It is seen that women are nearly three times more likely to suffer from migraines than men due to a combination of hormonal fluctuations, genetic predispositions, and differences in brain sensitivity. 
It is believed that estrogen plays a crucial role. estrogen fluctuates rapidly throughout the menstrual cycle, could be major cause of migraine attack during periods. Migraine can become very frequent during perimenopause because of rapid fluctuation in level of estrogen but it gets better after menopause.
but the question arises at Menopause , estrogen decreases rapidly then how migraine gets better after menopause because it is not the low levels of estrogen that is triggering migraine , it is the frequent fluctuation in its levels. at menopause estrogen levels are low but stable throughout.
CGRP(Calcitonin Gene Related Peptide) , a key migraine neuropeptide, appears more active or heightened in women. Fremanezumab (brand name Ajovy , by TEVA pharmaceuticals) is an FDA-approved prescription monoclonal antibody used to prevent episodic and chronic migraines in adults. It works by blocking calcitonin gene-related peptide (CGRP).
So the question arises if a women had migraine problem and after menopause if she is given with hormonal replacement therapy for estrogen, there are chances that the migraine can worsen or never subsides. So what should be the treatment approach, route of administration and whether it is possible in indian set up ?
MBH/PS