Vertigo as a menopausal migraine
Vertigo and dizziness are common in migraine sufferers. It is much less common for vertigo to be the only symptom of migraines. This seems to be the case with vertigo that begin at menopause, according to a recent report presented at the last meeting of American Academy of Neurology. The report describes symptoms in 12 women, so its conclusions cannot be accepted as definitive. All of the women had history of menstrual migraines and all had a normal ear-nose-throat examination and a normal MRI scans. They all suffered from vertigo for at least a year. Treatment with standard migraine medications and hormonal therapy reduced attacks of vertigo by 50% and was more effective than non-hormonal treatment alone. It is not surprising that the hormonal therapy helped because some women with menstrual attacks also improve with hormonal therapy, such as continuous contraception. This report should raise awareness of the fact that menopausal women with vertigo may be suffering from migraines and may respond to hormonal and migraine therapies.
I developed vestibular migraines 4 years ago as a result of entering perimenopause. No history of headache or migraines. I’ve used a variety of preventatives (anti convulsants, anti depressants and blood pressure meds) to try and address the issue but they had horrible side effects. I have Botox scheduled to try next month. Currently they have ramped up in frequency as my period has become more erratic and the hot flashes have increased. I’ve had good success using Bioidentical hormones to try and stave them off in the past with using a triptan 5-7x month. I am currently using sumatriptan 100 mg plus .25mg Ativan to get through the day. Is this a reasonable tx approach for the next few years until this passes? I have little to no side effects from sumatriptan and have a healthy heart and lifestyle including many of the supplements and lifestyle choices you describe on your blog. I’ve been told the hormonal migraines are especially difficult to treat.
I am an early 60’s female and first experienced a “classic” migraine at age 15 and hormone-related migraines starting in my 20’s. I have been post-menopausal for 15 years with almost no migraines. I have had auras from time to time since then, but no real pain. About 2 years ago I awoke in the middle of the night with dizziness (and accompanying nausea) that disturbed me enough to go to the ER. Final dx was probable crystals in the inner ear. Two years later and it happened again. No ER visit this time. Once the symptoms passed, I commented to my husband that I felt exhausted, much as I did after a migraine, which led me to an internet search and this site. While my dizziness has never been finally diagnosed, I firmly believe it is a new form of migraine.
We usually start with non-drug approaches, such as aerobic exercise (stationary bike, so you don’t have to worry about your balance), magnesium, riboflavin, CoQ10, feverfew, boswellia, and other supplements. Antidepressants (amitriptyline, Cymbalta, etc) can be effective but can cause side effects and can be difficult to stop. Epilepsy drugs (Neurontin, Depakote, Topamax, and other) and blood pressure medications (Inderal, atenolol, Benicar, Bystolic, etc) can also help, but also can cause side effects.
I’ve been menopausal for three years and in excellent health, no hormones. I started having mild menopausal migraines in my eye area about 2 years ago and I started taking an over the counter vitamin for menopausal women and my doctor told me to take an aspirin everyday. These things helped for the past year but lately the migraines are getting worse and today I woke up with vertigo. I’m going to my doctor tomorrow and get on migraine meds and hormones. He had told me the meds they use for the migraines is an antidepressant but I’m not depressed but I really need to do something. The migraines are not incapacitating, they are more annoying than anything but the vertigo would make me unable to go to work.