You're 45, your periods are unpredictable, and suddenly you're getting headaches unlike anything you've experienced before. If you're wondering "can perimenopause cause headaches," the answer is more complex than most doctors will tell you.

Perimenopause absolutely can cause headaches, but it's not just about dropping estrogen levels. The real culprit is often a perfect storm of hormonal changes, increased stress, and spinal dysfunction that gets worse during perimenopause.

Here's what makes perimenopause headaches particularly problematic: estrogen crosses the blood-brain barrier, meaning hormonal fluctuations directly affect your brain. During estrogen crashes, your brain loses its natural pain protection, making you more sensitive to triggers like stress, tension, and even minor spinal dysfunction.