Why have I had a migraine now? Does it have anything to do with menopause?

The incidence of first migraine episode tends to peak in the mid-30s, with a decline in prevalence later in life. Any new headache that develops later in life, particularly after 50 years old needs to be investigated for serious causes including disease related to the blood vessels, autoimmune disease and tumours.

The natural history of migraine varies between migraine sufferers. Migraine is a typically life-long condition that evolves over an individual’s lifetime. Sometimes in the case of a late diagnosis of a migraine, Other headache episodes experienced in the past such as “sinus” headaches may in fact have been a migraine. With age, changes to brain neurotransmitter production, blood vessel integrity and hormonal changes, particularly within women can, change the intensity and frequency of migraine events, and the experience of migraine aura. Typically people who are diagnosed with migraine later in life are more likely to achieve remission.

In women, fluctuations in hormone levels during menstruation can be a trigger for migraine attacks, as can the perimenopausal period. The intensity, nature and frequency of migraine may change from woman to woman, some experience migraines outside their regular periods, and during the perimenstrual period, they may ramp up. Typically migraine frequency tends to worsen during the perimenstrual period and ease off following. Migraine auras may have their own trajectory, continue to occur in isolation or not at all.