Menopausal headaches

Headaches during menopause are a very common and unpleasant phenomenon, which is associated not only with disorders of the cerebral vascular tone, but also with other causes - arterial hypertension, impaired nerve conduction and tone of the sympathetic and parasympathetic nervous system, psychosomatic condition. Headaches during menopause are particularly long-lasting, persistent and severe, so they require correction of the general condition. Timely diagnosis of this condition allows not only to reduce the severity of clinical manifestations, but also helps prevent complications.

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Causes menopausal headaches

Headaches can be an early manifestation of menopause and can accompany it for a long time. This is a very unpleasant symptom that significantly reduces performance and affects the general condition of a woman. Although menopause is a physiological process, the disorders that occur in a woman's body during this period can significantly affect the condition of the entire body. The hormonal background of the female body is very diverse and ensures not only the functioning of the female genital organs, but also affects metabolism, vascular muscle tone, blood pressure, regulation of nervous activity, and blood circulation in the vessels of the brain. Due to this phenomenon, a woman's nervous system is very labile, and any hormonal disorders contribute to changes in nervous regulation. This affects the development of not only headaches, but also other serious disorders. The climacteric period is conventionally divided into:

1. premenopause – the period from 45 years to the onset of menopause;
2. menopause – the period of the last menstruation, average age is about fifty years;
3. postmenopause – the period from the last menstruation until the end of a woman’s life.

All these periods are characterized by consistent changes in the body and if there are no disorders, then the nervous system works normally and headaches can be a rare transient phenomenon. But in the case of a pronounced violation of hormonal homeostasis during menopause, headaches can be very strong and accompanied by other unpleasant symptoms. In this case, it is imperative to diagnose this condition and conduct treatment.

Premenopause is a period characterized by hormonal disorders, which are primarily of a central nature. There is an involution of the highest regulatory center - the hypothalamus, which is characterized by a gradual decrease in the sensitivity of the hypothalamus to the influence of estrogens, which disrupts its regulatory function according to the principle of feedback regulation. As a consequence of all these processes - there is not a sufficient concentration of estrogens, which normally regulate the tone of the vessels of the whole body and the brain, including. In this case, there is a violation of the regulation of vascular tone, which is the main pathogenetic mechanism for the development of cerebral vascular spasms. Such vascular spasm leads to increased pressure in the vessels and the appearance of headaches.

Therefore, the main cause of headaches during menopause can be considered, as a primary phenomenon, a hormonal imbalance. Estrogen deficiency in turn contributes to spasm of the cerebral vessels, arterial hypertension and intracranial hypertension, which leads to the appearance of headaches. In addition, the processes of inhibition and excitation in the brain are disrupted, and this also disrupts conduction along nerve fibers. At the same time, nervous excitability increases, the sympathoadrenal system is activated and catecholamines are released, which, as is known, further spasm the vessels. Such a hormonal background is constantly observed during menopause and therefore headaches are also constant, very strong and often accompanied by other unpleasant symptoms. Therefore, in treatment, not only symptomatic remedies for headaches are important, but also hormone replacement therapy.

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Pathogenesis

The pathogenesis of headaches during menopause also consists of increased intracranial pressure. This occurs due to impaired venous outflow with impaired regulation of venous tone, as well as due to sodium and water retention and increased circulating blood volume. Low concentrations of estrogens contribute to sodium and water retention, which in turn leads to arterial hypertension. Thus, a vicious circle is formed, which further contributes to the severity of headaches during menopause.

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Symptoms menopausal headaches

Headache during menopause differs from that of other pathologies. This is due to the constant action of the causative factor in the absence of treatment of the pathology.

The nature of headaches during menopause has its own characteristics, which is associated with prolonged vascular spasm and the accompanying state of hypertension not only in the brain vessels, but is also associated with intracranial hypertension. Therefore, the characteristics of such a headache are that it begins from the moment of awakening, lasts throughout the day with moments of decreasing pain intensity. Such a headache is debilitating, it does not respond well to painkillers and sometimes requires taking sedatives. Often, such a headache is accompanied by other symptoms, which is associated with the pathogenetic features of the development of the process. Arterial hypertension often accompanies headaches during menopause and further intensifies such pain. Also, the headache can be accompanied by a feeling of nausea, loss of appetite, and sometimes vomiting.

The first signs of a serious condition that requires treatment are headaches that are difficult to treat with painkillers. Often, such headaches do not appear immediately, but may be emotional and vegetative manifestations. A woman feels a flush of heat to the face, increased irritability, excessive lability of the nervous system, and only after that a headache may appear. Often, such attacks of headache during menopause are accompanied by disorders of the cardiovascular system, and there is palpitations or a feeling of stopping in the work of the heart, a feeling of arrhythmia. There may also be vegetative manifestations in the form of holding your breath or a feeling of lack of air. All these symptoms develop at first, and then a headache appears. Such features of a combination of headache with other symptoms are very typical for menopause.

Severe headaches during menopause are one of the reasons not only for taking painkillers, but also for a thorough examination and identification of the true cause with mandatory screening of the woman’s hormonal background.

Complications and consequences

The consequences of headaches during menopause can be quite serious, since these headaches are intense and, in the case of concomitant pathologies, can cause a stroke. Complications of headaches during menopause can be avoided by timely correction of hormonal levels. The prognosis for recovery from headaches during menopause is characterized by a long and difficult to treat course, so it is important to prevent such conditions.

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Diagnostics menopausal headaches

Although menopause is a physiological condition, it is very important to diagnose any of its manifestations in time and begin treatment of pathological conditions. It often happens that a woman seeks help after she has already tried many painkillers and does not know what to do because of the symptoms that bother her. In this case, it is necessary to conduct a thorough examination not only for the purpose of diagnosis, but also for the purpose of differential diagnosis of such headaches. First of all, it is necessary to begin diagnostics with a thorough collection of anamnesis. It is necessary to find out when the first delay in menstruation was, what their nature is now, how the symptoms changed with the onset of menopause, and also to detail the patient's complaints. It is necessary to clarify the nature of the headache and its connection with stress, any other characteristic symptoms and the reaction to sedatives and painkillers. It is also necessary to measure blood pressure to know whether the headaches are connected with hypertension.

During the examination, you need to ask the woman to indicate where her head hurts the most and to clarify other characteristics of such a headache. It is very important to conduct additional research methods in the diagnosis of headaches.

Since changes in metabolism are inevitable during menopause, a thorough laboratory examination of the woman's body is necessary. The tests that are necessary to clarify the diagnosis are general clinical and special. General tests include a blood test, a biochemical blood test with a lipidogram and kidney function indicators, and a urine test. During menopause, due to the activation of the breakdown of fatty acids, an increase in triglycerides and low-density lipoproteins is possible. These substances can play a secondary role in the pathogenesis of headaches during menopause, so it is important to determine this indicator.

As for special tests, it is necessary to determine the level of the main female hormones in the blood. This is necessary not only for further treatment of menopause and headaches, but also for analyzing the level of hormonal changes and the duration of the pathology.

Instrumental diagnostics of headaches during menopause is aimed not only at identifying the etiology, but also at excluding other organic pathologies. Mandatory and special research methods are carried out. Among the mandatory methods is electrocardiography, which allows excluding cardiac pathology in the case of concomitant symptoms from the heart.

Special methods of diagnosing the etiology of headaches during menopause include echoencephalography. This method involves recording echo signals that allow you to establish the blood supply to the cerebral hemispheres and also allows you to judge the difference in intracranial pressure. This examination allows you to determine organic pathology and identify the possible cause of headaches.

Also, for the purpose of differential diagnosis, it is necessary to conduct an X-ray of the cervical spine in order to exclude vertebrogenic headaches. In the case of compression of the vertebral artery, which supplies the brain, headaches of an ischemic nature are also possible. Then the X-ray image will show the area of compression or narrowing of the artery.

Additional research methods are possible in case of concomitant symptoms from the cardiovascular or skeletal system. Then the calcium level in the blood is determined, an ultrasound examination of the heart is performed.

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Differential diagnosis

Differential diagnostics of headaches during menopause should be carried out with hypertension, which is also accompanied by such symptoms and may manifest for the first time during menopause. Then a simple measurement of blood pressure is not enough and it is necessary to conduct daily monitoring of blood pressure. In this case, each element of the rise in blood pressure is determined, which can be compared with possible etiological factors and episodes of headache. This method also allows you to exclude hypertension. Also, with hypertension, headaches have a slightly different character - they are localized in the occipital region and bother more in the morning, are well relieved by taking antihypertensive drugs. Also, in this case, the woman has a hereditary history of hypertension.

Headaches during menopause must be differentiated from other pathologies that are accompanied by such symptoms. First of all, it is necessary to exclude organic pathology - migraine, vertebrobasilar insufficiency syndrome, stroke. Therefore, a thorough examination is carried out, sometimes even magnetic resonance imaging is necessary.

Treatment menopausal headaches

Considering the fact that headaches during menopause are very pronounced, treatment must be carried out immediately. There are drug and non-drug treatments. Drug treatments are divided into symptomatic agents, as emergency aid, and drugs for long-term treatment. Non-drug treatment is aimed at correcting hormonal imbalance on the one hand and at the analgesic effect on the other. Therefore, the use of folk remedies is a priority only in the complex treatment of menopause and during remission.

First of all, lifestyle adjustments play a huge role in the treatment of headaches.

1. It is necessary to eliminate bad habits, because smoking has a very negative effect on vascular tone, and nicotine further constricts blood vessels and can provoke headaches, so this factor must be categorically excluded.
2. Eliminate stress and tension that lead to headaches and avoid traumatic situations.
3. Normalization of sleep by means of a regimen of rest – it is necessary to go to bed at about the same time, to sleep at least 8-9 hours a day. It is necessary to carry out hygienic measures in the room where the woman sleeps – wet cleaning, airing, fresh linen – all this promotes rest at night and improves blood circulation in the vessels of the brain, which reduces episodes of headaches.
4. Correction of the daily routine with normalization of the period of rest and work. It is necessary to precisely establish the rest regime after each work. This will help the body to distribute forces correctly and relieve tension in the head.
5. It is important to organize proper nutrition with dietary elements. It is necessary to exclude fatty foods, which burden the internal organs and contribute to the disruption of the metabolism of essential nutrients. It is also necessary to organize frequent fractional meals in small portions with the exclusion of simple carbohydrates and with a predominance of vegetable protein. It is necessary to eat at least 300 grams of fruits and vegetables per day. Also, do not forget about the drinking regime and drink clean water at least 1.5 liters.
6. It is necessary to properly organize leisure time with measured physical activity in the form of light jogging, swimming or simple walking.

Drug therapy for headaches during menopause is aimed primarily at correcting hormonal imbalance and at the same time eliminating headaches through pain relief. This is achieved through hormone replacement therapy, which is combined with nonsteroidal anti-inflammatory drugs and sedatives.

Hormonal replacement therapy, which is used in the treatment of headaches during menopause, helps to normalize the level of estrogens and thus normalizes the tone of the brain vessels, as well as the processes of excitation and inhibition in the nervous system, which leads to the normalization of intracranial pressure and a decrease in the severity of clinical symptoms. Two-phase drugs containing both estrogens and progesterone are used for a softer correction of menopause.

1. Logest is a drug containing estradiol and gestagen, is a high-dose drug that helps to balance hormonal imbalance and replenish estrogen deficiency during menopause. Logest is available in the pharmacological form of capsules, containing 21 pieces per package. It is necessary to start taking it from the first day of the cycle. It is possible to start taking it from the fifth day of the menstrual cycle in case of menopause in a woman. The course of taking the drug is one capsule per day for three weeks, then a break for seven days, then you need to resume taking it. Side effects are possible from the gastrointestinal tract in the form of stool disorders, nausea, bitterness in the mouth, vomiting. There may also be asthenovegetative reactions, manifestations of hormonal treatment from the chest in the form of engorgement of the mammary gland, pain, discharge, and increased vaginal secretion. Contraindications to the use of the drug for treatment are problems with blood clotting and a history of heart attack or stroke, malignant neoplasms, liver dysfunction, pancreatic damage and diabetes.
2. Triziston is a complex hormone replacement drug. This drug is produced in the pharmacological form of dragees of three colors, which are used according to a special scheme for three weeks, then a break for a week. The course of treatment is at least three to six months. Contraindications for prescribing the drug are malignant tumors of any localization, vascular pathology in the form of thrombosis in the anamnesis, hepatitis. It is necessary to use with caution in diabetes mellitus, since the drug can change glucose tolerance, as well as in arterial hypertension. Side effects may appear in the form of cholestasis, liver dysfunction, embolism, as well as allergic and dyspeptic reactions.
3. Nootropil is a drug from the nootropic group, which is used to treat headaches as a pathogenetic agent. It can be one of the drugs of basic complex therapy due to its pronounced effect on the brain vessels. The drug improves blood circulation in the brain vessels, has a vasodilatory property, which helps reduce pressure and headaches. Also, the active substance of Nootropil improves the conductivity of nerve impulses along the nerve ganglia, which increases stress resistance. An additional property of the drug is its protective abilities regarding nerve cells, which improves memory and cognitive abilities. The drug is available in the form of capsules, tablets, oral solution and parenteral solution. The daily dose of the drug is 800 milligrams twice a day, the dose can be adjusted. Side effects are possible in the form of digestive disorders with nausea and vomiting, as well as allergic reactions of varying degrees of complexity, and an increase in the woman's body weight. Side effects from the central nervous system are also possible in the form of dizziness, drowsiness, depression, increased nervousness. Contraindications to the use of the drug are impaired renal function, a history of hemorrhagic stroke.

Symptomatic remedies used in case of headaches during menopause consist of a more pronounced effect in case of taking combined remedies. Preference is given to drugs with a combined composition of antispasmodics - Baralgin, Spazmalgon, Combispasm, Spazgan, Farmadol. Such remedies cope better with headaches due to their comprehensive action.

Surgical treatment of headaches during menopause is not used, since there are no specific indications for such intervention.

It is important to conduct physiotherapy along with medications. Therapeutic physical exercises in the form of swimming or therapeutic gymnastics are used. Magnetic therapy, laser therapy, electrophoresis with medicinal solutions on the neck area, and Shcherbak compresses give a very good effect. A contrast shower is very useful due to its tonic effect, which is recommended to be taken in the morning and can be done even at home.

As a complex therapy, it is recommended to use vitamins of group B, C, A, preferably in combination in complex vitamin preparations. Vitamin preparations can be taken prophylactically in spring and autumn.

Folk remedies for headaches during menopause

Traditional methods of treating headaches during menopause are used very widely. The drugs used are aimed at correcting hormonal homeostasis and at the same time normalizing vascular tone and an analgesic and vasodilatory effect. For this, traditional remedies and herbal treatment are used. The main traditional methods are:

1. An effective way to normalize hormonal levels is to use walnut shells. Walnut tincture is prepared as follows: the membranes or shells are boiled for about five minutes in hot water, then the water is drained and half a glass of alcohol is poured in. This solution needs to be infused for about five to seven days, after which it can be taken one teaspoon twice a day, pre-diluted with boiled water in equal proportions. The course of treatment is twenty-one days.
2. Pine buds are brewed at the rate of one tablespoon of raw material per liter of water, infused in a thermos overnight and drunk throughout the day, half a glass 3-4 times a day for at least a month.
3. The following recipe has a very good pain-relieving and calming effect: pour one glass of oat grains with boiled water and cook for half an hour, then drain the infusion and add an equal amount of milk. You need to take the solution twice a day, add a spoonful of honey before taking it and drink half a glass warm. The course of treatment is one month.

Herbal infusions are also widely used to treat this pathology:

1. Birch buds are poured with hot water, boiled for five minutes and left to brew for a day, after which it is necessary to take this solution one tablespoon twice a day, the course of treatment is at least seven days.
2. A collection of medicinal plants also helps to normalize the tone of the brain vessels and has a calming effect. To do this, take mint, nettle and currant leaves, one tablespoon of each herb, pour boiling water over it and boil for several minutes. The herbal infusion is consumed warm, half a glass on an empty stomach for three weeks.
3. Raspberry, viburnum and hawthorn leaves are boiled in water for ten minutes and half a glass of the decoction is consumed twice a day before meals. The course of treatment is twenty days.

Homeopathic remedies are able not only to correct hormonal imbalance, but they also restore the normal tone of the brain vessels and reduce the severity of headaches during menopause.

1. Klimaktoplan is a homeopathic preparation that is an analogue of phytoestrogenic preparations and helps to normalize hormonal levels during menopause. The preparation also normalizes the tone of the brain vessels and dilates them with a decrease in pressure. The preparation well corrects headaches during menopause, hot flashes, heartbeat, and normalizes sleep.

Klimaktoplan is used in tablets, one tablet before meals or one hour after three times a day. The course of treatment with the drug is long - about two months. No side effects have been identified. Contraindications to taking Klimaktoplan are hypersensitivity to individual components of the drug.

2. Remens is a homeopathic drug that improves microcirculation in the vessels of the brain, regulates hormonal imbalance during menopause due to the effect on the hypothalamic-pituitary zone, and also has protective properties on myocardial cells and vessels. The drug is available in the form of a solution and tablets. The medicine is used on the first and second day in an increased dose - one tablet or ten drops eight times a day, and then for three months in the same dose, but only three times a day. No side effects have been identified. Contraindications to taking Remens are hypersensitivity to individual contents of the drug.
3. Ginekohel is a combined homeopathic remedy that has an effect on menopause disorders by normalizing the synthesis of estrogen and progesterone, which helps reduce the effects of deficiency of these hormones. The drug is available in drops and is dosed ten drops three times a day, can be dissolved in water or taken as a pure solution. Side effects are rare, but stool disorders, dyspeptic phenomena and allergic reactions may occur. No contraindications have been identified.

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Prevention

Preventive measures for the development of headaches during menopause are non-specific prevention of any disease, which consists of maintaining a healthy lifestyle. Since menopause cannot be avoided, it is possible to prevent the appearance of its symptoms and the manifestation of VSD during menopause. It is necessary to properly organize your daily routine with alternating periods of rest and work. You need to eat right, excluding all harmful foods and eating fruits and vegetables. Sleep is a necessary measure for health, its duration should be at least 8-9 hours. It is necessary to exclude stress in life and play sports, at least in the walking mode. It is also necessary to exclude bad habits and treat concomitant pathologies in the form of hypertension, because blood pressure control is very important for the prevention of headaches.

There are no specific measures to prevent the development of headaches during menopause, but only non-specific methods can easily protect you from this unpleasant pathology. It is important to conduct hormone replacement therapy from the very beginning of premenopause, which will reduce the severity of any clinical symptoms, including headaches.

Headaches during menopause are characterized by pronounced manifestations and impair work capacity, so it is necessary to promptly identify the symptoms, differentiate the etiology of these pains and conduct complex treatment. It is best to prevent such manifestations of menopause by contacting a doctor and timely hormone replacement therapy.

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