Headaches and migraines: what to record
Headache pattern changes are common during the transition, and the pattern is the clinically useful part.
Start with the part that is not tracking. Some headaches are reasons to seek urgent assessment rather than to keep a record: a sudden severe headache unlike any you have had, one with weakness, confusion, speech difficulty or visual loss, one after a head injury, or one with fever and a stiff neck. Your own health service publishes guidance on this and it should be followed rather than an article.
For everything else, six fields:
| Field | Example |
|---|---|
| Date and start time | Tuesday 14th, woke with it |
| Duration | About 9 hours, eased by evening |
| Where | Right side, behind the eye |
| Other features | Nausea, could not tolerate light; no visual changes |
| What you took, did it help | Two paracetamol at 8am, minimal effect |
| Cycle day, if known | Two days before bleeding started |
The last row is the one people cannot answer from memory once cycles have become irregular, and it is one of the specific things a clinician asks about.
Record aura specifically, meaning neurological symptoms such as visual disturbance before or during the headache. Whether migraines occur with or without aura is clinically relevant, including to some prescribing decisions, so "with aura" or "no aura" is worth writing rather than describing loosely.
Why the cycle relationship is worth the effort
A headache diary that records dates alone tells a clinician frequency. One that records dates alongside your bleeding pattern tells them whether there is a relationship, and that is a different piece of information.
During perimenopause this gets harder exactly when it becomes more useful, because cycles stop being predictable and so the relationship cannot be inferred from a calendar. It has to be recorded as it happens. Tracking periods and bleeding.
Two entries a week is not enough here. Headaches are events; record each one when it happens, and nothing on the days without one.
What else to note alongside
The context column separates causes, and here the usual suspects are:
- Sleep, and how broken it was. Sleep and night sweats.
- What you had eaten and drunk, including caffeine and alcohol, without turning this into a food diary.
- Medication started or changed, with the date. Including HRT, dose and route. How to log HRT changes.
- Stress and workload, briefly.
- Whether you had been using screens for a long stretch, if that seems relevant to you.
Do not try to identify the trigger yourself. Trigger attribution from a small number of events is unreliable in both directions, and the record's job is to give a clinician the raw material rather than to produce a conclusion.
Taking it to an appointment
What gets a general answer: "I've been getting a lot of headaches."
What does not: "Eleven in eight weeks. Seven of those started within two days of bleeding beginning. Six lasted more than six hours. No visual aura on any of them. Paracetamol helps about half the time. Here are the dates."
Frequency, duration, timing, aura status and what you have tried, which is most of what will be asked, answered before it is asked.
That also protects you from the specific failure of a bad month, where recall reports that it has been constant and the record shows eleven episodes clustered in two weeks. Those are different pictures and they lead to different questions.
What to take to your first appointment. · What to say when you are not taken seriously. · Why appointments go badly.
What this page does not do
It does not tell you what your headaches mean, whether they are migraines, whether they are related to the transition, or what to take for them. Those are clinical questions, and headache is one of the areas where the difference between a benign pattern and something needing assessment is exactly the thing a professional is for.
HormoneLog records and does not assess. No score, no threshold, no interpretation. What it does is hold a dated record you would otherwise be reconstructing in a ten-minute appointment.
Why tracking perimenopause symptoms is worth it. · Keeping a record when you have no energy. · Anxiety and mood.
More in this section
About HormoneLog
HormoneLog is an iOS app from Baker Ventures LLC for tracking perimenopause and menopause symptoms and keeping an HRT record: what you took, at what dose, from when, and what changed afterwards. It is built for the appointment, where "it has been bad lately" is worth far less than a dated record of frequency and severity. The app is in development.
HormoneLog is a record-keeping tool. It does not diagnose, does not score you, and makes no claim about symptom relief. The guides on this site link to NICE, the NHS, the Menopause Society and peer-reviewed sources, and say plainly where the evidence is thin. Everything here is free and needs no account.
Questions and answers
Can perimenopause change your headaches?
Changes in headache and migraine pattern are commonly reported during the menopause transition, and health services list headaches among menopause symptoms. Whether a particular person's change has that cause is a clinical question, and the pattern over time is what helps answer it.
Why does the relationship to my cycle matter?
Because the timing of headaches relative to the cycle is one of the specific things a clinician asks about, and it can affect what they consider. It is also almost impossible to answer accurately from memory once cycles have become irregular.
What should I record about a headache?
The date and time it started, roughly how long it lasted, where the pain was, whether there were other features such as visual changes, nausea or sensitivity to light and sound, what you took and whether it helped, and where you were in your cycle if you know.
What is aura and why does it matter to record?
Aura is a set of neurological symptoms, often visual, that can precede or accompany a migraine. Whether migraines occur with or without aura is clinically relevant, including to some prescribing decisions, so it is worth recording specifically rather than describing generally.
What headaches should not wait?
A sudden severe headache unlike any you have had, a headache with weakness, confusion, speech difficulty or visual loss, one after a head injury, or one accompanied by fever and a stiff neck. Health services publish specific guidance and these are reasons to seek urgent assessment rather than to keep a record.
Will tracking help my appointment?
Substantially. A clinician asking how often, how long and what triggers them gets a far better answer from eight weeks of dated entries than from recall, and recall after a bad month reports something different from what happened.
HormoneLog. “Headaches and migraines: what to record.” Baker Ventures LLC, September 7, 2026. https://hormonelog.bakerventuresstudio.com/guides/headaches-and-migraines-what-to-record/