Objective.—To assess the association between estrogen replacement therapy and migraine aura.
Background.—Estrogen replacement therapy is increasingly used by perimenopausal and postmenopausal women for management of menopausal symptoms and for long-term protection against osteoporosis and arterial disease. There are few reports about the effects of estrogen replacement therapy on migraine.
Method.—Case reports were collected from women developing migraine aura related to use of estrogen replacement therapy.
Results.—Four patients who developed migraine aura associated with the use of estrogen replacement therapy are described. In all cases, reducing the dose of estrogen or changing the route of delivery was associated with loss of aura.
Conclusion.—These findings suggest that high levels of estrogen in women using replacement therapy can trigger migraine aura.