TL;DR
A systematic review and meta-analysis of five studies, involving nearly 24,000 women, found hormone therapy was associated with more frequent migraine attacks and longer episodes among postmenopausal women. Researchers reported no significant differences in migraine severity scores or monthly analgesic use, and say further research is needed to establish what the association means.
A review of five studies involving nearly 24,000 women found that hormone therapy was associated with more frequent migraine attacks and longer-lasting episodes among postmenopausal women. The findings are due to be presented at The Menopause Society’s 2026 annual meeting in San Diego, but the review does not establish that the therapy caused the changes.
The researchers examined associations between hormone therapy and several migraine outcomes: whether migraines occurred, how severe they were, how often attacks happened, how long episodes lasted, and how much analgesic medication participants used. Their analysis pooled results from five studies that together included nearly 24,000 women. The reported mean migraine incidence in the pooled analysis was 18.94%.
The analysis linked hormone therapy to increased migraine frequency and longer episode duration. It found no significant differences in migraine severity scores or in the number of analgesics used per month. The report does not give further figures for how much frequency or duration differed, nor does it provide a breakdown by treatment type or route of administration.
The work is titled “Impact of Hormone Replacement Therapy on Migraine Outcomes in Postmenopausal Women: A Systematic Review and Meta-Analysis.” Lead author Dr. Flavia Fairbanks Ruano is affiliated with the University of Miami Miller School of Medicine. The findings are being presented as research for discussion at the meeting, rather than as a final answer about the effects of treatment.
Balancing Migraine and Menopause Care
The findings may matter to people weighing treatment for menopause symptoms who also experience migraines. Hormone therapy is used to manage a range of bothersome symptoms, especially hot flashes, while the study raises a possible association with changes in migraine frequency and duration. That is relevant to treatment discussions, but the evidence reported here does not show that hormone therapy caused migraines to worsen in individual patients.
Dr. Stephanie Faubion, medical director for The Menopause Society, said hormone therapy remains the most effective treatment for bothersome vasomotor symptoms and can be used safely in many women with migraine. She cautioned that women with migraine may be more likely to seek treatment for menopause symptoms, meaning differences between therapy users and non-users could reflect who receives treatment rather than an effect of therapy itself.
The results therefore do not support a one-size-fits-all conclusion. They point to a question for further study and a reason for individualized discussions between patients and qualified health professionals. Anyone considering starting, stopping, or changing hormone therapy should discuss their circumstances with a clinician rather than making a change based on this review alone.
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Estrogen Changes and Migraine
Migraines are estimated to affect 10% to 29% of women during the menopause transition, according to the source report. Symptoms often worsen or become more frequent during perimenopause, a stage when estrogen levels can fluctuate unpredictably. The review focuses on postmenopausal women using hormone therapy, so it addresses a related but distinct population and question.
Hormone therapy can help manage menopause symptoms, but changes in estrogen may also influence migraine patterns. The study set out to examine migraine outcomes among postmenopausal women using therapy, including whether the route of administration mattered. The report says the evaluation was designed to consider the association independently of route, but it does not provide route-specific findings.
Because the results combine five studies, they summarize an association across the included research rather than reporting a single trial that assigned participants to treatment. The supplied account does not describe the designs, dates, or individual results of those studies. That limits what can be said about how the finding applies to specific therapies or patients.
“Migraines can have a significant impact on quality of life, particularly during the menopause transition when many women experience changes in their symptoms.”
— Dr. Flavia Fairbanks Ruano, lead author and researcher at the University of Miami Miller School of Medicine
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What the Review Cannot Establish
The reported results show an association, not proof of causation. The source account does not provide enough detail to determine whether other differences between women who use hormone therapy and those who do not contributed to the findings. Faubion specifically said that differences in who seeks treatment may help explain the results.
The report does not state the size of the observed changes in attack frequency or duration, give confidence intervals, or explain whether results differed by hormone dose, formulation, route, or participant characteristics. It also does not describe the five studies’ methods in enough detail to assess the strength or consistency of the evidence. The 18.94% figure is a pooled mean migraine incidence; the account does not specify a comparison baseline for interpreting it as a change.
Researchers say further clinical trials are needed to better understand the relationship and inform treatment. Until more evidence is available, it remains unclear whether hormone therapy itself changes migraine burden, and which patients or treatment regimens, if any, are most affected.
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Meeting Presentation and Further Trials
The study is scheduled for presentation at The Menopause Society’s annual meeting in San Diego, running October 20-24, 2026. The presentation may provide additional details about the included studies and the analysis; those details are not included in the supplied report.
The researchers call for further clinical trials to clarify how hormone therapy relates to migraine outcomes and to guide more effective treatment. For now, patients and clinicians will need to weigh the reported association alongside the benefits and risks relevant to each person’s menopause symptoms and health history. The review does not prescribe a treatment change.
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Key Questions
What did the review find about hormone therapy and migraines?
Across five studies involving nearly 24,000 women, hormone therapy was associated with more frequent migraine attacks and longer-lasting episodes in postmenopausal women. The analysis did not find significant differences in migraine severity scores or monthly analgesic use.
Does this prove hormone therapy causes migraines to worsen?
No. The reported result is an association and does not establish cause and effect. The report also raises the possibility that women who seek hormone therapy differ from those who do not.
Should someone with migraines avoid hormone therapy?
The findings do not establish that everyone with migraine should avoid hormone therapy. The Menopause Society’s medical director said it can be used safely in many women with migraine. Decisions about starting or changing treatment should be discussed with a qualified health professional.
When will the study be presented?
The results are scheduled for presentation at The Menopause Society’s 2026 annual meeting in San Diego, October 20-24, 2026.
What remains unknown?
The supplied report does not quantify how much migraine frequency or duration differed, explain whether results varied by therapy type or route, or give detailed methods for the five studies. Researchers say further clinical trials are needed.
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