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How To Relieve A Menstrual Migraine

How Do Hormone Changes Trigger Migraines

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Hormonal changes in the menstrual cycle are one of the most common migraine triggers for women.

Studies show that a migraine is most likely to occur in the two days leading up to a period and the first three days of a period.

The two most accepted theories on the cause for menstrual migraine are:

  • the withdrawal of oestrogen as part of the normal menstrual cycle and
  • the normal release of prostaglandin during the first 48 hours of menstruation.
  • As diagnosis cannot be confirmed via testing, the only accurate way to tell if you have menstrual migraine is to keep a diary for at least three months to record your migraine and the days you menstruate.

    This will also help you to identify non-hormonal triggers that you can try to avoid during the most vulnerable times of your menstrual cycle.

    How To Prevent Menstrual Migraines

    If you get migraines often, you may want something that is taken on a regular schedule to prevent your migraines before they begin. The following are some options mentioned by the American Migraine Foundation as well as some new medications.

    • Birthcontrol: It’s worth mentioning again that hormonal birth control is a preventive measure for migraines. Taken regularly, birth control can maintain an even estrogen level, preventing dips that can trigger headaches. Deciding to take birth control pills or other hormonal contraceptives is a decision that extends beyond treating your migraines. Other factors should be taken into account, such as safety considerations, potential side effects, and whether you want to use a daily pill, an injection every few months, or an IUD to prevent pregnancy. See our birth control pill guide for more information.

    • Magnesium: As discussed above, taking magnesium once a migraine sets in won’t do much to treat it, but taking it long term as a supplement has been shown to reduce the number of migraines patients experience.

    • Newly developing therapies: Another newer class of drugs called anti-CGRP monoclonal antibodies can help with migraine prevention. The goal is to lower the number of migraines every month. Some examples are Aimovig , Ajovy , and Emgality . These drugs are given intravenously, or in a vein in your arm, every 4 to 12 weeks in a clinic or at home.

    How To Get Rid Of A Period Headache

    • Reviewed By: Shannon DeVita DNP, FNP-BC, CPNP-PC, Alethea Robbins, WHNP-BC

    If you regularly experience headaches during your period, then that “time of the month” can feel especially intrusive. We’ll share science-backed treatment options for how to get rid of your period headaches so you can decide what to do next .

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    Combination Birth Control Pills

    Doctors also say that using combination birth control pills to skip your period can help to reduce menstrual migraines. Your typical pack of birth control pills has a week of placebo pills, which is when you’d expect to get your monthly period. Using the pills continuously means you would skip that week and therefore not get a monthly period.

    However, if you experience migraines with aura, using combined birth control pills to skip your period is not recommended. Instead, if you have migraines with aura, your doctor might recommend a hormonal IUD like Mirena or Kyleena. Using an IUD can greatly reduce the frequency of periods or eliminate them altogether over time.

    Prescription Treatment For Menstrual Migraines

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    If OTC medicines and natural remedies are not enough to control your menstrual migraines, a prescription treatment may be the best option for you. Furthermore, menstrual migraines can be more difficult to treat due to the effect of estrogen in your body. You may need a prescription on hand for when you get headaches around your period. Here are some commonly used prescription treatments.

    • Estrogen cream or patches: Remember how we said that a major cause of menstrual migraines is thought to be the drop in estrogen levels that happens during your period? Preventing such a quick and major drop in these hormones can help keep menstrual migraines away. For this, estrogen cream or patches can be used, starting a few days before your period.

    While birth control pills can help prevent menstrual migraines, it can take some time for them to work. For more information on starting regular birth control, read our birth control pill guide.

    Please note that this discount is solely from Cove and not related to The Pill Club or from engaging with The Pill Club website.

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    Prescription Medicine For Menstrual Migraine

    If over-the-counter pain relief isn’t working for you, your doctor may consider prescription medicine. One type of medication for migraines is the family of triptans, which help balance chemicals in the brain. Your doctor may prescribe frovatriptan , which has shown to be better tolerated than other triptans and can offer significant improvement.

    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 Im 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 theyre 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.


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    Why Do You Get Menstrual Migraines

    Throughout your menstrual cycle, estrogen and progesterone hormone levels fluctuate in order to prepare your body for pregnancy. During your period, your estrogen levels are at their lowest. Estrogen plays a role in how sensitive you are to pain, so when estrogen levels are lower, you may feel more pain in the form of migraines, cramps, and back pain.

    These hormone level fluctuations may help explain why migraines are more common in women than they are in men.

    It can be hard to identify whether a migraine you experience during your period is actually a menstrual migraine, or if it’s a migraine happening during your period. However, it was observed in one study that patients with menstrual migraines tend to experience more symptoms associated with migraines for a longer period of time, and have a worse experience overall.

    We asked Dr. Sara Crystal, Neurologist and Medical Director at Cove, about why women get migraine attacks around their period.

    Dr. Crystal said,

    “The worsening of migraine is probably related to the drop in estrogen levels that occurs about 2 days before menstruation. Estrogen has a role in the perception of pain.”

    Headaches And Hormones: What’s The Connection

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    Treatment Menstrually Related Migraine

    As you review these, remember that all medications have side effects, and you should discuss them with your doctor.

    In general, MRM can be effectively managed with strategies similar to those used for non-MRM. Behavioral management is an important concept in menstrual as well as nonmenstrual migraine. Menstruation is one of many factors that put women at risk for migraine disease. Hormonal changes are just one of many potential trigger factors.

    Most women living with menstrually related migraine are treated with acute medications. When attacks are very frequent, severe, or disabling, preventive treatment may be required.

    How To Treat A Migraine

    While birth control can disrupt natural estrogen and progesterone levels, it does help in planning your period. This can be a strategy to prevent migraines, suggests Martin.

    Another useful treatment is triptans. “You can take a medication called a triptan for 4-5 consecutive days starting 1-2 days before the day that you expect the period headache to start and ending 4-5 days later. This can help you prevent the period headache by treating the headache before it even begins,” says Martin.

    According to the American Migraine Foundation, taking triptans such as sumatriptan, rizatriptan, zolmitriptan, almotriptan, or eletriptan in combination with NSAIDs such as naproxen or ibuprofen early on in the migraine attack can help to relieve painful symptoms.

    NSAIDs such as 550 mg of naproxen can also be taken separately. When NSAIDs are taken twice a day around the 5-7 days surrounding your menstrual migraine window, i.e. 2 days before the start of your period and 3 days after, it can help prevent migraines or cause it to be less severe.

    Magnesium supplements can also help manage migraine pain, says Pavlovic. Low levels of magnesium have been reported with increased migraines, per the American Migraine Foundation. Taking a daily oral dose of 400-500 mg of magnesium oxide is a preventable method that’s also safe during pregnancy. And because of magnesium’s ability to prevent heightened sensory changes in the brain, it has also been effective in migraines with aura.

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    Talk To Your Doctor About Birth Control

    For someone women, birth control can help with menstrual headaches. For other women, it can actually cause the headaches. A lot can depend on you, your individual migraine triggers, and the type of hormonal birth control you take, says ob/gyn and womens health expert Sherry Ross, M.D., at Santa Monica Women’s Health.

    Some women suffer migraines just before their period due to a drop in estrogen levels, she explains. Women in that situation who are on a combination pill can actually be helped by birth control because it keeps estrogen levels steady throughout their cycle. Combination pills contain synthetic versions of the female hormones estrogen and progesterone.

    For other women, the combination pills can make migraines worse and more frequent. Combination pills are generally not recommended for migraine sufferers because a) they can make migraines worse and b) they can put you at an increased risk of having a stroke, says Jessica Shepherd, M.D., an assistant professor of clinical obstetrics and gynecology and director of minimally invasive gynecology at The University of Illinois College of Medicine at Chicago. Instead, doctors usually recommend a progestin pill or an IUD, she says.

    If you suffer from migraines and suspect your period and/or birth control might be a factor, experts say its important to talk to your doctor. Together you can find a birth control method that works for youand keeps you headache-free.

    What Is A Period Headache

    8 doctor

    There are different types of headaches, depending on the cause and symptoms. Let’s break down how different types of headaches are categorized.

    Tension headache:

    This is the most common type of headache affecting 80% of Americans. It’s often caused by stress, dehydration, or exhaustion. Tension headaches usually cause a pressing or tightening pain on both sides of the head.


    This is an intense, throbbing headache that affects 29.5 million Americans. Women in particular are affected, as about 75% of people who get migraines are female. Migraines can cause pain on both sides of the head, but one side, usually in the temple or behind the eye.

    Menstrual migraine:

    A menstrual migraine or period headache is a type of migraine. It occurs anywhere from two days before to three days after your period begins and may last until your period is over.

    Please note that this discount is solely from Cove and not related to The Pill Club or from engaging with The Pill Club website.

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    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 womans 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

    Ways To Treat Hormonal Headaches Naturally

    Whether its a debilitating migraine or the dull throbbing from a stressful day, headaches have the ability to zap your energy, ruin your focus and turn your otherwise centered self into a crabby mess.

    As one of the most common and vague health conditions, headaches are generally accepted as just part of being human, whether brought on by fatigue, dehydration, stress or lack of sleep. Headaches can indeed be caused by all of these things, but for women, theres often a hormonal imbalance at the root of those menstrual migraines or the constant tension between your eyes.

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    What Triggers Migraines In Women

    In addition to a drop in estrogen, birth control pills and hormone replacement therapy for menopause can change the frequency or severity of migraines. If you notice your migraine headache getting worse after starting one of these medications, it may be worthwhile to ask your healthcare provider for a medication that contains a lower dose of estrogen, or ask for a change from an interrupted dosing regimen to a continuous one.

    What Can I Do To Help Relieve The Symptoms Of A Menstrual Migraine

    Menstrual Migraine Relief (Headaches During My Period)

    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 cant.

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    Daily Magnesium Has A Preventive Effect

    I really like magnesium as a natural supplement to take every day to help prevent menstrual migraine, says Hindiyeh. There is evidence to support using magnesium, though the mechanism of action, or the why behind how it improves migraine, is not totally understood, she says. It could be stabilizing cells or decreasing hyperexcitability or neuronal firing, but thats all theoretical at this point, she adds.


    You can learn more about the various types of magnesium supplements on the website Migraine Again, and remember that its always a good idea to talk with your doctor about any supplements you are taking or are interested in taking.

    What Causes Menstrual Migraine

    There is a link between migraine and falling levels of the hormone oestrogen. The natural drop in oestrogen levels before your period starts is linked to menstrual migraine. Women who have heavy and painful periods have higher levels of prostaglandin , which has also been identified as playing a role in a menstrual migraine.

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    How Can I Prevent Menstrual Migraines

    Migraines are excruciating headaches that can make the simplest tasks impossible. Getting out of bed in the morning with a migraine can seem like a futile exercise, let alone actually going to work. The pain can be a pounding sensation, like a hammer in the head or sharp and shooting, like being stabbed with a needle or a knife.

    Menstrual migraines are a type of headache that can occur around a womans menstrual period. In fact, 50 percent of women experience this phenomenon. Menstrual migraines tend to be more severe than typical migraines. They are triggered by the hormonal changes that occur before the start of a womans period.

    How We Can Help

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    Menstrual migraine relief can be a complicated and frustrating process for women but at Advanced Functional Medicine, we can support you to overcome your symptoms and stop dreading each months migraine arrival.

    With hormonal balancing supplements and lifestyle changes, we can help lessen the intensity of your migraines, if not, stop them completely. We also assess you overall biochemistry, investigating other contributing factors such as your gut health, methylation pathways and potential diet and lifestyle interactions.

    Book an appointment with our female hormone specialist Shiree Walker NP for a comprehensive womens hormone health check.

    To find out more about how we can help you alleviate your migraine pain, contact us via the form below.

    Jarrod Cooper ND

    Jarrod Cooper – ND is the founder of Advanced Functional Medicine Australia. He is a Naturopathic Doctor with extensive functional medicine training from leading practitioners in the USA and worldwide.

    He is leading the way with advancements of functional medicine, clinically implementing worldwide best practices in Functional Medicine throughout Australia.

    Jarrod consults in person from Perth, Western Australia and also online via Telehealth throughout Australia and worldwide.

    If you are looking for personalised treatment, we highly recommend contacting Jarrod Coopers Advanced Functional Medicine clinic in Australia.

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    How To Identify A Period Headache

    Migraines are easily misdiagnosed as a common headache. Because of this, the American Migraine Foundation reports that less than 5% of migraines are seen, diagnosed, and appropriately treated by a health care provider. Here are some ways to identify menstrual migraines.

    Pavlovic emphasizes that migraines are more severe than the common headache. It’s a chronic neurological disorder. “Though headache is generally the most disabling symptom of migraine, migraines are disorders of brain hyperexcitability that encompasses many other features,” she says.

    Unlike migraines, headaches cause throbbing pressure that differs in intensity based on where the pain is on your head. The average headache goes away by itself and may last from 30 minutes to a couple of hours. This is a short amount of time compared to menstrual migraines, which can last for days.

    Migraines may also be thought of as a PMS symptom. However, menstrual migraines have more severe symptoms that set them apart from the average period. Pavlovic says difficulty sleeping is also associated with menstrual migraines.

    Sensitivity to movement, including vertigo and balance issues, is another notable symptom of menstrual migraine. Johns Hopkins Medicine reports women are more vulnerable to this symptom around the time of their period.


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