Migraine is closely associated with hormones. Some women find their migraine attacks start at puberty and are linked to their menstrual cycle. The additional hormonal trigger for women may explain why more women than men experience migraine during their reproductive years. Menopause is often the most challenging time for women with migraine. Postmenopause many women find their migraine eases, while men of a similar age find their migraine gets worse.
If you get a menstrual migraine, a low dose or estrogen-free birth control option (including long-acting reversible contraceptive solutions that can stop periods altogether like Mirena IUDs and Depo Provera shots) may be a good option. However, if you have migraine aura, you should discuss this carefully with your neurologist (and gynaecologist or GP), as your risk of stroke is higher. Some hormonal birth control options can significantly increase the risk of stroke.