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Headaches & Nausea with Menopause

Answers, by Dr. Joseph Collins


I am 49 years old and have been extremely sick now for 7 months with constant headaches and nausea. My quality of life is not very good, as I am sick most of the time. I have been to several doctors, each one of them tells me something different. My gynecologist prescribed an estrogen, but I have been afraid to take it because of the cancer risks and the weight gain attributed to this hormone replacement therapy. I have used progesterone cream. It seems to help sometimes, but the terrible headaches and nausea return. Can you please help me?



It is always a good idea to discuss symptoms such as chronic headaches and nausea with your private physician. Nausea related to menopause is not widely recognized, but I have seen and consulted on a number of such cases. Headaches related to menopause appear to be more common. Unfortunately, the connection between menopause and headaches is not widely recognized and they are treated as two unrelated conditions.

Women experiencing increased pain, such as headaches, or increased agitation of any body system, such as nausea may have a progesterone deficient menopause type. In my experience, menopause related nausea and headaches are often related to a progesterone deficiency.

It may be because progesterone opposes the action of prostaglandins, substances that increase pain and inflammation symptoms such as headaches and nausea. Of interest; estrogens increase prostaglandins, so may increase pain and inflammation balance is the goal. Some types of PMS respond well to progesterone for this reason.

As well as opposing prostaglandins, progesterone is more calming or quiescent to the nervous system. Progesterone and its metabolites can calm a body system that is showing signs of agitation - there are increased irritable bowel symptoms with progesterone deficiency. This calming effect is in sharp contrast to the stimulating and agitating effects of estrogens. I have seen progesterone stop menopause related nausea a number of times.

The progesterone metabolites that are more calming to the body include allopregnanolone. This metabolite is relaxing, reduces anxiety and may have analgesic (pain relieving) properties. When progesterone is taken by mouth more of it will become metabolized to allopregnanolone. This may be why I have had better results with oral progesterone than with progesterone cream when treating nausea related menopause.

What can be done?

A woman experiencing nausea and or headaches relate to menopause should talk to her physician, pharmacist of other healthcare professional about testing all three hormones. Also, take the on-line questionnaire and use the study guide that is chooses for your menopause type. If a progesterone imbalance is noted then oral progesterone is the best choice.

It is important to remember that with oral progesterone there is increased production of the mineralcorticoids (from 11-Deoxycorticosterone to aldosterone). This can be good if a woman is predisposed towards low blood pressure and needs help holding on to her minerals and water. But if a woman is predisposed to high blood pressure or edema, she needs to use oral progesterone with caution - and cut back on the salt.

It is also a good idea to do what can be done to treat the discomfort of headaches and nausea. Relief of nausea may be achieved by taking ginger or mint teas. Headache relief may be found in homeopathic remedies, as well as Chiropractic and Cranial Techniques. See the Resources for Women page for a list of professional organizations that can help you find a healthcare practitioner who is experienced in natural therapies and can help with these choices.



Dr. Joseph J. Collins








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