Hormone therapy linked to more frequent and longer-lasting migraines

Migraines are estimated to affect 10% to 29% of women during the menopause transition, when migraines often worsen and become more frequent, especially during perimenopause. This is due to unpredictable estrogen drops. A new study suggests postmenopausal women using hormone therapy will experience more frequent, longer-lasting migraines. Results of the study will be presented at the 2026 Annual Meeting of The Menopause Society in San Diego October 20-24, 2026.

Hormone therapy has proven to be successful in managing a wide array of bothersome menopause symptoms, especially hot flashes. A challenge, however, is that fluctuations in estrogen levels may influence migraines.

Researchers in a new study sought to evaluate the associations of hormone therapy with migraine outcomes, including incidence, severity, frequency, duration, and analgesic use in postmenopausal women, independently of the route of administration. They based their findings on five studies that collectively included nearly 24,000 women. The pooled analysis showed a mean migraine incidence of 18.94%.

Based on their findings, the researchers concluded that hormone therapy was associated with increased frequency of migraine attacks and longer duration of migraine episodes. However, no significant differences were observed in the number of analgesics used per month or in migraine severity scores.

Further clinical trials are necessary to better understand the physiopathology and to guide more efficient treatments.

Migraines can have a significant impact on quality of life, particularly during the menopause transition when many women experience changes in their symptoms. More research is needed to better understand the relationship between hormone therapy and migraine and to help guide individualized treatment decisions."

Dr. Flavia Fairbanks Ruano, lead author, University of Miami Miller School of Medicine

Details of the study will be discussed as part of the presentation titled "Impact of Hormone Replacement Therapy on Migraine Outcomes in Postmenopausal Women: A Systematic Review and Meta-Analysis"

"Hormone therapy remains the most effective treatment for bothersome vasomotor symptoms and can be used safely in many women with migraine," says Dr. Stephanie Faubion, medical director for The Menopause Society. "Because women with migraine may be more likely to seek treatment for menopause symptoms, the findings of this study may reflect underlying differences between women who use hormone therapy and those who do not. More research is needed before drawing conclusions about the effect of hormone therapy on migraine burden."