30% Increased Stroke Risk With HRT In Women With Migraine History

A recent report has found that women using hormone replacement, and experiencing more severe migraines, may have an increased stroke risk. Heart disease is a major health concern at menopause and hormone balance is one way to tackle it.


There have been many health risks associated with HRT, but recently researchers suggested that women with a history of migraines should discuss this with their doctor. This is because there seems to be a link between HRT and an increased stroke risk if the migraines are severe, and worse when on HRT.

The link between migraines, strokes and HRT

HRT has already been linked with an increased stroke risk but a research team at the Zeenat Qureshi Stroke Institute in Minneapolis, Minnesota, and a neurology resident at Houston Methodist Hospital in Texas found that women who currently used hormone replacement and reported more severe migraines were 30 percent more likely to have an ischemic stroke (clot-caused) and this is the most common type experienced.

Women at menopause are at risk of heart disease and strokes, but researchers found that women on HRT were more likely to experience worsening migraines than women who never started or were on hormone replacement in the past. The risk is related to whether a woman is experiencing a greater number and severity of migraines when she is on HRT.

This new study was the first to look at a change in migraine severity with hormone replacement as a risk factor for ischemic stroke. It involved analysing data for 82,208 women aged 50 to 79 years old from the Women’s Health Initiative Study, begun by the U.S. National Institutes of Health in the early 1990s. When they enrolled in the study, all of the women reported having some degree of migraines, and about 45 percent of them were using hormone replacement.

At a follow-up visit three years later, women completed a questionnaire to assess if their migraines were better or worse. Altogether the women were followed for 12 years, and during that time 2,063 had an ischemic stroke.

Are you at risk of a stroke?

Family history clearly will play a part, but that aside women at menopause do have an increased risk and these factors are all relevant:

– High blood pressure
– High blood cholesterol
– Diabetes and prediabetes
– Smoking
– Being overweight or obese
– Being physically inactive
– Having a family history of early heart disease
– Unhealthy diet
– Age (55 or older for women)

Helpful information:

Headaches are hormonally related to oestrogen usually, so hormone balance is essential to reduce your risk and oppose oestrogen dominance by balancing with bioidentical progesterone. These findings do suggest that women who have a history of migraines should be proactive and talk to their doctor about the risks and benefits of hormone replacement if it is being offered. If HRT is given then it is essential to monitor migraine severity. Don’t ignore an increasingly bad migraine and you should also tell your doctor if you have no previous migraine history but get them while on HRT.