Menstrual migraines: causes, symptoms and treatment

Reviewed by our clinical team

If you’ve noticed your migraines get worse around your period, or perhaps you only have a migraine close to your period. You could be experiencing menstrual migraines. In this article we look at what causes menstrual migraines, symptoms and migraine treatment options available. 

What is menstrual migraine?

Menstrual migraine is a type of migraine that is closely linked with the menstrual cycle. Many people who menstruate find their migraine develops either 2 days before their period or during the first 3 days of their period. 

Menstrual migraines are common, with 50-60% of women noticing a link between their migraines and periods. This type of migraine is believed to be triggered by hormonal fluctuations, particularly the changes in oestrogen levels around your period. 

Menstrual migraine symptoms

Menstrual migraines attacks tend to be more severe than other migraines experienced during the rest of the month. They also tend to come back the next day. Symptoms often last for several hours to a few days.  

The symptoms of menstrual migraines are similar to typical migraines and may include:

• Intense throbbing or pulsating headache
• Sensitivity to light and sound
• Nausea
• Vomiting
• Sometimes visual disturbances known as auras

What causes menstrual migraine?

Fluctuations in oestrogen levels are thought to play a significant role in triggering menstrual migraines. Oestrogen levels naturally drop before your period. This drop is a trigger for these migraines. 

Another hormone, prostaglandin also plays a role in menstrual migraines. People who have heavy or painful periods have higher levels of this hormone. 

Periods aren’t the only trigger for hormonal migraines. Other instances when your hormones change can trigger migraines, such as: 

• Pregnancy
• Menopause including taking HRT
• Contraception including the combined pill 

If you notice your migraines getting worse when taking new medication or during pregnancy talk to your GP or midwife. 

How is menstrual migraine diagnosed?

If you or someone you know experiences menstrual migraines, you should speak to your GP. They can help identify triggers, manage symptoms, and provide guidance on how to improve the overall quality of life during menstruation.

Your GP will likely ask you questions to find out the history of your migraines, including:

• How painful they are and what the pain feels like
• Where the pain is located 
• How often you get migraines
• If you take any medication for your migraines and if this makes them better or worse
• Your migraine triggers such as food or stress
• If anyone in your family gets migraines
• How you felt before and after the migraine

Keeping a headache diary of at least three menstrual cycles can help you keep note of all of the above. So you can give your doctor all the information they need to diagnose you. Download your diary here. 

Menstrual migraine treatment

Managing menstrual migraines involves a combination of lifestyle changes, stress management, and sometimes medication. Some ways that can help to reduce the frequency and severity of menstrual migraines include:

• Keeping a headache diary to identify triggers and patterns
• Maintaining a healthy lifestyle, including regular exercise and a balanced diet
• Stress reduction techniques such as yoga, meditation, or deep breathing exercises
• Avoiding known triggers like certain foods, caffeine and alcohol
• Hormonal therapies like contraception or hormone-regulating medications 

Migraine medication through Online Doctor

There are also migraine treatments available via our online service. Simply answer a few questions and one of our UK based clinicians will check your suitability for a range of treatments. These include triptans like Rizatriptan and Sumatriptan which work to reduce symptoms. You can find out more about how Sumatriptan works in our guide. 

There’s also Vydura, a wafer placed under the tongue which can be used to prevent migraines. Our clinicians will make sure any migraine treatment is right for you. 

We also have migraine advice you might find useful, including does diet affect migraines and migraines during pregnancy. 

References

https://migrainetrust.org/understand-migraine/types-of-migraine/menstrual-migraine/ 
https://www.nhs.uk/conditions/hormone-headaches/ 
https://www.nationalmigrainecentre.org.uk/understanding-migraine/factsheets-and-resources/menstrual-migraine/