cautions that these products are often less regulated than medications.