Is My Period Causing Migraines? Understanding Menstrual Migraines

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Migraines are one of the most painful types of headache. For people who get them, they can get in the way of their day and life.

In general, women are more likely to get migraines. According to the Journal of the American Medical Association, women are three times more likely than men to have migraines.

If you get a migraine right before your period, you may wonder if your hormones are to blame. The medical term for these hormonal headaches is a menstrual migraine.

What Are Menstrual Migraines?

Period migraines are one of several types of migraine. Doctors define menstrual migraines as severe headaches triggered by your period. Other symptoms include light and sound sensitivity, visual changes, nausea, and vomiting.

Period migraines can start anywhere from two days before your period to the third day of flow.

What triggers menstrual migraines?

Menstrual migraines are a type of hormonal headache. These are headaches triggered by changes in hormones, especially estrogen levels. Estrogen is a steroid hormone that plays a role in female sexual and reproductive development.

The migraine trigger is a rapid drop in estrogen levels before your period begins. Your period isn’t the only thing that can cause hormone levels to change. Your hormones can also change because of:

• Hormone replacement therapy.
• Menopause.
• Oral birth control pills.
• Perimenopause.
• Pregnancy.

Are you at risk of menstrual migraines?

Nearly two out of three women with migraines have attacks around their period. That’s according to the American Migraine Foundation (AMF).

You may not have period migraines every cycle. And if you have them, you can also have migraines at other times of the month.

Symptoms of menstrual migraines

For many women, menstrual migraines can cause serious disability. The symptoms of a migraine can get in the way of work, school, or home life.

Compared to migraine attacks at other times of the month, period migraine symptoms are more severe and last longer. Symptoms of period migraines often include:

• Greater sensitivity to light and sound.
• Migraine with aura. Seeing visual disturbances, such as wavy lines or flashing lights. They can start about 10 to 60 minutes before the actual headache. These disturbances often last no more than an hour.
• Nausea or feeling sick to your stomach.
• Pulsing or throbbing pain on one or both sides of your head.
• Vomiting or throwing up.

How Do You Treat Menstrual Migraines?

Menstrual migraines can be hard to treat because they are poorly understood. That’s because medicines that work on migraine attacks at other times may not work to treat period migraines. Doctors think it may have something to do with how estrogen levels affect medicines to treat migraines.

Acute menstrual migraine treatment means treating migraine pain and symptoms when they happen. Medicines that your doctor may prescribe to treat your period migraine include:

Oral medicine

Your doctor may first suggest trying fast-acting triptans. These include almotriptan, eletriptan, rizatriptan, sumatriptan, and zolmitriptan. These drugs can help manage symptoms when taken with a non-steroidal anti-inflammatory drug (NSAID) early in an attack.

Injections

Severe migraine attacks may need a faster response. And if you are vomiting or nauseous, oral medicines may not be the best option. That’s where migraine shots come in.

Shots work much faster than oral medicines. They are also often used with an NSAID.

These medicines include injectable versions of sumatriptan, which works in less than 10 minutes. Dihydroergotamine is another shot used to treat menstrual migraines.

Nasal sprays

If you don’t want a shot, a triptan in nasal spray form can work faster than a pill. Sumatriptan and zolmitriptan are available as sprays, and so is dihydroergotamine.

How to Prevent Menstrual Migraines

Stopping menstrual migraines before they start is a standard part of treatment plans. Your doctor may suggest either short-term or long-term prevention methods.

Short-term prevention methods

Short-term prevention is what the AMF calls “mini-prevention.” These strategies aim to prevent migraines in the days before your period starts. The U.S. Food and Drug Administration has not approved these mini-prevention strategies.

But because they have worked for some women, your doctor may suggest one of the following mini-prevention strategies:

• Hormone replacement. This is estrogen in a pill, patch, or vaginal gel. You take the hormone replacement during your period week. This helps prevent the natural estrogen drop that triggers your migraine.
• Taking NSAIDs. For this strategy, you would take NSAIDs twice daily for up to a week before your period starts. Taking 550 mg of naproxen (Aleve) twice daily is an effective migraine prevention strategy for some women. Other NSAIDs like ibuprofen should have similar results.
• Taking triptans. Your doctor may suggest using triptans twice daily for about 4 to 5 days during your period. According to AMF, this strategy can help to decrease or prevent period migraines.

Long-term prevention methods

You may find it even more difficult to treat your menstrual migraines if you have irregular periods. You may want to consider long-term prevention methods. These are strategies you use throughout the month and include:

• Continual hormone replacement therapy. You’ll take birth control pills all month without a placebo break. You can also replace a vaginal ring with a new one immediately instead of waiting for the end of your cycle.
• Taking magnesium. Daily magnesium oxide supplements can help decrease or prevent symptoms of period migraines. Your doctor will tell you how much magnesium to take daily.

Other Ways to Manage Migraines

Relaxation and at-home techniques can help manage symptoms of any type of migraine. The next time you have a migraine attack, try these tips:

• Avoid smoking and drinking alcohol or drinks with caffeine, such as coffee, sodas, or energy drinks. Small amounts of caffeine, however, may help during a migraine’s early stages.
• Drink plenty of fluids, especially if you throw up. Sipping ice water may help.
• Nap or rest with your eyes closed in a cool, dark, quiet room.
• Place a cold cloth or ice pack on your forehead.

When Should You Talk to Your Doctor About Migraines

Women are often told that headaches are a normal part of their period. That doesn’t mean you should suffer in silence. Don’t feel you need to deal with menstrual migraines or headaches alone.

Talk to your doctor if you notice migraine attacks right before or during your period. They can do a complete physical to make sure nothing else is going on. They can also get you started on a treatment plan to help manage your symptoms.