Although migraines are most common in young adult life and tend to improve or stop completely after the age of 50 to 60, there are plenty of people in later life who are still troubled by them.
For women, migraine is often linked to monthly hormones and two-thirds of women report migraines improve after the menopause. But for some, the menopause makes migraines worse and could even trigger them. It’s not clear why this is and experts don’t really understand what causes migraines in the first place.
Some women find HRT helps, others find that it aggravates the problem. Occasionally migraines begin for the first time after the age of 60 but this is unusual and it’s important to rule out other causes for headache such as high blood pressure, more common with age, and possibly tumours.
Even if migraines continue, the nature of the headache and associated symptoms often change with time. In migraine with auras, people typically experience odd sensory symptoms 10-30 minutes before the headache such as flashing lights, numbness, tingling sensations, or a disturbed sense of smell, taste or touch. As you get older you may find you still get auras but not the headaches.
In other types of migraine, the pain may become less severe, accompanying symptoms such as nausea and vomiting fade away, or attacks become less frequent. The things that trigger your migraines may also change, so it is worth keeping a migraine diary if you haven’t done one for a few years.
When you talk to your GP about migraines, discuss other health problems you might have which could contribute to your headaches. High blood pressure, diabetes and cardiovascular disease can all have implications for managing migraines, and controlling these conditions could help to lessen them. Migraines can add to problems such as depression and anxiety, so headache management can help to control these issues.
Make sure your medication is carefully reviewed because some drugs, such as those for heart disease and high blood pressure, could aggravate headaches. Many headache medicines have been less well tested in older people, so be alert for side effects. Non-steroidal anti-inflammatory painkillers (NSAIDs such as ibuprofen or aspirin) carry a high risk of gastric irritation and bleeding and should be used carefully. Another class of drugs often used in migraine, triptans, constrict blood vessels and may potentially be a risk in people with coronary artery disease so should be used cautiously.
Q I’ve heard virgin coconut oil can ease dementia symptoms – is this true?
Dr Trisha says: There is no credible scientific evidence that coconut oil can help dementia. It’s been suggested as a treatment because it provides an alternative source of energy to your brain cells instead of the usual energy source, glucose. In Alzheimer’s disease parts of your brain may no longer use glucose effectively. Coconut oil contains a type of fat that is broken down into chemicals called ketones, which cells can use as fuel instead.
There have only been a couple of very small trials and these are not enough to provide scientific proof. It’s also important to remember that dementia symptoms usually begin to appear many years after damage first develops in the brain, so coconut oil would have to be taken many years before symptoms to prevent the disease.
Ask Dr Trisha about your health problems by emailing firstname.lastname@example.org.