HRT and Migraines: A Doctor Explains the Risks and Safe Alternatives

Millions of women experience migraines, and many also face menopause. The question of whether hormone replacement therapy (HRT) is safe for those with migraines is a common concern. Dr. Sooj, MBBS BSc MRCGP, a board-certified family medicine physician, recently addressed this question in a video. "The combined oral contraceptive pill carries an increased stroke risk," explains Dr. Sooj. "However, with HRT, we can use body-identical estrogen in a patch or gel, bypassing the liver and thus, the risk." He stresses the importance of using the lowest effective dose and adds, "If you still have a uterus, you'll need progesterone." Dr. Sooj highlights safer alternatives such as the levonorgestrel intrauterine system (Mirena coil), combined patches with norethisterone, or oral micronized progesterone. For those who prefer non-hormonal options, he suggests escitalopram or venlafaxine to manage symptoms. Dr. Sooj's video offers valuable insights into managing migraines and menopause, providing women with informed choices.