Breaking Down Three Main Treatment Strategies For Menstrual Migraine And How To Pick The Best Option For You
For nearly two out of three women with migraine, attacks occur around the same time as their period. By definition, if you have migraine attacks that start between the two days before your period and the third day of flow, you likely have menstrual migraine. These attacks are often more severe, longer, and cause greater light sensitivity than attacks occurring other times of the month.
Menstrual migraine is caused by the rapid drop in estrogen levels that occurs just prior to your period. “I have patients that tell me, ‘Aren’t headaches a part of having a menstrual cycle?’” says Dr. Paru David, an internist who works in the division of women’s health internal medicine at Mayo Clinic in Arizona. “I educate them that not all women have headaches during their menstrual cycles.”
Migraine attacks occurring just before and during a woman’s period can be the most challenging kind to treat. They do not always respond to the same medicines that work on migraine attacks happening at other times. The reason medications don’t work the same is not entirely clear. But it’s likely related to estrogen’s effects on other chemicals.
You Should Not Skip Or Delay The Second Dose Even If You Had Side Effects After The First
Even if you had a bad headache after your first dose of the Pfizer or Moderna vaccine, you should absolutely not skip or delay the second shot, says Estemalik. The J&J vaccine requires only one dose.
“In simple terms, you could think of the first dose as the primer; the second booster dose is what really elevates the antibody production and drives the high efficacy of the vaccines — 94 percent for the Moderna vaccine and 95 percent for the Pfizer vaccine,” he says.
The Pfizer-BioNTech vaccine doses should be given three weeks apart, and the Moderna vaccine doses four weeks apart, according to the CDC.
Experts Advise Against Taking Migraine Drugs Or Painkillers Before Getting The Vaccine
There’s a lot of debate, even within the scientific community, about whether a person should take a medication as a preventive measure to ease side effects before getting the vaccine — and particularly about what effect medications could have on the immune response, says Estemalik.
A found that nonsteroidal anti-inflammatory drugs such as ibuprofen may reduce the production of antibodies and affect the immune response to the virus itself.
The CDC recommends against the use of pain relievers before the vaccine shot.
Estemalik agrees. “In my opinion, people should not premedicate with any medication before taking the vaccine. That would include any migraine treatment or over-the-counter painkillers,” he says.
Strauss suggests making sure you’re fully hydrated before getting the vaccine. This may help not only with any potential headache, but also with dizziness, another possible side effect, she says.
Headaches Or Migraine Attacks That Occur Following Vaccination Can Be Treated As Usual
After getting the vaccine, if a person has a headache, they can take either their regular migraine abortive drug or an over-the-counter medication to help ease any of the symptoms, says Estemalik.
“There was initial concern that if you took an over-the-counter medication after your vaccine that it might make it less effective, but there isn’t evidence to support that,” says Strauss.
“Since people can manage any headache that may come on as a side effect of the vaccine with their normal medications, I hope that takes a little of the fear away. This headache might last longer than what you’re used to, but you can certainly treat it,” she says.
Speak To Your Gp If You Experience A Headache Between 4 And 28 Days After Covid Jab
- Dr Zoe Williams
- 18:37 ET, Apr 18 2021
HEADACHES are really common. But while we’ve all had one, there are lots of different types and causes.
In most cases, a headache will go away on its own and isn’t serious.
?Read our coronavirus live blog for the latest updates
There has been talk of headaches in relation to the Covid-19 vaccine.
A mild headache in the first few days after the vaccination is a normal side-effect and not concerning.
As with the flu jab, a mild fever, feeling tired, sore muscles and a headache for a few days are normal.
It is usually a GOOD sign that your immune system is responding to the vaccine and getting ready to kick into gear if you come into contact with the live virus itself.
But if you experience a headache between four and 28 days after the jab that is severe and doesn’t respond to painkillers, speak to your GP.
There has also been a lot of talk about the very rare blood clots that could be linked to AstraZeneca’s jab.
There were 79 cases and 19 deaths after 20million doses were given, a review by the Medicines & Healthcare Products Regulatory Agency reported last week.
I Get Migraines Right Before My Period Could They Be Related To My Menstrual Cycle
More than half of migraines in women occur right before, during, or after a woman has her period. This often is called “menstrual migraine.” But, just a small fraction of women who have migraine around their period only have migraine at this time. Most have migraine headaches at other times of the month as well.
How the menstrual cycle and migraine are linked is still unclear. We know that just before the cycle begins, levels of the female hormones, estrogen and progesterone, go down sharply. This drop in hormones may trigger a migraine, because estrogen controls chemicals in the brain that affect a woman’s pain sensation.
Talk with your doctor if you think you have menstrual migraine. You may find that medicines, making lifestyle changes, and home treatment methods can prevent or reduce the pain.
Understanding Migraine Progression Can Help You Anticipate & Manage Your Symptoms
Migraine attacks have distinct phases, and understanding them can help people manage their disease. Symptoms associated with the earliest stages of a migraine attack, like the fatigue and blurred vision that can accompany the prodrome and aura stages, . Identifying and treating a migraine early can even help prevent the symptoms for some people. Additionally, identifying risk factors that can contribute to postdrome “hangovers” may help individuals anticipate the duration of their attack and its aftereffects.
Hormonal Changes Can Cause Migraines In Women Find Migraine Relief With Excedrin
Four out of every ten women suffer from migraines — and more than half of them report a link between those migraines and their monthly cycle. Called menstrual migraines, they typically strike immediately before and after the first day of a woman’s period. They qualify as menstrual migraines if they occur without aura and around the onset of your period during at least two-thirds of your cycles. 1
If You Get A Pounding Headache Every Month Like Clockwork You Need To Read This
It’s bad enough that once a month women have to deal with unpleasant period symptoms like cramps, mood swings, and bloating, but if you find that your head begins to pound just before you start — or shortly after — your hormones are probably to blame for that, too.
“Most women who suffer from headaches during their period are suffering from menstrual migraines,”G. Thomas Ruiz, MD, an ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, told POPSUGAR. These headaches are triggered by a drop in hormone levels , which also jump-starts your flow. Here, experts explain how to tell if you have a menstrual migraine and what you can do to find relief.
Understanding What Causes Headaches And Finding Treatments To Relieve The Pain
Nearly everyone has had headache pain, and most of us have had it many times. A minor headache is little more than a nuisance that’s relieved by an over-the-counter pain reliever, some food or coffee, or a short rest. But if your headache is severe or unusual, you might worry about stroke, a tumor, or a blood clot. Fortunately, such problems are rare. Still, you should know when a headache needs urgent care and how to control the vast majority of headaches that are not threatening to your health.
Ive Already Tried Everything What Else Can Be Done To Help Menstrual Migraines
You may have trialed numerous amount of treatments such as, staying on the contraceptive pill, having the contraceptive implants such as the Implanon, or taking various types of Hormonal Replacement Therapy medications. All of which alters and changes the females natural hormonal components and cycle. An important note to remember are females with menstrual migraines do not have any hormonal abnormalities. Hence, medicating to alter the females natural hormonal levels have been shown to not be the safest or best treatment option.
If you suffer from menstrual migraines, have you had your neck assessed to see whether that is the cause of your problems?
What Questions Should I Ask My Healthcare Provider About Menstrual Migraines
- Am I experiencing a menstrual migraine or another type of migraine?
- Should I change any of the medications I’m taking?
- What treatment do you recommend?
- What medications should I take?
A note from Cleveland Clinic
A migraine is more than a bad headache. Not only can menstrual migraines get severe, but women have reported that they can be even worse than a migraine that occurs when they’re not on their period. Talk to your healthcare provider about your symptoms. There are preventative measures and treatment options. A menstrual migraine might not be something you just have to “live with” every month.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.
Avoid Migraine Triggers In General In The Days Leading Up To Your Period
Don’t skip meals or fast, and avoid processed foods, artificial sweeteners, alcohol and highly caffeinated drinks, notes the Mayo Clinic. Keep your sleep patterns as normal as possible, and try to either avoid stress or learn how to cope with it.
You can also be proactive about preventing migraines in general by asking about certain vitamin supplements, like magnesium.
What Are The ‘red Flags’ That My Visual Symptoms Are Not Due To Migraine
The typical symptoms of a visual migraine are “positive,” meaning that there is something shimmering or sparkling that is disrupting the vision. Migraines are less likely to cause “negative” symptoms of pure visual darkness. An episode of visual darkness typically requires additional evaluation for other conditions, including a “mini-stroke” .
Natural Treatments And Lifestyle Adjustments For Menstrual Migraines
Lifestyle treatments are always tricky to study, since they are hard to control and not as well-funded as pharmaceutical medicine.
Magnesium: There’s some evidence that magnesium can relieve migraine pain . In a small preliminary trial, participants took magnesium supplements three times per day starting from Day 15 of their cycle until the start of their next period . This treatment helped decrease the participants’ total pain and also improved their PMS symptoms . In a randomized control trial where participants received either a placebo or a drug containing magnesium, vitamin B2, and coenzyme Q10, the severity of migraines was lower among those taking the drug, though the number of days in which migraines were experienced was not statistically different from the placebo .
What Are The Types Of Headaches What Type Of Headache Is A Migraine
There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.
What Are The Four Stages Or Phases Of A Migraine Whats The Timeline
The four stages in chronological order are the prodrome , aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.
The phases are:
It can take about eight to 72 hours to go through the four stages.
When Should I Seek Immediate Help Or Contact My Healthcare Provider
- You are experiencing the “worst headache of my life.”
- You are having neurologic symptoms that you’ve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
- Your headache comes on suddenly.
- You have a headache after experiencing a head injury.
Schedule a visit with your healthcare provider if:
- The number or severity of your headaches increase or your headache pattern changes.
- Your medications no longer seem to be working or you’re experiencing new or different side effects.
What Can I Do To Help Relieve The Symptoms Of A Menstrual Migraine
Do your best to figure out what makes your hormone headaches better or worse. For example, if light causes pain and you feel overheated, stay in a cool, dark room. Additional tips include:
- Keep your blood sugar levels up by eating small, frequent snacks. Never miss a meal.
- Learn relaxation techniques.
- Avoid too little or too much sleep, and keep a regular sleep pattern.
- Change your diet, if needed.
- Avoid stress when you can, and learn how to manage it when you can’t.
Dealing With Menstrual Migraines: 10 Hormonal Headaches Remedies
If you tend to get migraines regularly, especially if they arise on a monthly basis, there’s a chance they’re menstrual migraines.
A migraine is different from a run-of-the-mill headache—though you can experience both on your period. Migraines are characterized by a throbbing pain that starts on one side of the head . Migraines can also accompanied by nausea, vomiting or sensitivity to light and sound. Whether you suffer from headaches or full-blown migraines during your period, it’s no fun.
So, why does your period cause migraines and headaches? There are two main reasons. First, there’s the fluctuation in estrogen and progesterone—the hormones responsible for regulating your reproductive cycle—that accompanies your period. A period-induced headache can also be caused by blood loss associated with your period, according to a recent study in Headache: The Journal of Head and Face Pain.
If they’re a regular occurrence, there are things you can do to prevent and tread the monthly pain. We asked the experts for menstrual migraine remedies that will help bring you relief.
Recommended Lifestyle Adjustments For Migraines And Headaches
Not all lifestyle changes are studied, but these recommendations are fairly standard for how to help you cope with your headaches. Give them a try, see what works best for you.
Get enough sleep: Since fatigue and sleep disturbances are linked to being migraine/headache triggers , be sure to adjust your bedtime accordingly so that you wake up relaxed and well rested. If you commonly have headaches in the morning after waking up, it may be a good idea to get checked for sleep apnea .
Reduce your stress levels: Stress, whether it’s particular events, feelings, or time periods, are linked to triggering migraines and headache . For this reason, stress management techniques like relaxation therapy, cognitive behavioural therapy, and biofeedback could help . It’s easier said than done, but prioritize de-stressing as best you can.
Avoid extreme weather: Weather changes, both hot and cold, can trigger migraines and headaches . Check the weather forecast and plan ahead. Be extra cautious about extreme heat and sun exposure, as exhaustion and dehydration can also cause headaches .
Find a dark and quiet space: For people experiencing a migraine headache, light and sound can aggravate migraine symptoms . Some people find relief by lying in dark, quiet rooms.
My Periods Stopped Four Years Ago Why Do I Still Get Migraine
Even though your periods have stopped, it can take a few years for the hormone fluctuations to completely settle. This is usually just one or two years, although some women find that they still get hot flushes and migraine ten or more years after the menopause. More often, even when hormonal triggers have settled, non-hormonal ones persist and may even increase post menopause. Chronic medical conditions, while not directly triggering migraine, will make migraine more likely to occur as they generally lower the migraine threshold. Maintaining good migraine ‘habits’ – regular meals, regular exercise, a good sleep routine, balancing triggers, and looking after your general health, are all as important after the menopause as before.
Treating Migraine Headaches: Some Drugs Should Rarely Be Used
Migraine attacks can last for hours—or even days. They can cause intense pain, nausea and vomiting. They can make you sensitive to light or noise and they can affect your life and work.
To treat migraines, you may be given a prescription for an opioid or a barbiturate called butalbital. These are pain medicines. But you should think twice about using these drugs for migraine. Here’s why:
These drugs can make headaches worse.
Using too much pain medicine can lead to a condition called medication overuse headache . Two kinds of pain medicine are more likely to cause MOH:
- Drugs containing opioids—such as codeine , morphine , Hycodan or oxycodone .
- Drugs containing butalbital .
They are not as effective as other migraine drugs.
There are other drugs that can reduce the number of migraines you have and how severe they are—better than opioids and butalbital. Even in the emergency room—where people with severe migraines often ask for opioids—better drugs are available, including triptans.
They have risks.
Opioids and butalbital can cause serious withdrawal symptoms if you stop taking them suddenly. People who use high doses for a long time may need to be in the hospital in order to stop using them.
Opioids, even at low doses, can make you feel sleepy or dizzy. Other side effects include constipation and nausea. Using them for a long time can lower your sex drive and cause depression and sleep problems.
Which drugs are good for migraines?
Limit the use of all pain medicines.
What Should I Do If I Have A Headache After Getting The Covid
“If a headache develops, it’s OK to take over-the-counter medications such as acetaminophen or ibuprofen,” Dr. Calderwood told POPSUGAR. He added that, if you have a history of migraines, it’s also fine to take the medications you typically use to halt a migraine. Dr. Calderwood also emphasized that, if you do have a headache after getting your first dose of the vaccine, it’s not a reason to skip the second dose.
There’s also no reason to believe that your headaches will last longer than any other side effects of the vaccine. “In terms of long-lasting headaches that have been seen in some individuals who have recovered from COVID-19 infection, this is reported following infection rather than vaccination,” Dr. Calderwood explained. “As the vaccination reduces your risk of infection, it can help to prevent the risk of some of these long-term sequelae of natural infection.”
If by chance your headache or any other symptoms are severe or last for longer than a few days, check in with your doctor.
Botox Injections For Migraine Are Safe Before Or After Covid
There have been reported side effects when it comes to certain cosmetic fillers and the mRNA vaccines, says Estemalik. Some people who have received dermal fillers may develop swelling at or near the site of filler injection following a dose of the vaccine. This appears to be temporary and can resolve with medical treatment, according to the CDC.
Dermal fillers are a different kind of medication from Botox, says Estemalik. “This side effect has not been reported in people who have received Botox injections for preventative migraine treatment. It is safe for patients who are getting Botox injections to take the COVID-19 vaccine,” he says.
There are no reports of additional side effects or risks for the J&J vaccine in Botox users.
How Are Menstrual Migraines Treated What Medicines Can I Use
A menstrual migraine is usually treated with nonsteroidal anti-inflammatory medications . The NSAIDs most often used for menstrual migraine include:
- Ketoprofen .
These drugs should also be started two to three days before your period starts. Continue taking them throughout your menstrual flow.
Because fluid retention often occurs at the same time as your menses, diuretics have been used to prevent menstrual migraines. Some healthcare providers may recommend that you follow a low-salt diet immediately before the start of your menses.
Leuprolide is a medication that affects your hormone levels. It’s used only when all other treatment methods have been tried and haven’t worked.
What Symptoms Must You Have To Be Diagnosed With A Migraine
Migraine with aura . This is a headache, plus:
- Visual symptoms or vision loss.
- Sensory symptoms .
Migraine without aura . A common migraine is a headache and:
- The attacks included pain on one side of your head.
- You’ve had at least five attacks, each lasting between four and 72 hours.
Plus, you’ve experienced at least one of the following:
- Nausea and/or vomiting.
- Lights bother you and/or you avoid light.
- Sounds bother you and/or you avoid sounds.
Oral Contraceptives May Reduce Menstrual Migraine Frequency
“There is some evidence to suggest that certain types of oral contraceptive pills can actually reduce the frequency of menstrual migraine and menstrually related migraine,” Hindiyeh says.
This doesn’t apply to all kinds of oral contraception, so you should talk with your gynecologist, primary care doctor, or neurologist about which ones you’d want to consider, says Hindiyeh. “There are specific ones that will keep your estrogen level from fluctuating so much,” she adds.
How Can I Be Sure It Is Not A More Serious Type Of Headache
With tension headaches, you are normally well between headaches, and have no other ongoing symptoms. A doctor diagnoses tension headaches by their description. In addition, there is nothing abnormal to find if a doctor examines you . Tests are not needed unless you have unusual symptoms, or something other than chronic tension headache is suspected. Of particular note, medication-overuse headache should be ruled out as this can often be mistaken for chronic tension headache.
Compared to migraine, a tension headache is usually less severe, and is constant rather than throbbing. Also, migraine attacks usually cause a one-sided headache, and many people with a migraine attack feel sick or are sick . Some people have both migraine attacks and tension headaches at different times. In addition, some people find that one of the types of headaches is followed by another, perhaps because the pain and tiredness due to the first headache cause the second.