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.
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.
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.
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.
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 .
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.
- You’re 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.
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.
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.
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 Tell If I Have A Migraine Or Just A Bad Tension
Compared with migraine, tension-type headache is generally less severe and rarely disabling. Compare your symptoms with those in this chart to see what type of headache you might be having.
|Aura before onset of headache||x|
Note: Rebound headache may have features of tension and/or migraine headache. Adapted from a table produced by the American Council for Headache Education.
Although fatigue and stress can bring on both tension and migraine headaches, migraines can be triggered by certain foods, changes in the body’s hormone levels, and even changes in the weather.
There also are differences in how types of headaches respond to treatment with medicines. Although some over-the-counter drugs used to treat tension-type headaches sometimes help migraine headaches, the drugs used to treat migraine attacks do not work for tension-type headaches for most people.
You can’t tell the difference between a migraine and a tension-type headache by how often they occur. Both can occur at irregular intervals. Also, in rare cases, both can occur daily or almost daily.
Take The Same Medications Youd Take For Normal Migraines
Your doctor can also prescribe triptans, which are drugs that reduce inflammation by restricting blood vessels. They work as well or better than over-the-counter meds, but because of their effect on blood vessels they can’t be used by people with coronary heart disease, a risk of stroke or uncontrolled high blood pressure.
You can prevent migraines completely, and you can stop head pain from developing into a full-blown migraine, Halker says. All it takes is a little bit of record keeping and some coordination with a doctor to see which protocols work best for you.
Headaches And Women: What Do Hormones Have To Do With It
A bad headache can ruin your workday, strain your relationship with family members and affect your ability to exercise. In the U.S., headaches cause 112 million sick days each year. While one-third of the population gets headaches, women suffer more than men do.
Changes in hormones could be among the reasons women have more headaches than men do.
These hormone-related headache triggers include:
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.
It’s 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.
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.
How Can I Tell If I Have A Migraine Or A Sinus Headache
Many people confuse a sinus headache with a migraine because pain and pressure in the sinuses, nasal congestion, and watery eyes often occur with migraine. To find out if your headache is sinus or migraine, ask yourself these questions:
In addition to my sinus symptoms, do I have:
If you answer “yes” to two or three of these questions, then most likely you have migraine with sinus symptoms. A true sinus headache is rare and usually occurs due to sinus infection. In a sinus infection, you would also likely have a fever and thick nasal secretions that are yellow, green, or blood-tinged. A sinus headache should go away with treatment of the sinus infection.
What’s The Difference Between A Headache And A Migraine
“A migraine is a type of headache,” Medhat Mikhael, MD, pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center, told POPSUGAR. But there are certain characteristics that help distinguish a migraine from a run-of-the-mill headache. “Migraines are unilateral, pulsating in nature, and associated with one or more of the following: photophobia , phonophobia , and nausea with or without vomiting,” Dr. Mikhael said.
Migraines are also more common in women, a study in The Journal of Headache and Pain found. Women have a 43 percent lifetime incidence of migraines, compared with only 18 percent in men. Before puberty, migraines affect both sexes equally. It’s not until after a woman gets her period and starts experiencing these estrogen fluctuations that they become much more susceptible to migraines than men.
International Classification Of Headache Disorders Iii
A1.1.1 Pure menstrual migraine without aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.1 Migraine without aura and criterion B below B. Occurring exclusively on day 1 ± 2 of menstruation in at least two out of three menstrual cycles and at no other times of the cycle
A1.1.2 Menstrually related migraine without aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.1 Migraine without aura and criterion B below B. Occurring on day 1 ± 2 of menstruation in at least two out of three menstrual cycles, and additionally at other times of the cycle
A22.214.171.124 Pure menstrual migraine with aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.2 Migraine with aura and criterion B below B. Occurring exclusively on day 1 ± 2 of menstruation in at least two out of three menstrual cycles and at no other times of the cycle
A126.96.36.199 Menstrually related migraine with aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.2 Migraine with aura and criterion B below B. Occurring on day 1 ± 2 of menstruation in at least two out of three menstrual cycles, and additionally at other times of the cycle
Whats The Relationship Between Hormones And Headaches
Headaches in women, especially migraines, are related to changes in the levels of estrogen. Levels of estrogen drop immediately before the start of your menstrual flow .
Premenstrual migraines regularly occur during or after the time when the female hormones, estrogen and progesterone, drop to their lowest levels.
Migraine attacks usually improve during pregnancy. However, some women have reported that their migraines started during the first trimester of pregnancy, and then went away.
Can Using Birth Control Pills Make My Migraines Worse
In some women, pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe. But in other women, the pills may worsen their migraines. In still other women, taking birth control pills has no effect on their migraines.
The reason for these different responses is not well understood. For women whose migraines get worse when they take birth control pills, their attacks seem to occur during the last week of the cycle. This is because the last seven pills in most monthly pill packs don’t have hormones; they are there to keep you in the habit of taking your birth control daily. Without the hormones, your body’s estrogen levels drop sharply. This may trigger migraine in some women.
Talk with your doctor if you think birth control pills are making your migraines worse. Switching to a pill pack in which all the pills for the entire month contain hormones and using that for three months in a row can improve headaches. Lifestyle changes, such as getting on a regular sleep pattern and eating healthy foods, can help too.
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:
Progestogen-based contraceptives to prevent ovulation .
- 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.
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.
Cephalalgiatreatment of migraine
“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; it’s probably not the best time to go for a jog or do some aerobic activity,” says Hindiyeh.
Are Migraine Headaches More Common In Women Than Men
Yes. About three out of four people who have migraines are women. Migraines are most common in women between the ages of 20 and 45. At this time of life women often have more job, family, and social duties. Women tend to report more painful and longer lasting headaches and more symptoms, such as nausea and vomiting. All these factors make it hard for a woman to fulfill her roles at work and at home when migraine strikes.
What Are The Treatment Options For Period Migraines
The good news is that there are plenty of treatment options if you’re having period-related migraines. The first line of treatment recommended typically involves things you can try at home. “Always, my first approach is to minimize lifestyle triggers that could be exacerbating the migraines outside of hormones,” says Phillips, such as avoiding stress , cutting out foods that you already know can trigger your migraines, correcting irregular sleep patterns, and staying away from second-hand smoke.
Sekhon takes a similar approach. “I would start with lifestyle alterations: improving sleep hygiene, nutrition, staying well-hydrated, eating regular meals, getting regular exercise, and avoiding triggers such as alcohol and certain foods that make it worse,” she says. She also recommends tracking what you eat and drink, as well as your activities so that if you do get a migraine, you can identify potential triggers. Over-the-counter, nonsteroidal anti-inflammatory drugs, like naproxen or ibuprofen, can treat menstrual migraines and also help reduce pain from cramps.
If doing these things isn’t enough, it may be time to chat with your doctor. They can help you figure out the best course of action to take. According to Phillips, some patients take prescription-strength triptans a few days before their period starts to prevent or reduce migraine symptoms. “Hormonal therapy with oral contraceptives or an estrogen patch might provide relief,” says Phillips.