Menopause headaches: causes, symptoms, and treatments

Menopause can be a real headache — and in this case, it’s not just a figure of speech. Hormonal fluctuations during perimenopause and menopause, especially changes in estrogen levels, can lead to new headaches or changes in your headache patterns.

For people who already experience migraine or other headaches, the transition to menopause can sometimes intensify headache discomfort or change their pattern. Others may develop menopause headaches for the first time, such as menopause migraine triggered by hormonal shifts. While perimenopause and menopause headaches can be disruptive, there are effective ways to manage symptoms and get relief.

Read on to learn about menopause headaches, their causes, symptoms, and treatments. Plus, get exercises that can help ease headaches from Hinge Health physical therapists.

Menopause starts when you haven’t had a period for 12 months. The phase leading up to it, called perimenopause, usually begins in your 40s or 50s and can last several years. 

What are menopause headaches?

Menopause headaches are headaches that develop, worsen, or change during perimenopause or menopause. These are often described as hormonal headaches because they can occur with changes in estrogen and progesterone levels. 

While menopause headaches are often linked to hormone changes, other factors — like disrupted sleep, stress, and health history — also play a role. They can present as menopause migraine headaches, tension-type headaches, or other patterns. They may be accompanied by symptoms such as sensitivity to light or sound, nausea, and changes in mood or sleep.

For those with a history of migraine tied to hormonal changes (such as migraine related to pregnancy or the menstrual cycle), menopause can amplify these episodes or alter their pattern. “The transition is usually a continuum, not an abrupt switch,” notes Brittney Sellers, PT, DPT, a physical therapist at Hinge Health. “Having said that, there are some people who experience their first migraine during the menopause transition, even if they've never had migraines before,” says Dr. Sellers. Shifting hormone levels can trigger new headache patterns in midlife, so it’s not unusual to see new-onset migraine around this time, she explains.

Does menopause or perimenopause cause headaches?

Yes, menopause and perimenopause can cause headaches, often due to changing hormone levels — especially fluctuations or drops in estrogen. Many people notice new headaches or changes in their usual pattern during perimenopause and menopause, including more frequent migraines or tension-type headaches. These hormonal shifts can make existing headaches more severe, or lead to new symptoms for those who haven’t had headaches before. But headaches during menopause can have many possible causes — not just hormones — including stress, sleep disruptions, or changes in overall health or lifestyle.

Causes of menopause headaches

There’s no single cause of menopause headaches. Instead, these headaches are often linked to a combination of hormonal, lifestyle, and individual health factors. Understanding which of these are modifiable (things you can influence with changes to habits, routines, or treatments) and non-modifiable (factors you can’t change, but may need to work with) can help guide management strategies.

Modifiable factors

• Muscle tension. Tight or strained muscles, especially in the neck and upper back, can cause or worsen headaches during menopause. “Fascia and muscle tightness, especially in the upper body, often go hand in hand with headaches,” says Dr. Sellers. “Staying in uncomfortable positions at your workstation or spending long hours at your computer can create muscle strain that feeds into headache patterns.”

• Sleep disruption. Hot flashes and night sweats can interrupt sleep, which is linked with more frequent or severe headaches. Sleep problems often worsen both migraine and non-migraine headaches in midlife.

• Stress. Emotional and physical stress are common in midlife transitions and can contribute to the onset or worsening of menopause headaches.

• Medication or caffeine changes. Perimenopause is often a time when people start or change medications (like menopause hormone therapy, antidepressants, or over-the-counter pain relief), or alter caffeine intake. Any of these shifts can affect headache patterns.

• Inflammation. Inflammation is believed to play a significant role in headaches. Chronic inflammation, especially when linked to obesity, can also contribute to migraine worsening in menopause.

• Weight gain/obesity. Carrying extra weight is linked to a higher risk and severity of headaches, especially migraine, during menopause. This is partly due to chronic inflammation. Fat tissue releases inflammatory substances that can influence the nervous system and promote headache symptoms. Research suggests that weight loss may help reduce migraine frequency and severity.

• Health conditions (sometimes modifiable). Changes in blood pressure, mood, or physical activity levels during menopause can work together to influence headaches. For example, being less active may lead to more tension headaches, while sudden or intense physical exertion can trigger exertion-related headaches or migraines for some individuals.Some health conditions can be addressed through medical care, healthy habits, or treatment.

Non-modifiable factors

• Hormonal changes. Levels of estrogen and progesterone change during perimenopause and menopause. Research shows that sudden drops or swings in estrogen can contribute to hormonal headaches (tension-type or migraine), especially in those already prone to them.

• Surgical menopause. Experiencing menopause suddenly due to surgery, such as removal of the ovaries, can cause a rapid and significant drop in estrogen levels. This abrupt hormonal change sometimes leads to new or intensified headaches, particularly migraine.

• Genetics. Your genetic makeup can contribute to how likely you are to experience headaches around menopause. Certain genetic variations, including in hormone receptor genes, may make migraine or other headache types more common, especially when combined with psychological and environmental factors.

Types of headaches during menopause

Understanding the type of headache you’re experiencing can help you choose the right treatment and prevention tips, since each type comes with its own pattern of symptoms, such as throbbing or aching pain, sensitivity to light or sound, pain radiating from the neck, facial pressure, or other related issues.

Hormonal headaches are triggered by fluctuations in estrogen and progesterone and can present as migraine or tension-type headaches.

• Tension-type headaches. Mild to moderate, constant, aching pain that usually feels like a tight band or pressure around both sides of the head. These headaches often come with muscle tenderness in the scalp, neck, or shoulders and usually are not accompanied by nausea or sensitivity to light and sound.

• Migraine headaches. Intense, throbbing headaches, often on one side of the head. Additional symptoms may include nausea, vomiting, and sensitivity to light, sound, or smells. Migraine episodes can last from a few hours to several days and are sometimes triggered by hormonal changes, certain foods, stress, or sleep disruption.

• Cluster headaches. A type of severe headache that causes intense, piercing pain most often around or behind one eye and on one side of the head. These headaches occur in cycles or “clusters,” and may cause eye redness, tearing, nasal congestion, or restlessness during an episode.

• Cervicogenic headaches. Headaches resulting from issues in the neck — such as muscle or ligament strain near the upper neck joints. Pain typically starts at the base of the neck and radiates over the top toward the eye. These headaches often get worse with neck movement or from holding your head in one position for an extended time, such as when using a computer.

• Sinus headaches. Pain and pressure in the forehead, cheeks, and around the eyes. These sometimes occur if sinus congestion or allergies are triggered during menopause-related hormonal changes.

How long do menopausal headaches last?

The duration of menopause headaches can vary widely. Some people experience headaches only during the perimenopausal transition, when hormone levels are the most unpredictable. For others, headaches may continue or even become more frequent into menopause itself, especially if other triggers like stress or poor sleep are present.

“It can be reassuring to hear that for some types of menopause headache, your symptoms are likely to improve once you settle into menopause and your hormones stabilize,” says Dr. Sellers. Many people find that once their body adapts to lower, more stable levels of estrogen after menopause, hormonal headaches — especially those with a migraine pattern — may decrease in frequency or become less intense. Factors such as muscle tension, sleep quality, and everyday stress can still play a role in ongoing headaches beyond the menopause transition. If menopause headaches are long-lasting, getting worse, or interfering with your daily life, it’s important to talk with your healthcare provider. Together, you can discuss possible causes and effective strategies to help you manage headache symptoms at any stage of menopause.

Symptoms of menopause headaches

Menopause headaches can look and feel different for everyone, causing symptoms like dull or throbbing pain, sensitivity to light or sound, neck pain that radiates to the head, nausea, or brain fog.

Many people notice changes in their usual headache patterns or experience new symptoms as hormone levels fluctuate during perimenopause and menopause. “If you tend to get headaches, there’s a good chance you’ll notice those patterns become even more pronounced as you enter perimenopause and menopause,” says Dr. Sellers. While menopause headaches are often a continuation or increase in what you’ve experienced before, new symptoms can sometimes appear. Common symptoms of menopause headaches can include:

• A dull, persistent ache or throbbing pain, often on both sides of the head (typical of tension-type headaches), or one side for migraine

• Sensitivity to light, sound, or smell

• Nausea or vomiting, especially with migraine

• Feeling “foggy” or having trouble focusing 

• Pain that starts at the base of the skull or neck and radiates over the head and toward the eye 

• Headache worsened by neck movement or by holding the head in one position for a long time 

• Headache associated with hot flashes, mood changes, or poor sleep

Treatments for menopause headaches

Managing menopause headaches involves a combination of movement, lifestyle approaches, and medical support when needed. Here’s more on treatments for menopause headaches:

• Physical therapy and targeted exercises. It’s natural to want to rest or sleep when a headache hits — sometimes, taking it easy is exactly what your body needs. But when you’re feeling up to it, gentle movement can make a big difference. Simple exercises, done regularly, can help relieve muscle tension, improve posture, and support flexibility in your neck and upper back — areas that often contribute to menopause headaches. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. 

• Stay active. When you’re dealing with headache pain, even small amounts of movement can feel challenging. It’s important to listen to your body and rest when you need to. But gentle activity —  like walking, stretching, or even light household chores — when you’re feeling able can help with recovery and support your general wellbeing. Movement can boost energy, improve mood, and help with headache control over time, so find what feels manageable for you on any given day. 

• Manage stress. Mindfulness practices, breathing techniques, gentle yoga, or meditation have been shown in recent studies to support headache management and decrease frequency. Scheduling brief, regular breaks for relaxation throughout your day can make a difference.

• Check your posture. There’s no single “perfect” posture, but mixing up your position and avoiding staying in one spot for too long can help prevent strain and tension that contribute to headaches. “It’s a good idea to check your posture and your workstation set-up; even a quick adjustment to your chair or monitor to avoid craning your neck toward your screen,” says Dr. Sellers. This can help relieve muscle tension and help keep headaches at bay, she explains. Aim to change your position throughout the day — stand up, roll your shoulders, or adjust your sitting arrangement regularly, she suggests. Small shifts can make a big difference in reducing headache risk.

• Improve sleep hygiene. Keeping a regular bedtime and wake time, limiting screens before bed, and keeping your bedroom cool and comfortable can reduce headache triggers related to poor sleep.

• Consider menopause hormone therapy (MHT). This can help address the underlying hormonal causes of menopause headaches, although its effects can depend on the dosage, delivery method, and type of hormones used. Some forms of MHT may actually worsen certain types of headaches, so it’s important to discuss your options with your healthcare provider to find the approach that’s right for you.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain when you have menopause headache pain. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are ‌safe to take.

• Consider prescription medications. If menopause headaches are frequent or severe, you may want to explore options, such as migraine-specific drugs (triptans or CGRP inhibitors) or other preventive headache medications. Discuss your options with your healthcare provider.

• Monitor medication use. Work with your healthcare provider to track how often you use over-the-counter or prescription headache meds, to avoid medication-overuse headaches and manage side effects from any medications or supplements. Medication-overuse headaches can develop when pain relievers are taken too frequently, causing headaches to become more frequent or persistent over time.

“Menopause hormone therapy can be a first-line management tool for some, but a comprehensive approach is usually best,” says Dr. Sellers. “Headaches are rarely due to just one factor — movement, posture, and stress management all play a role. Combining these strategies can mean more effective, long-term relief.”

Physical therapy for menopause headaches

If you haven’t considered physical therapy for headache relief before, you’re not alone — many people don’t realize physical therapy can play a helpful role in managing certain types of headaches, especially those related to muscle tension and neck pain. Headaches often have more than one cause, but tight muscles in your neck and shoulders can be a significant trigger, particularly during menopause.

Physical therapy is a key treatment for menopause headaches due to muscle tension, focusing on safe movement, targeted exercises, and stretches to help ease headache pain. The goal is to strengthen muscles that support your neck and upper back, improve flexibility, and reduce tension that can trigger or worsen headaches.

A physical therapist (PT) can evaluate your posture, movement habits, and sources of muscle tension, and create a program with targeted stretches and strengthening exercises tailored for you. These movements are designed to relieve tension, support the muscles in your neck and upper back, and increase flexibility — helping to reduce the frequency and intensity of headaches. They can also suggest ways to modify your everyday activities to minimize symptoms and empower you with tools and tips to help reduce pain. Recommendations may also include relaxation techniques, mindful breathing, or ergonomic tips for your work or home environment.

You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. Some exercises they may recommend can be found below.

These exercises can help you manage and prevent menopause headaches by reducing muscle tension, supporting healthy posture, and promoting relaxation. Head tilts stretch tight muscles along the side of your neck to ease tension. The levator stretch targets the muscles between your neck and shoulder, relieving stiffness that can trigger headaches. Chin tucks improve neck mobility and decrease strain from forward head posture. Scapular squeezes activate upper back muscles to support better posture. Scapular clocks improve shoulder mobility to reduce neck and upper back tightness. Open book rotations increase flexibility in the upper back and chest. Seated cat cow keeps your spine mobile and relieves overall back and neck tension. Diaphragmatic breathing calms your nervous system and decreases physical stress linked to headaches. Practicing these regularly can help you find relief and support your overall well-being during menopause.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

When to see a doctor

Menopause headaches can often be managed with at-home or simple treatments. But if your headaches are severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have:

• Sudden, severe headache unlike any you’ve had before

• Headache accompanied by fever, stiff neck, or confusion

• Headaches that start after age 50 and are new to you

• Changes in vision, weakness, or difficulty speaking

PT tip: Pause and breathe

Taking just one or two minutes throughout your day to pause for deep breathing and relaxation can help calm your body, reduce stress, and lower inflammation, all of which may help prevent headaches before they start, explains Dr. Sellers. “Since stress often comes before a tension headache or migraine, scheduling brief relaxation breaks during busy or tense moments can make a real difference.” 

How Hinge Health can help you

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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