Serving Two Masters: When Migraine and Menopause Run Your Life

Groundhog Day is my life now. I run in a migraine-menopause loop.

Hot flashes, nausea, and with hemiplegic migraine as the driver, my hormones take on a whole new meaning. I’m 50 now and menopause is coming along for the ride. Some of this loop is "good". I use quotes because it's not actually good, because I have constant turmoil happening inside my body. Instead it’s “good” in the sense that on random days I have so much energy I don't even know what to do with it. You know days when you have that zing just before you fall off the cliff and can’t think straight, walk straight and the pain in your eyeball feels like an explosion. That kind of “good” day. Oh wait, is that just me?

The “good” has to do, in part, with my serotonin, but I'm not going into the mechanics today. Today I just want to tell you what I've been experiencing.

I've been forced to add a layer to my morning migraine audit. The night sweats I'm getting are not the kind where your sheets are soaked, they're much more subtle than that. For me I wake to use the bathroom, likely because my body is already heating up, and as I start to get up I feel the burn coming from inside.

If you've been there, you know what I mean. It's like a wave you can't control, growing hotter and faster, and you want to will it away. You tell yourself to just stay still, stay cool. You envision a cascade of cold water or a strong winter wind crossing over you, but it doesn't work. You can't outthink it. So instead, you lay there trying your damndest to absorb the air coming from the fan as you toss the covers to the side.

The thing is, your temperature control comes from your brain, and my brain and I already have a love-hate relationship. So, what's always the first thing triggered for me when my brain is upset with the rest of my body? It immediately tells my stomach to declare its disdain for what's going on, and I become instantly nauseous.

Now I need to get up from the bed and pee. It's an overwhelming urge at this point, so I have to move. As I rise the nausea comes with me, bringing the heat along for the ride. I'm boiling from the inside as I make my way to the bathroom, and I sit there almost unable to stand it, because now, in the dead of night in a dark bathroom, I'm not only hot and nauseous but I'm a little dizzy too.

I get back to bed as fast as possible and lay there again, willing the nausea and heat to pass. When it finally does, then I'm cold. Freezing cold under four blankets. But I'm actually thankful for the release. Going from the desert to the arctic in ten minutes time actually feels good.

But here's the thing. It also sucks. Because I've just triggered a migraine cycle, and it happens every night, so I'm now layering one cycle on top of another.

My blender head was on high this morning. Before I opened my eyes, the crazy fast images of faces, the spiraling thoughts I couldn't control and that were in no way linear. At 5:30 am, as the morning light spilled into the room through a tiny opening in my curtains I had no choice but to get out of bed. I was terrified I'd start to overheat again, plus it was actually brighter with my eyes closed than with them open. Again, if you know, you know.

Today was better than yesterday. Yesterday I was nauseous until about 4pm. This morning I got to drink my coffee and eat half a banana without feeling like I was forcing it down my throat.

The loop is nonstop now, and I'm toying with the idea of using HRT. Like I told you from day one, I believe in it all. I'm not opposed to anything, but I do have a cancer history and I do have a rare cancer-adjacent disease, so I have concerns. I've treated myself with natural remedies for quite some time now, but there comes a point where you have to pull out the big guns, and I won't lie, I worry about what these constant migraine symptoms are doing to my brain. My mom passed from vascular dementia, my history is complex and a little scary, so I am a frozen in fear at the moment.

The truth is it’s immensely frustrating. I had things really well contained, and I rarely had to even consider taking a prescription migraine rescue medicine to get relief. But as the seasons change, so does the female body. Those of us suffering from a neurological condition like migraine get the exclusive rights to having our already unpleasant menopause years intertwined with our declining hormones. Like two trees living next to each other whose roots grow together, we're bound to serve two masters.

This is the way I live, and it's likely the way you live if you're reading this. If you need someone to hear you out, I'm here.

Amanda Richardson, BCDFN, CFNC is a Board Certified Doctor of Functional Nutrition, researcher, and publisher of Migraine Unread. She lives with hemiplegic migraine and has made it her mission to connect the dots that conventional medicine never thought to connect. Her upcoming book Sick of Being Sick is set to be released early 2027. Work with Amanda at AmandaRichardson.co.