Waking up with headaches during perimenopause

Could perimenopause be involved?

Mayo Clinic explains that hormone-related migraines can become more frequent or painful during perimenopause, when hormone levels rise and fall. That does not mean every new headache is hormonal, or that a morning headache identifies perimenopause.

It is worth discussing a new or changing headache pattern with a healthcare professional rather than assuming it is a normal part of midlife.

Why sleep is worth discussing

NHLBI notes that women's risk of sleep apnea increases during and after menopause. In women, symptoms can include morning headaches, fatigue, insomnia and waking often. Snoring may not be an obvious symptom.

Morning headaches alone do not diagnose sleep apnea. Tell your clinician if you also wake unrefreshed, feel sleepy during the day, or someone has noticed gasping or breathing pauses while you sleep. A clinician may consider a sleep study based on the full picture.

Other possibilities to bring up

The NHS lists dehydration, irregular meals, alcohol, stress, eyesight problems and frequent painkiller use among possible headache contributors. Teeth grinding can happen during sleep and may come with headaches, jaw pain or tooth damage. Ask a dentist about jaw or tooth symptoms, or if someone has heard you grinding your teeth.

This is a list of topics for a conversation, not a way to choose a diagnosis. Do not change a prescribed medicine or start a supplement for headaches without discussing it with a healthcare professional.

What to note before an appointment

• When the headache starts, how often it happens, how long it lasts and how it feels.
• Whether it wakes you from sleep or is there when you first wake.
• Any nausea, light sensitivity, vision changes or other symptoms.
• Sleep quality, daytime sleepiness, gasping or breathing pauses noticed by someone else.
• Jaw or tooth pain, medicines and painkiller frequency, and any pattern around your periods.

A headache diary can help you explain a pattern. It cannot tell you the cause.

When to seek help

Arrange a medical review if headaches keep coming back, change or worsen, or affect everyday life. Seek urgent medical advice for a severe headache with blurred or double vision, a sore scalp or jaw pain when eating.