Menopause hormone therapy, migraines, and thromboembolism

Best Pract Res Clin Obstet Gynaecol. 2022 May;81:31-44. doi: 10.1016/j.bpobgyn.2021.11.011. Epub 2021 Dec 3.


Migraine, a common form of headache, is a highly prevalent and disabling condition with a predilection for females. Migraines are neurovascular diseases. The two main types of migraines are migraines with and without aura, and several subtypes exist. There is a strong link between sex steroids and migraines. In women, migraine remissions are associated with stable and critical oestrogen levels. The literature reveals an association between migraine with aura and stroke, with a higher incidence in the young compared with that in the old. The absolute risk of stroke is low; tobacco use and a high dose of oral oestrogens may increase the risk. Early diagnosis, follow-up, and nonhormonal symptomatic and preventive treatments address the neglected area of migraines. Judicious use of hormones throughout the lifespan as needed would improve the quality of life.

Keywords: Menopause; Menopause hormone therapy; Migraines; Oestrogen; Stroke; Venous thromboembolism.

Publication types

  • Review

MeSH terms

  • Estrogens / therapeutic use
  • Female
  • Hormone Replacement Therapy / adverse effects
  • Humans
  • Menopause
  • Migraine Disorders* / diagnosis
  • Migraine Disorders* / drug therapy
  • Migraine Disorders* / etiology
  • Quality of Life
  • Stroke* / complications
  • Stroke* / prevention & control
  • Thromboembolism* / complications
  • Thromboembolism* / prevention & control


  • Estrogens