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How To Stop Migraines Before Period

How To Prevent Menstrual Migraine Headaches: What The Researchers Say

I get bad headaches during my period. What can I do?

If you want a pretty much fail-proof method of how to prevent period migraines, consider the use of magnesium. Magnesium, of course falls in the category of vitamins and minerals necessary for your health, and its taken as a supplement to get benefits such as migraine reduction.

In 2014, the journal headache offered its readers an article titled, Headache Toolbox: Menstrual Migraine. The researchers recommended that those who wanted to stop menstrual migraines keep a diary of your headaches, while simultaneously following your menstrual cycle in the diary. They specifically listed magnesium as the #2 treatment.

The journal Neurological Science in 2012 had an article titled, Premenstrual Syndrome and Migraine as well. In this article from scientists at the University of Turin in Italy, they mentioned natural remedies that had evidence backing them for preventing menstrual migraines. The number 1 natural remedy was magnesium.

But it was the journal Medical Hypotheses in 2011 that provides the real answer to the question of why magnesium is the answer to menstrual migraines. According to the researchers, magnesium and vitamin B6 modulates the level of nitric oxide in the cell, both of which are deficient in those with migraines. Magnesium is essential for the removal of trapped nitric oxide from within the cell which does not occur under low magnesium levels. The trapped nitric oxide reacts with other free radicals and creates additional damaging free radicals.

Complementary Menstrual Migraine Treatments

There are many different approaches to help manage menstrual migraine some involve medicinal treatments and others do not. Often it may involve a combination.

Rest assure that it is possible to reduce and in some cases eliminate menstrual migraine. But it may involve working with a specialist and some trial and error.

Complementary approaches for those with menstrual migraine include:

  • Dietary changes
  • Magnesium
  • Other natural therapies

Most women with menstrual migraine have a healthy hormonal balance. However, if there is an imbalance of estrogen in relation to progesterone then a healthy diet is the first step . What we eat plays a huge role in our overall health and wellbeing.

Nothing else affects our health more than what we eat.

If you experience migraine attacks then your diet can be important.

We hear all the time from the health community something like eat a varied and well-balanced diet to help prevent disease. Its been said so many times we can become numb to this important advice.

To complicate things, some healthy foods may also act as triggers. Finding out which foods trigger attacks is not always easy.

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 cant.

Recommended Reading: Headache Tablets Without Side Effects

Hormonal Contraception For People With Migraine

People with migraine with aura are not recommended to use combined hormonal contraceptives . Having migraines with aura is a risk factor for experiencing a stroke , plus taking combined hormonal contraceptives up to doubles that risk . The combination of these risk factors is associated with a 3x increased risk of stroke, compared to people with migraine who donât use combined hormonal contraceptives .

The United States Centers for Disease Control and Prevention says people with chronic migraine are safe to use certain forms of contraception:

How The Menstrual Cycle Can Cause Migraine

9 Tips to Prevent Menstrual Migraines

Women who experience menstrual migraine may be sensitive to hormonal fluctuations experienced just prior to the onset of menstruation. Just before menstruation there is a natural drop in progesterone levels.

The two important females hormones involved are progesterone and estrogen.

Progesterone is a natural steroid hormone involved in the female menstrual cycle that stimulates the uterus to prepare for pregnancy. It is a naturally occurring hormone in the female body that helps a healthy female function normally.

Estrogens or oestrogens , are a group of compounds that are important in the menstrual and reproductive cycles. They are also naturally occurring steroid hormones in women that promote the development and maintenance of female features of the body.

It is important to note that estrogens are used as part of some oral contraceptives and in estrogen replacement therapy for some postmenopausal women.

Throughout the natural menstrual cycle the levels of these hormones fluctuate. During the cycle, the levels of progesterone and estrogens also change in relation to each other. See the image below for how these levels change throughout the cycle.

These fluctuations are normal and part of being a healthy and fertile woman.

Several research studies confirm that migraine is significantly more likely to occur in association with falling estrogen in the late luteal/early follicular phase of the menstrual cycle.

Is estrogen withdrawal the sole trigger for menstrual migraine?

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Is Your Birth Control Causing Headaches

Headaches are sometimes a side effect of hormonal birth control . In one study, taking oral contraceptives affected migraines, with 24% of people experiencing increased frequency of migraines .

Estrogen-withdrawal headaches are a type of headache that people get during their âpill-freeâ or âsugar-pill weekâ when they are taking oral contraceptives. This type of headache usually goes away within 3 days, but then will return during the estrogen-free week of the next cycle .

Medicines That Prevent Menstrual Migraine

Talk to your doctor about whether these medications might help you stop your headaches before they start.

If your periods don’t come on schedule or you also get migraine headaches at other times in your menstrual cycle, you can take preventive medicine every day. Drugs that prevent migraine headaches include:

  • Some types of antidepressants
  • Some types of antiseizure medicines
  • Blood pressure medicines such as beta-blockers and calcium channel blockers
  • CGRP inhibitors, these are a new class of preventive medicine

Devices which may be used for treatment or prevention include:.

  • Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked with migraines
  • Spring TMS or eNeura sTM, a device for people who have an aura before migraine headaches. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.
  • Noninvasive vagus nerve stimulator gammaCore is a hand-held portable device placed over the vagus nerve in the neck. It releases a mild electrical stimulation to the nerve’s fibers to relieve pain.

Recommended Reading: Tylenol Good For Headaches

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.

Other Causes Of Migraine Attacks

Learn How to Deal with Menstrual Migraines

Certain risk factors, such as age and family history, can play a role in whether you get migraine or menstrual migraine. Simply being a woman puts you at increased risk.

Of course, you cant control your sex, age, or family tree, but it may help to keep a migraine diary. This can help you identify and avoid triggers.

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Signs Of Period Coming But No Period

If you experience signs of period coming but no period, then it may be due to pregnancy.

Pregnancy may cause you to have signs of period Headache and cramps, but no period coming.

If pregnant, you may experience brown spotting before period or sometimes an unusual early light period.

Are you getting tired easily? Do you feel like vomiting? Are you craving for a specific kind of diet? Then its possible you may be pregnant.

Other causes of signs ofperiod coming but no period are stress, weight loss, contraceptive pills, obesity, weight loss, ovarian cyst and polycystic ovarian disease.

What Causes Menstrual Period To Come Out

Period occurs due to cyclical change of your hormones during your menstrual cycle.

What is the menstrual cycle?

The menstrual cycle is the number of days between 2 periods. For example, if your last menstrual period started on the 27th of April and your next period starts on the 26th of May, then you have a 30-day menstrual cycle.

Some women may have an erratic menstrual cycle, short menstrual cycle or long menstrual cycle.

What causes period to come out?

At birth and during puberty, the ovaries contain a fixed number of follicles that are released in each cycle. Weeks before you are born, your body stops producing follicle that develops to release an egg.

It is estimated that throughout the lifetime of women, about 500 eggs are released from the ovaries. These release of the egg is called ovulation.

Before ovulation occurs, your body increases the secretion of estrogen. This hormone works to help grow the endometrium covering the inner part of the uterus.

If you get pregnant, you will have no period because the endometrium helps provide nutrition for your baby.

However, if youre not pregnant, the endometrium breaks down coming out from your vagina as period.

Now its your turn. Do you have a headache or pains before your period starts? Are your menstrual period symptoms affecting your daily activities?

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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.


How To Identify Menstrual Migraine

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The most important tool is your diary. It is not just for the doctors conviction, it is also for your own personal knowledge as to whats relevant and not relevant.

Under- and over-reporting of the role of hormones is very significant. People with migraine really need a diary. A completed diary also helps assess the response to treatment. If you can see a pattern or improvement of 50% it is easier to determine how effective or ineffective your management is.

In the above example, there are frequent attacks in the earlier months which then become less frequent with more headache free days. The menstrually-related migraines seem to be some of the longer lasting and remaining attacks, which could not be determined without a diary noting the days of menstrual bleeding, migraine and responsiveness to treatment.

The things to note in menstrually-related migraine is how predictable, reliable and regular the periods are. If they are all over the place, it is difficult to predict when the estrogen drop is going to occur and thus difficult to treat early or even preemptively.

It is also important to ask about associated symptoms. Are there any perimenstrual symptoms of bloating or period pain? Its not so much that you are being asked about how bad your pain is, it is more if you have other uterine symptoms, there could be other factors such as prostaglandins at work. If heavy bleeding is experienced, then you can have a relative iron deficiency later on in the period cycle.

Read Also: How To Get Rid Of Migraine When Pregnant

Treatment Of Hormonal Migraine

1) Mini prophylaxis or prevention

If the periods are regular in their timing related to the period, you can use treatments in a way that we call mini-prophylaxis or mini prevention.

A long acting treatment such as a non-steroidal anti-inflammatory medication Naproxen or triptan Naratriptan or Zolmitriptan, can be started on the day before you reliably wake up with an established, untreatable, menstrual migraine, and continued regularly for the duration of that high risk time.

Starting before the expected onset of menstrual migraine:

Level A evidence

  • Naratriptan twice a day
  • Zolmitriptan 2.5mg twice a day for 6 days

Level B evidence

  • Naproxen 550mg, twice a day taken for 7-14 days, starting during the week before expected onset of menstruation.

Note: there is a risk of a withdrawal headache on the day after stopping.

As you can see, this means that some people might be using 5 to 7 days of naratriptan, which for anyone who is wanting to avoid medication overuse gets tricky if they have more than 3 other days of migraine the rest of the month as well. It is therefore worth noting that this strategy is for a very specific subgroup with severe menstrual migraine.

2) Continuous low-dose estrogen

The second, and probably the most useful thing to do if there are no contraindications, is to use a continuous low-dose estrogen combination pill to suppress ovarian function and the estrogen changes.

3) Progestogen

4) Prostaglandins

Hysterectomy caution

Foods To Help Prevent Migraines

Although the easiest way to get more magnesium in is to simply take a 400-500 mg supplement once a day, or two 300 mg magnesium supplements one in the morning and one in the evening, you can also get the mineral in your diet with foods you eat.

Heres a list of several high magnesium foods:

  • Dark leafy greens kale, spinach, Swiss chard
  • Nuts and seeds pumpkin, almonds, Brazil nuts, cashews, sesame seeds, flaxseeds, sunflower seeds
  • Broccoli
  • Also Check: Naproxen And Migraines

    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.

    Treatment Menstrually Related Migraine

    How to Treat Menstrual Migraine–LIFE CHANGING

    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.

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    Supplement For Hormone Health

    If you already have your foundational basics covered like eating, drinking, moving, thinking, breathing, sunlight, sleeping, and play, then it may be time for supplements. The first place to go is providing the building blocks to our hormones and their balancing systems like B vitamins and especially methylated ones for migraines sufferers, zinc, selenium, vitamin E, magnesium, and vitamin C. You may want to work with a holistic healthcare professional to identify which supplements you most need.

    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 doesnt apply to all kinds of oral contraception, so you should talk with your gynecologist, primary care doctor, or neurologist about which ones youd want to consider, says Hindiyeh. There are specific ones that will keep your estrogen level from fluctuating so much, she adds.

    If youre considering taking oral contraceptives as a means of birth control or to try to improve your migraine symptoms, tell your healthcare provider about your migraine history, says Hindiyeh.

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    Prophylactic Menstrual Migraine Therapy

    Prophylaxis may either be perimenstrual or continuous . Many of the regimens suggested for perimenstrual migraine prophylaxis depend on regular menstruation and the ability to predict headacheonset in relationship to menses. Perimenstrual prophylaxis commences a few days before the period is expected and continues until the end of menstruation. In women whose cycles are difficult to predict, continuous prophylaxis with standard migraine prophylactic agents is called for .

    NSAIDs are considered first-line agents for perimenstrual prophylactic therapy in patients with either menstrual-associated migraine, or PMM, when the timing of menstruation is predictable. Different classes of NSAIDs should be tried because response may vary in a given individual. Ergot derivatives can also be effective when used as perimenstrual prophylactic drugs around the time of menstruation. Risks for rebound headaches are minimal, given the limited duration of treatment when drugs are used perimenstrually. Frovatriptan, naratriptan, and zolmitriptan have been found to be effective for perimenstrual prophylaxis and are included in the AAN and AHS guidelines on migraine prophylaxis . It is worth noting that severe menstrually related migraine may respond better to short-term or perimenstrual prophylaxis while on a chronic preventive agent.

    Jan Lewis Brandes, in, 2003


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