When To See A Doctor
If period headaches interfere with daily life, talk to a doctor.
When PMS is the underlying issue, a range of treatments can help, including hormonal contraception, antidepressant medication, and calcium supplements.
The right course of treatment will depend, in part, on the severity and specific symptoms.
Healthcare professionals can recommend ways to help prevent menstrual migraine headaches. They can also prescribe stronger pain relief medication, when necessary.
In pregnant women, a persistent headache can be a symptom of preeclampsia. Anyone who thinks that they may be experiencing this potentially serious issue should seek medical attention.
You Have Excruciating Migraines Before Or During Your Period
If migraines were even remotely considerate, theyd at least leave you alone when youre about to get your period. Unfortunately, period migraines are another issue you can add to the list of common period problems.
Its not that menstruation will just randomly cause migraines in unsuspecting people who have never had one, but people with a history of migraines may experience them before or during their periods, according to the Mayo Clinic, which adds that this may be due to estrogen fluctuations. They tend to get the headache right as they go into their periods, and it seems to get better after they have had their menses for a day or two, Dr. Minkin says.
If youre dealing with this, your typical migraine medication may work for you. As you probably know if youve grappled with migraines, the treatment options are legion. They include pain-relieving medications to relieve symptoms ASAP and preventive drugs to ward off migraines altogether, according to the Mayo Clinic. In the former camp, you have choices like anti-nausea meds and triptans, which constrict swollen blood vessels and block pain pathways in the brain. In the latter, youve got meds like tricyclic antidepressants, which affect brain chemicals like serotonin that may be implicated in migraines.
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.
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What Are Rebound Migraines
Women who use acute pain-relief medicine more than two or three times a week or more than 10 days out of the month can set off a cycle called rebound. As each dose of medicine wears off, the pain comes back, leading the patient to take even more. This overuse causes your medicine to stop helping your pain and actually start causing headaches. Rebound headaches can occur with both over-the-counter and prescription pain-relief medicines. They can also occur whether you take them for headache or for another type of pain. Talk to your doctor if you’re caught in a rebound cycle.
When Should I Seek Immediate Help Or Contact My Healthcare Provider
Schedule a visit with your healthcare provider if:
- The number or severity of your migraines increase, or your headache pattern changes.
- Youre experiencing new or different side effects.
- Your medications no longer seem to be working.
- Your headache comes on suddenly.
- You are experiencing the worst headache of my life.
- You have a headache after experiencing a head injury.
- You are having neurologic symptoms that you have never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures, or numbing/tingling sensations.
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It Can Be So Distracting And Painful That It’s Almost Impossible To Think Or Carry On A Conversation Amanda 27
I’ve always had frequent headaches, but the migraines started around age 22. The first symptom I feel is a severe, piercing pain right between my eyebrows or sometimes what feels like behind my eye sockets. It can be so distracting and painful that it’s almost impossible to think or carry on a conversation. Then, my sensitivity to light and smell become increasingly worse, which sometimes will lead to nausea. Often, my migraines seem to come out of nowhere and advance very quickly.
One distinct memory I have is getting a migraine right before a date. At the time, I was in my apartment finishing getting ready when all of a sudden I keeled over and had a piercing pain in my forehead. I had to turn off all the lights and lay down on my side, practicing slow breathing to try to relieve the pain. I had to cancel the date less than an hour before we were supposed to meet, which was definitely embarrassing, and I lied there on my bed for hours.
Hows A Menstrual Migraine Diagnosed What Tests Are Done
Your healthcare provider will want to establish a history of your migraine-related symptoms, likely asking you to:
- Describe the severity and location of your pain. Is the pain pounding? Pulsing? Throbbing?
- Tell how often you get migraine headaches.
- Remember if anything makes your headache better or worse.
- Discuss what medications you take to relieve the pain and how often you take them.
- Talk about the activities, foods, stressors, or the situations that may have brought on the migraine.
- Remember if anyone in your family gets migraine headaches.
- Tell how you felt before, during and after the headache.
Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An electroencephalogram may be ordered to rule out seizures.
Its helpful to both you and your healthcare provider if you keep a migraine journal. Take note of what symptoms you get, how long your symptoms last, and what makes your menstrual migraine better or worse. You and your healthcare provider may be able to use that information to help you heal, and possibly prevent or anticipate your migraine.
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Can Migraine Be Worse During Menopause
If your migraine headaches are closely linked to your menstrual cycle,;;may make them less severe. As you get older, the nausea and vomiting may decrease as well. About two-thirds of women with migraines report that their symptoms improve with menopause.
But for some women, menopause worsens migraine or triggers them to start. It is not clear why this happens.;, which is prescribed for some women during menopause, may be linked to migraines during this time. In general, though, the worsening of migraine symptoms goes away once menopause is complete.
Contraceptives As A Treatment For Menstrual Migraine
Hormonal contraceptives are a useful option if menstrual migraine is a problem and you also need contraception. Options may include:
- These include desogestrel Cerazette®), the contraceptive implant , or the contraceptive injection.
- Most women with migraine at any age can use progestogen-based contraceptives even if they have migraine attacks with aura.
- The only time you would not be advised to use progestogen-based contraception is if you started to develop migraine attacks with aura only after starting to take one of these types of contraceptive.
Combined hormonal contraceptives ;also prevent ovulation; however, during the pill-free week some women with menstrual migraine will still experience their headaches. Moreover, not all women with menstrual migraine can take these treatments.
- If you have or develop migraine attacks with aura, you should never use combined hormonal contraception again at all.
- If you have migraine attacks without aura you should not use combined hormonal contraception again if you are aged 35 or older. See the separate leaflet called Migraine,;which deals with migraine with aura.
In some women with migraine who use combined hormonal contraceptives, migraine attacks are also triggered by the drop in the blood level of oestrogen during the pill-free or patch-free interval.
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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
- 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.
Why Do I Get Migraines During My Menstrual Cycle
According to , FDN-P, CHNC, a functional nutritionist and gut and hormone specialist, hormonal headaches occur because your body is trying to communicate to or request something from you.
“Typically when hormonal headaches are coming up every month , this can indicate estrogen dominance, thyroid/cortisol imbalances, or nutrient/mineral deficiencies like B vitamins and magnesium,” she says.
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How Many Sessions Would You Need
The number of sessions varies depending on the needs of the individual and the type of NF used. For instance, one 2010 study used a combination of NF, passive-infrared hemo-encephalography , and thermal biofeedback .13
Treatment in this study consisted of an average of forty sessions, an average of thirty frequency-based NF sessions, and an average of ten pIR-HEG sessions, all conducted over six months. Treatment in another study consisted of just five thirty-minute sessions.14
How The Menstrual Cycle Can Cause Migraine
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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The Impact Of Mismanaged Migraine
Many doctors believe that migraine is often misdiagnosed in children, and many Migraine.com readers would agree. In Health Unions 2018 Migraine In America survey, 2,458 out of 4,356 people said they had migraine symptoms before age 18. Of those, more than 7 out of 10 people who had migraine symptoms in childhood said they did not get effective treatment as a child. They also reported missing out on events and feeling like others thought they were faking their pain and other symptoms.
Menstrual Migraine Treatment And Prevention
Since period-related headaches are fueled by hormonal changes, it can help to prevent large fluctuations, explains Dr. Woods. A birth control pill that levels out those hormones throughout the month … can really help, he says.
Some women will still get headaches during the placebo week of a 28-day pill;regimen, Dr. Woods adds. If that happens, he says, doctors may recommend that patients skip the placebo week and start right in on a new pack of pills.
You can do that for a couple years, and you effectively level the playing field across the whole month, he says. If theres no change in hormones, youre less likely to get those headaches.
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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.
What Are The Treatment Options For Menopausal Migraines
If you need to continue estrogen supplements after menopause, you should start on the lowest dose of these agents, on an uninterrupted basis. Instead of seven days off the drug, you may be told to take it every day. By maintaining a steady dose of estrogen, the headaches may be prevented. An estrogen patch may be effective in stabilizing the levels of estrogen.
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Regular Exercise Can Help Prevent Menstrual Migraine
When we consider all the strategies to prevent migraine attacks, I love it when people choose to make lifestyle modifications that can make a real difference, says Hindiyeh.
There’s lots of evidence to suggest regular aerobic exercise can work as a preventive medication all on its own, and there are some studies to suggest that yoga and HIIT can be helpful as well, says Hindiyeh.
Not only can regular exercise help prevent migraine attacks for some people, but also, if the headache is mild, a short bout of exercise can actually help relieve that headache that’s happening, according to Hindiyeh.
On the other hand, overexerting yourself can be a trigger for migraine, especially if you are already having a migraine attack, she says.
One of the cardinal definitions and features of migraine is that normal activity can make you feel worse. If you’re already in the middle of a severe migraine attack, moving around excessively is going to make things worse for you; its probably not the best time to go for a jog or do some aerobic activity, says Hindiyeh.
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 .
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Why Do I Get Period Headaches
Your hormones fluctuate throughout your monthly menstrual cycle, says James Woods, MD, a professor of obstetrics and gynecology at the University of Rochester. Just before your period beginsassuming you;didnt become pregnant after ovulationyour estrogen levels drop sharply.
People sometimes dont realize that our hormones are linked to brain chemicals and to our mental state, says Dr. Woods. Any sudden change in hormones can mean changes in mood or anxiety levels, or it can mean experiencing more symptoms like headaches.
Research suggests that up to 20% of women experience a form of migraine tied to their period, known as menstrual migraines. These tend to occur in the two days leading up to a period and the three days after a period starts.
Its hard to say whether all period-related headaches are migraines, says Dr. Woods, since the definition of migraines has changed and expanded over the years. But what we can say is that the vast majority of these headaches are linked to this drop in hormones, he says.
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Period Problems You Shouldnt Ignore
As basically anyone who menstruates knows, certain period problems are just an unfortunate fact of life, like pain radiating through your midsection, a shorter fuse than usual , and bleeding more than you would like to be bleeding from your vagina.
On the flip side, some menstrual cycle problems are a clear sign that you should chat about whats going on with your doctorjust in casebecause they fall outside the bounds of what’s normally expected during menstruation. Here are some period problems that are worth discussing with a medical expert.
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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 itâs 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 . Itâs 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.