PERIMENOPAUSAL MIGRAINE

Perimenopausal period is a period in which there is a risk of migraine attacks becoming more frequent, along with many complications related to irregular menstrual cycles. Vasomotor symptoms observed during this period can be prevented with hormone replacement therapy. Oral estrogen preparations can trigger migraine attacks, therefore non-oral treatments are recommended for these symptoms. Intrauterine levonorgestrel may be a treatment option. In women with contraindications to estrogen use, paroxetine 7.5 mg (nightly) or gabapentin can be used to prevent vasomotor symptoms.