Are there special considerations for patients who suffer from migraines wanting to start hormone therapy?

Hormone fluctuations, specifically oestrogen fluctuations, may precipitate migraine attacks in those predisposed to them. Having said that hormone treatment would not ordinarily be withheld on the basis of migraines. Using hormone gels or patches allows for a gradual increase in hormone levels which reduces the risk of migraines. If you have a history of migraine, we like to start with a low dose and increase based on the tolerance of the individual.