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Women's Health

Are Estrogen Cream and Migraines Related? A Gynecologist Weighs In

Some women experience first-time or worsening migraines during perimenopause.

Menopause and perimenopause symptoms can be relentless: hot flashes, weight gain, bladder leaks. “The change” is no picnic. For some, symptoms also include vaginal atrophy, a condition wherein the tissues lining the inside of the vagina become thin, dry, and inflamed. This can be extraordinarily painful, and can reduce what may already be a diminished sexual appetite (due to menopausal hormone fluctuations). Relief can be found in estrogen creams that mitigate dryness and itching. Like all treatments, however, these creams are not free of side effects.

One First for Women reader wondered if the estrogen cream she uses for vaginal atrophy might be related to the migraines she recently began experiencing. We put her question to our consulting gynecologist, Barbara DePree, MD. Here’s what she had to say.

Q: The estrogen cream I’ve used for several months is working wonders to ease the dryness and itching of vaginal atrophy, but now I’ve started to have migraines. I’m 48. Could they be related?

A: It’s unlikely. I’m glad you’re getting relief from vaginal atrophy, which causes dryness, burning, itching, painful sex and recurring urinary tract infections. It occurs when declining estrogen levels cause thinning of the vaginal walls, and the localized estrogen you’re taking is a powerful remedy.

I suspect that you’re actually experiencing menstrual migraines triggered by fluctuating hormones. Some women, like you, may experience migraines for the first time during perimenopause, while others with existing migraines report a worsening in severity or frequency during this stage. The good news is that these migraines typically disappear after menopause, when hormones steady and your period ceases. If yours don’t, I recommend having your primary care provider evaluate them for further treatment.

In the meantime, try downloading a free smartphone app, like Migraine Buddy, which will help you track your headaches and identify any other potential triggers. And if your doctor confirms that you are experiencing menstrual migraines, try supplementing with 250 mg. of ginger root extract each day (Buy from Walmart, $21.00). The herb boasts anti-inflammatory properties, and has been shown to decrease migraine symptoms like pain and nausea. Note: Avoid ginger if you’re on blood thinners, as it may increase the risk of bleeding.

Meet our expert

Barbara DePree, MD, is a gynecologist in private practice and director of Women’s Midlife Services at Michigan’s Holland Hospital. A Certified Menopause Practitioner, she is the founder of, an educational resource for women’s sexual health in perimenopause and beyond. To ask her a question, send an email to

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.

This article originally appeared in our print magazine, First For Women.

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