Yes, Period Headaches Are a Real Thing—and Here’s How You Can Prevent Them

Periods can be annoying enough, even if we’re only talking about symptoms like cramping, bloating, and, of course, bleeding. But on top of that, many women find they also experience headaches at this time of the month, as well—adding yet another layer to an already less-than-pleasant few days.

If you’re one of those women, it may help to know that your recurring headaches aren’t just your imagination. Menstrual migraines and other types of headaches during (or before) your period are a real medical phenomenon, and experts say they’re actually quite common. Here’s what to know about this type of pain, and what you can do about it.

RELATED: 6 Things You Should Know About Having Sex During Your Period

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 begins—assuming you didn’t become pregnant after ovulation—your estrogen levels drop sharply.

“People sometimes don’t 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 (and up to 60% of women who get regular migraines) 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.

It’s 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.

RELATED: 10 Things That Mess With Your Period

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 there’s no change in hormones, you’re less likely to get those headaches.”

RELATED: Is It Really OK to Skip a Period Using Birth Control?

Women who are going through menopause often experience menstrual migraines as well. Wearing an estrogen patch or taking estrogen can help keep hormone levels stable during this transition and may help reduce headaches. Once a woman has stopped having periods altogether, those migraines are likely to stop as well.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) and prescription pain relievers (like triptans) can also help treat period headaches and may be good solutions for women who choose not to or cannot take hormonal birth control. (Some types of birth control may not be safe for women who get migraines with auras, for example.)

“Some people benefit from strong coffee, some people take Excedrin, and people increase their doses of their migraine medication,” says Dr. Woods. He recommends talking to your doctor about what type of medication regimen is best for you.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

Stress can also contribute to headaches, says Dr. Woods. Finding ways to relax during your period—and all month long—may help relieve symptoms. Alternative therapies, like acupuncture, yoga, or hypnosis, may benefit some people as well.

“There’s no one simplistic treatment that works for everyone,” Dr. Woods adds. “It’s often a trial of different approaches until we find something that fits.”

Menstrual migraine

Whilst many women report that menstruation is a migraine trigger, there is a specific condition known as ‘menstrual migraine’.

Menstrual migraine is associated with falling levels of oestrogen. Studies show that migraine is most likely to occur in the two days leading up to a period and the first three days of a period. This type of migraine is thought to affect fewer than 10% of women. The two most accepted theories on the cause for menstrual migraine at the moment are:

  1. the withdrawal of oestrogen as part of the normal menstrual cycle and
  2. the normal release of prostaglandin during the first 48 hours of menstruation.

There are no tests available to confirm the diagnosis, so the only accurate way to tell if you have menstrual migraine is to keep a diary for at least three months recording both your migraine attacks 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.

Treating menstrual migraine

There are several treatment options depending on the regularity of your menstrual cycle, whether or not you have painful or heavy periods, menopausal symptoms or you also need contraception. Although none of these options are licensed specifically for menstrual migraine, they can be prescribed for this condition if your doctor feels they would benefit you.

If you have migraine and heavy periods, taking an anti-inflammatory painkiller such as mefenamic acid could help. Mefenamic acid is an effective migraine preventive and is also considered to be helpful in reducing migraine associated with heavy and/or painful periods. A dose of 500 mg can be taken three to four times daily. It can be started 2 to 3 days before the expected start of your period. If your periods are not regular, it is often effective when started on the first day. It is usually only needed for the first two to three days of your period. Naproxen can also be effective in doses of around 500 mg once or twice daily around the time of menstruation.

You may wish to discuss using oestrogen supplements with your doctor. Topping up your naturally falling oestrogen levels just before and during your period might help if your migraine occurs regularly before your period. Oestrogen can be taken in several forms such as skin patches or gel. You put the patch on your skin for 7 days starting from 3 days before the expected first day of your period. Similarly, you rub the gel onto your skin for 7 days. In this way the oestrogen from the patch or gel is absorbed directly into your blood stream. You should not use oestrogen supplements if you think you are pregnant or you are trying to get pregnant. Again keeping a diary of your migraines will help you to judge when best to start the treatment.

If your periods are irregular your doctor may suggest other ways to try and maintain your oestrogen levels at a more stable rate such as a combined oral contraceptive pill.

FAQ: Will having a hysterectomy help menstrual migraine?

In order to answer this question, it’s important to understand the female reproductive organs, i.e. the uterus (womb) and the two ovaries each side of the uterus. The ovaries contain the eggs and also produce the sex hormones oestrogen and progesterone. At the beginning of each menstrual cycle, some of the eggs will start to mature under the influence of hormones produced by the ovaries. In the middle of the cycle, one egg (sometimes more) will ovulate. If the egg is not fertilised it will get absorbed by the body but more importantly the level of hormones fall. This fall of hormones triggers the lining of the womb to break down and be shed through the vagina – called menstruation.

It is this withdrawal of hormones that acts as a trigger in women with menstrual migraine or menstrual-related migraine. So, if someone is considering a hysterectomy to treat menstrual migraine, it would not help as the ovaries would need to be removed.

There are a few diagnoses where for a small minority of women, surgical removal of the ovaries is the only measure that will allow them to continue a normal life. It is a very controversial treatment and is therefore very rare.

The first options are non-surgical ways of putting the ovaries out of action. Once the ovaries are out of action (in whatever way) the woman must take hormone replacement therapy until the average age of menopause (age 55) to prevent the long term consequences of oestrogen deficiency (e.g. risk of osteoporosis).

One way to suppress the hormonal cycle is to use different forms of hormonal contraception. The combined contraceptive pill, one progestogen-only pill, the progestogen-only injection and implant will work by stopping ovulation.

Did you find this information helpful?

You can help make sure that everyone with migraine gets the support they need. Please donate now.

Why Do I Get a Headache On My Period?

Getty Images/Science Photo Library

Even if you don’t use a period tracker, you can probably tell when your time of the month is looming: Aside from cramps and bloating, getting your period can also wreak havoc on your skin, energy levels and diet (cravings are real). And for some women, headaches are part of the period fun too.

That’s right: If you tend to suffer from headaches around your period, it isn’t all in your head (get it?!); period headaches are based in real science and are pretty common, too. Here, docs explain the connection between hormones and headaches—and what you can do to keep period headaches under control.

What Causes Period Headaches?

Unsurprisingly, it’s all about hormones. “Estrogen is the female hormone important in triggering headaches in women,” says Kristina Rauenhorst, M.D., a gynecologist at Mayo Clinic Health System. “Headaches are thought to occur when levels of estrogen drop, which happens before the menstrual period starts each month.”

Here’s how it works: The drop in estrogen levels cause chemical changes to occur in the brain, resulting in dilation of the vessels in the brain. Some of the nerves in the head are also more sensitive during this time related to the drop in estrogen, explains Dr. Rauenhorst, meaning pain can be felt in a more intense way during this time.

And even if you’re on a hormonal birth control pill, which levels out your hormones throughout the month, you *can* still experience period-related headaches while on an estrogen-containing BC if you miss any of your pills, or during the hormone-free interval during the last week of your birth control pack, adds Dr. Rauenhorst.

What About Period Migraines?

Unfortunately, some women experience even worse period headache symptoms, in the form of menstrual migraines. While they’re also caused by the estrogen drop, they tend to occur in women who already have a history of migraines, says Oluwakemi M. Edokpayi, M.D., a gynecologist at Northwestern Medicine.

Menstrual migraines typically start just prior to or during your menstrual cycle, last longer than regular migraines, and the symptoms are more severe. “These types of migraines may or may not be associated with aura (a series of sensory disturbances that happen shortly before a migraine attack) and they typically are associated with nausea, vomiting, and sensitivity to light/ sound,” says Dr. Edokpayi.

How to Prevent and Treat Period Headaches

“Unfortunately, since menstrual headaches are usually related to a decrease in estrogen and progesterone, there is nothing you can do to change the physiological aspect of what is happening in your body,” says Dr. Edokpayi. However, there are steps you can take to manage period-related headaches.

“I usually encourage my patients to have a balanced diet, drink plenty of water, exercise, and find better ways to handle stressors in life (i.e. meditation) to try to decrease the severity of menstrual headaches,” says Dr. Edokpayi.

And, if you aren’t already taking a birth control pill, you may want to talk to your ob-gyn about starting, since again, the pill can help equalize those estrogen fluctuations that cause period headaches in the first place.

Taking a magnesium oxide supplement (400 mg daily) may also be able to help since some research shows they can be effective at preventing menstrual migraines, adds Dr. Rauenhorst. (Related: The Benefits of Magnesium and How to Get More of It In Your Diet)

If a period headache hits, you can manage pain by simply popping an Advil or Tylenol like you would with any other headache. “Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, and acetaminophen are helpful for treating period headaches in many women,” says Dr. Rauenhorst. While NSAIDs alone are effective for some women, more intense menstrual migraines may require additional medication, such as triptans, which can help reverse the changes in your brain that caused your migraine and inhibit over-active pain nerves, adds Dr. Edokpayi.

The Bottom Line On Period Headaches

If you’re concerned about your headaches, start to track their frequency and duration; it will help your doc determine an accurate diagnosis and find the right treatment options for you, Dr. Edokpayi says.

When is it time to make an appointment? “Patients should see their physician if headaches are becoming more severe or are affecting their day-to-day activities,” says Dr. Edokpayi. “If you find yourself lying in bed in a darkened room during your menstrual cycle because your headaches are so debilitating, then it’s time to see your doctor.”

  • By Emily Shiffer

How to manage bad headache before period

Being female comes with its own struggles, especially when it comes to headaches. Fortunately, there’s help.

Over-the-counter pain relievers can be of great help. They may soothe your pain soon after your headache begins.

Triptans are another option. You might feel their effects 2 hours after you take them.

You can also try acupuncture. This ancient Chinese practice may lower the number of tension headaches you get and could prevent a migraine before period.

Many women also report using biofeedback. Biofeedback may relieve your headaches by helping you monitor how your body responds to stress. Apart from biofeedback, you can also try relaxation techniques.

Sometimes, holding an ice pack to the painful area is the best solution. Simply wrap the ice pack in a towel in order to protect your skin.

Headache during period

There are two types of women. Those who report a severe headache before period, and those who have strong headaches during their period.

A bad headache during period is not unusual, and it may partly be due to the drop in the hormone estrogen that happens before you menstruate.

The main symptoms of a hormonal headache is a headache or a migraine. You will feel a throbbing pain that starts on one side of the head. You may also experience sensitivity to light and nausea or vomiting.

Causes of headache during period

The main trigger might be the drop in the hormone estrogen that happens before you menstruate.

Birth control pills can worsen the symptoms of a migraine. Your estrogen levels plummet and your headaches get worse when you take placebo pills or no pills at all, during the week of your period. If you’re prone to headaches, taking birth control pills that have low amounts of estrogen or only progestin may help.

Genetics are also thought to play a role. Women who have a headache during period tend to have a combination of factors that trigger their headaches.

Menopause and perimenopause are also one of the main causes of a bad headache during period. This is due to the fluctuating hormone levels.

Further causes might include:

  • skipping meals
  • getting too much or too little sleep
  • intense lights, sounds, or smells
  • severe weather changes
  • alcoholic beverages, especially red wine
  • too much caffeine or caffeine withdrawal

Ways to manage bad headache during period

  1. There are several ways to relieve a bad headache during period:Your doctor might recommend over-the-counter pills to help with your severe symptoms.
  2. Prescription drugs are another possible remedy for a bad headache during period.
  3. Certain vitamins and supplements have been shown to relieve headaches. They might include riboflavin, magnesium, and coenzyme Q10
  4. Regular exercise.
  5. Staying hydrated is essential, as well as eating nutritious meals.
  6. You can also try reducing stress. Try relaxation techniques like progressive muscle relaxation, guided imagery, and breathing exercises

Headache after period: what can it tell you about?

Women can suffer from three types of headaches: a headache before period, a headache during period, and a headache after period.

If you experience a headache after period, it may be due to high levels of stress, dehydration, and genetic or dietary triggers. However, a headache after period may also be due to hormonal imbalances and low iron levels.

A headache after period can be accompanied by:

  • nausea
  • vomiting
  • sharp, violent throbbing
  • painful pressure behind the eyes
  • extreme sensitivity to bright lights and sound

The symptoms usually fade away with a proper rest or sleep. However, you can try certain treatments to help minimize the pain of headaches after your period. These treatments include cold compresses, over-the-counter drugs, lots of fluid, and vitamin supplements.

Is it Common to Get Migraines Before Your Period?

  • Larger text sizeLarge text sizeRegular text size

I get migraines a few days before my period starts. Is it common to have migraines as part of PMS?
– Alaire*

Yes. Lots of women who have migraines get them as part of their PMS symptoms. Doctors believe that changing hormone levels are to blame for this type of headache, which is known as a menstrual migraine.

Take some steps to try to stop these headaches so you feel better. You could start by taking an over-the-counter medicine like ibuprofen to see if that works. If you often get headaches near your period, try taking the medicine for a few days around that time, even if your headaches haven’t started yet. Doing this might help you avoid getting a headache. Getting enough sleep, not skipping meals, exercising regularly, and managing stress are other ways to help prevent headaches.

If a headache does come on, sometimes a cool cloth or ice pack wrapped in a towel can help. You can also try lying down in a quiet, dark room.

If these things don’t work for you, or if your headaches are severe enough that you miss school or other activities, talk to your doctor. He or she may recommend a prescription medicine or refer you to a headache expert.

*Names have been changed to protect user privacy.

Reviewed by: Larissa Hirsch, MD Date reviewed: June 2017

So, periods stink: You’ve got PMS, agonizing cramps and body aches, bloating, cravings, and, of course, bleeding. Can it get worse? Well, you may also deal with a lovely aching, throbbing headache before or during your period. UGH.

Yep, it’s not just you—the period headache is real. “Indeed, many women do suffer from the fancy diagnosis of ‘premenstrual migraines,’” says Mary Jane Minkin, MD, a board-certified ob-gyn and clinical professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine.

“It is very difficult to tell if a migraine is hormonally related or not just from the symptoms, but it’s the timing that’s the usual clue,” Dr. Minkin says. “Many women get these headaches the day before or so and the first day of their period.”

Related Story

Some good news? By day two or three of menstruation, period headaches *usually* fade, Dr. Minkin says. But until then (and for next month!), it helps to know how to tell if it’s period-related head pain you’re dealing with—and how to ease your discomfort.

Here, everything you need to know about premenstrual headaches from a couple of period pros.

Why do some women get period headaches?

Blame estrogen, says Sheeva Talebian, MD, a board-certified reproductive endocrinologist at CCRM in New York and a Women’s Health advisory board member. “Most menstrual-related headaches are due to the rapid drop in estrogen right before the onset of your period,” she says.

A mini menstruation lesson: When you ovulate (as in, an egg is released from your ovary), your estrogen peaks and your ovary makes progesterone. For a while, your womanly hormones stay up. But if you’re *not* pumping pregnancy hormones a week or so later, your body halts estrogen and progesterone production, triggering your period, Dr. Talebian explains.

Related Story

That sudden drop in estrogen (a.k.a. “estrogen withdrawal”) tweaks chemicals in your brain that affect how you experience pain, and up goes your sensitivity, the U.S. Department of Health & Human Services’ Office on Women’s Health (OWH) explains. Add to that constricted blood vessels, which happens to some women when they’re low in estrogen, et voilà: the dreaded period headache.

Other potential factors that can play into period headaches? Dehydration, blood loss (especially if you’re anemic), and poor sleep, Dr. Talebian notes. Already prone to migraines? Then there’s a 60 percent chance you’ll suffer from menstrual migraines as well, per the National Headache Foundation (NHF). And if you’re on birth control, that can bring on more headaches when you switch to your sugar pills and your estrogen levels tank (yay, hormones!).

Does this feel like your typical headache or…?

They may present a little differently than a typical headache or migraine. Menstrual headaches can range from mild to severe when it comes to pain, says Dr. Talebian, and they tend to start on one side of your head before spreading (docs aren’t sure why this is, she says).

Classic migraine symptoms could strike, too; for instance, you might feel super-sensitive to light and sick to your stomach.

Okay, gimme the fix: How do I get rid of mine?

The first step is prevention. Stay hydrated, get some rest, and make sure you’re logging enough hours of sleep. If you know a headache tends to come with your period, try using a period tracker and then start taking over-the-counter pain meds like aspirin, ibuprofen (Advil or Motrin), or naproxen (Aleve) a few days before, Dr. Talebian suggests. These meds will help fight the inflammation causing that pounding in your head. Take ‘em as needed with food (to avoid upsetting your stomach and developing ulcers), and follow the recommended dosage on the back of the box.

If you’re on the Pill, you may be able to prevent your headaches by simply taking pills through your period and skipping the sugar pills to keep estrogen levels up. But always consult with your doctor first before making any changes to your medication regimen.

Got pain or killer nausea on top of a headache? It’s best to see your MD. You may need prescription meds to treat more severe migraine symptoms.

Another option if you’re really struggling with menstrual migraines: Ask your doctor about a script for an estradiol pill, suggests Dr. Minkin. Simply put, it’s like a boost of estrogen that you put under your tongue and can give you sweet relief in as little as 30 minutes, as estrogen is absorbed right into your bloodstream, she explains. “It’s truly amazing.”

Cassie Shortsleeve Freelance Writer Cassie Shortsleeve is a skilled freelance writer and editor with almost a decade of experience reporting on all things health, fitness, and travel.

Headaches and Women: What Do Hormones Have to Do With It?

Why hormones?

Estrogen is responsible for the development and regulation of the female reproductive system. A headache can be triggered any time there is a fluctuation in estrogen levels, including when there is a dip in estrogen levels around the time of your menstrual cycle. Women may also experience more headaches around the start of menopause and when they undergo hysterectomy.

Menstrual-related Headaches

Tariq explains that pre-pubescent girls and boys get headaches at the same rate. However, they occur more often for girls once they reach puberty and their menstrual cycle begins, and headaches only level off again after menopause.

To see if your menstrual cycle is affecting your headaches, Tariq suggests keeping a calendar to track when your symptoms begin. If you see a pattern, your doctor might be able to offer some preventions and treatment such as:

  • starting medications before your monthly menstrual cycle begins to help lessen the headache pain
  • taking oral contraception or using hormone replacement therapy, which may benefit some patients but not all
  • in some cases, shutting down the menstrual cycle with the help of medication if the pain is extreme

Do I have a migraine or a tension headache?

The most common types of headaches for women are tension headaches and migraines. Tension headaches are commonly described as feeling like a band around the head, but if you’ve ever felt a throbbing and pounding in your head, you may have experienced a migraine headache.

Migraine Headache Symptoms

  • typically last four to 72 hours (this includes pre-headache and post-headache symptoms)
  • spots or zigzag lines in vision (only among 15–25 percent of headache sufferers)
  • pain on one side of the head (15 percent of patients can have pain on both sides)
  • pain worsened by physical activity
  • sensitivity to light, sound or smell
  • nausea and/or vomiting (patients with tension type headaches typically do not have nausea)

Lifestyle Treatment Options

You may need to consider lifestyle changes to help manage your migraine headache symptoms. Avoid known triggers such as alcohol and stress, and be sure to hydrate, hydrate, hydrate! (You should drink 1.5 to 2 liters of water each day.) If your caffeine consumption is affecting your sleep patterns, limit excessive coffee and energy drinks. Lastly, sleep – both quality and quantity are extremely important for a healthy, migraine-free life. The key is to stay consistent with your sleep, wake-up and meal times.

Physical therapy, especially around the neck and shoulders, can be extremely useful in easing muscle stiffness that could cause a tension headache. Behavioral therapy and relaxation training can also help with stress reduction to treat headaches.

If lifestyle modification measures fail, see your doctor.

Tariq emphasizes that migraine as well as tension headaches can be managed, allowing you to enjoy your everyday activities. Understanding how hormones affect you and how they can cause migraines or headaches is the first step to finding treatment options that work for you.


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.

How to Get Relief From Menstrual Migraines

If you suffer from menstrual migraines, talk to your doctor to see if changing or adjusting your birth control could help relieve some of the symptoms. “The best way to prevent menstrual migraines is to be on a low-dose birth control pill and to not take the placebo pills,” Dr. Ruiz said. This will essentially lengthen your luteal phase, the time after ovulation and before your period when your estrogen levels are highest, helping to prevent menstrual migraines and other PMS symptoms, according to research published in Therapeutic Advances in Neurological Disorders.

If you prefer a different form of birth control or aren’t on birth control at all, Dr. Ruiz suggests increasing your caffeine intake, which may help reduce the pain. In fact, the National Headache Foundation states that when caffeine is taken in addition to an OTC pain reliever like aspirin or acetaminophen, the pain-relieving effect is increased by 40 percent. Just make sure to keep your caffeine consumption to 200 mg a day or less (about a 12-ounce cup of coffee), as too much caffeine can lead to withdrawal.

Image Source: Unsplash / Asdrubal Luna

Understanding Why You Get a Migraine During Your Period

You may have noticed that you get a migraine during your period. This isn’t unusual, and it may partly be due to the drop in the hormone estrogen that happens before you menstruate.

Migraines triggered by hormones can happen during pregnancy, perimenopause, and menopause. Learn why this happens and how it can be prevented.

Is It a Migraine or a Headache?

Migraines are different than common headaches. They typically cause high levels of throbbing pain and usually occur on one side of the head. Migraines are categorized as “with aura” or “without aura.”

If you have a migraine with aura, you may experience one or more of the following symptoms in the 30 minutes before your migraine:

  • unusual changes in smell
  • unusual changes in taste
  • unusual changes in touch
  • numbness in the hands
  • numbness in the face
  • tingling sensations in the hands
  • tingling sensations in the face
  • seeing flashes of light
  • seeing unusual lines
  • confusion
  • difficulty thinking

The symptoms of a migraine with aura can include:

  • nausea
  • vomiting
  • sensitivity to light
  • sensitivity to sound
  • pain behind one eye
  • pain behind one ear
  • pain in one or both temples
  • a temporary loss of vision
  • seeing flashes of light
  • seeing spots

Common headaches are never preceded by an aura and are typically less painful than migraines. There are several different kinds of headaches:

  • High levels of stress and anxiety can cause tension headaches. They may also be caused by muscle tension or strain.
  • Sinus headaches often include symptoms like facial pressure, nasal congestion, and severe pain. They sometimes occur with a sinus infection.
  • Cluster headaches are often mistaken for migraines. They typically cause pain on one side of the head and may include symptoms such as a watery eye, runny nose, or nasal congestion.

How Do Hormone Levels Affect Migraines?

Migraines can occur when hormone levels are in flux. They can also be caused by some medications, such as birth control pills.

Approximately 60 percent of women who have migraines get menstrual migraines. This can happen anywhere from two days before the start of menstruation to three days after menstruation ends. Migraines may begin when young girls get their first period, but they can start at any time. They can continue throughout the reproductive years and into menopause.

Perimenopause and Menopause

Dropping levels of estrogen and other hormones, such as progesterone, can cause migraines during perimenopause. On average, perimenopause starts four years before menopause, but it can begin as early as eight to 10 years before menopause. Women taking who are on hormone replacement therapy may also get migraines.


Hormone headaches during pregnancy are most common during the first trimester. This is because blood volume increases and hormone levels rise. Women can also experience common headaches during pregnancy. These have many causes, including caffeine withdrawal, dehydration, and poor posture.

What Else Causes Migraines?

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

Of course, you can’t control your gender, age, or family tree, but it may help to keep a migraine diary. This can help you identify and avoid triggers. These may include:

  • poor sleeping habits
  • alcohol consumption
  • eating foods high in tyramine, such as smoked fish, cured or smoked meat and cheese, avocado, dried fruit, banana, aged food of any kind, or chocolate
  • drinking excessive amounts of caffeinated beverages
  • exposure to extreme weather conditions or fluctuations
  • stress
  • fatigue
  • exposure to extreme, intense levels of light or sound
  • breathing in strong odors from pollution, cleaning products, perfume, car exhaust, and chemicals
  • ingesting artificial sweeteners
  • consuming chemical additives, such as monosodium glutamate (MSG)
  • fasting
  • missing meals

How Are Migraines Diagnosed?

Your doctor will do a physical exam and ask about your family history to help them determine any potential underlying conditions. If your doctor suspects something other than hormone fluctuation is causing your migraine, they may recommend additional tests, such as:

  • a blood test
  • a CT scan
  • an MRI scan
  • a lumbar puncture, or spinal tap

How to Relieve Migraine Pain

There are several ways to relieve a migraine or prevent migraine pain.

Over-the-Counter (OTC) Drugs

Your doctor may recommend that you try an over-the-counter (OTC) pain medication, such as ibuprofen (Advil, Midol). They may advise you to take these on a scheduled basis, before the onset of pain. If your sodium levels are found to be high during your physical exam, your doctor may also recommend that you take a diuretic.

Prescription Drugs

Many different prescription drugs are available to help relieve migraine pain. These can include:

  • beta-blockers
  • ergotamine drugs
  • anticonvulsants
  • calcium channel blockers
  • onabotulinumtoxinA (Botox)
  • triptans
  • CGRP antagonists to prevent migraines

If you’re on hormonal birth control, your doctor may also recommend that you switch to a method with a different hormone dose. If you aren’t on hormonal birth control, your doctor may recommend that you try a method such as the pill to help regulate your hormone levels.

Natural Remedies

Certain vitamins and supplements have also been shown to stave off migraines triggered by hormones. These include:

  • vitamin B-2, or riboflavin
  • coenzyme Q10
  • butterbur
  • magnesium

Read More: Migraine herbal remedies from around the world “


Regular exercise may help relieve migraines triggered by hormones. Other women may find that exercising makes their headaches worse. Stay hydrated, eat a high-protein meal before exercising, and warm up your muscles before exercise to maximize the migraine-busting benefits.

Reducing Stress

Lowering stress and anxiety may sound easier said than done, but there are simple steps you can incorporate into your daily life. Try a few minutes of meditation or yoga after waking up in the morning or before going to bed. Practice deep breathing exercises during difficult situations.

The Takeaway

Identifying your triggers and experimenting with different treatments can help you reduce or manage your migraines. If OTC medications aren’t working for you, make an appointment with your doctor. They may be able to recommend alternative treatments or prescribe a strong medication to help alleviate your symptoms.


Most women who experience migraine have their first attack during their teens, many around the time of their first period. The psychological impact of having these two events together can be traumatic.

Impact of the menstrual cycle

Around 50% of women with migraine say their menstrual cycle directly affects their migraine. The whole menstrual cycle, not just your period, is associated with biological changes in your body, both physical and psychological. Sex hormones, oestrogen and progesterone, and the physical and chemical processes that go towards producing them, all have a widespread effect on your body.

It has long been recognised that there is a close relationship between female sex hormones and migraine. Some women are more sensitive to the fluctuations within the menstrual cycle. Studies suggest that migraine can be triggered by a drop in oestrogen levels such as those which naturally occur in the time just before your period. Factors such as the release of prostaglandin (a naturally occurring fatty acid that acts in a similar way to a hormone) may also be implicated at this time.

Keeping a diary

Keeping a diary for at least three months is an effective way to show if there is any link between your migraine and your periods. After three months you can review your diary to see if your migraine can be managed better and if it highlights a particular hormonal connection. You will need to take your diary to your GP so that you can discuss the best course of action to manage your migraine.

There is a specific type of migraine called ‘menstrual migraine’ – read more about it and its treatment.

25 Oct Menstrual Migraine

Posted at 18:01h in Headache Fact Sheets by headache

Although only women suffer from “hormone headache,” both men’s and women’s headaches are prompted by hormones.

You would not feel pain without them, because it is the hormones that induce the pain response. Actually, the headache may be protecting you or warning you of something more damaging in the same way that touching a hot stove alerts you to the heat and protects you from burning yourself.

The word hormone is derived from a Greek word that means to “set in motion.” Hormones initiate and regulate many of your body’s functions. For example, metabolic hormones regulate the way your body turns food into energy. Growth hormones control childhood development and maintain certain tissue structure in adults. Regulating hormones determine your femininity, masculinity and sexuality.

Hormones are manufactured and secreted by your endocrine glands, which include the pituitary, thyroid, parathyroid, thymus, adrenals, pancreas, gonads and other glandular tissues located in your intestines, kidneys, lungs, heart, and blood vessels. The endocrine system works with your nervous system to keep your body in balance within a constantly changing environment.

As they interact, your endocrine and nervous systems are responsible for the thousands of automatic responses that regulate your bodily functions. They decide, for example, whether you will respond to a potential headache trigger with an actual sensation of pain.

Menstrual Migraine

Women suffer migraines three times more frequently than men do; and, menstrual migraines affect 60 percent of these women. They occur before, during or immediately after the period, or during ovulation.

While it is not the only hormonal culprit, serotonin is the primary hormonal trigger in everyone’s headache. Some researchers believe that migraine is an inherited disorder that somehow affects the way serotonin is metabolized in the body. But, for women, it is also the way the serotonin interacts with uniquely female hormones.

Menstrual migraines are primarily caused by estrogen, the female sex hormone that specifically regulates the menstrual cycle fluctuations throughout the cycle. When the levels of estrogen and progesterone change, women will be more vulnerable to headaches. Because oral contraceptives influence estrogen levels, women on birth control pills may experience more menstrual migraines.


The menstrual migraine’s symptoms are similar to migraine without aura. It begins as a one-sided, throbbing headache accompanied by nausea, vomiting, or sensitivity to bright lights and sounds. An aura may precede the menstrual migraine.

Menstrual Syndrome (PMS) Headaches

The PMS headache occurs before your period and is associated with a variety of symptoms that distinguish it from the typical menstrual headache. The symptoms include headache pain accompanied by fatigue, acne, joint pain, decreased urination, constipation and lack of coordination. You may also experience an increase in appetite and a craving for chocolate, salt, or alcohol.

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 puts women at risk for migraine. Hormonal changes are just one of many potential trigger factors.

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

Acute Treatment

Medications that have been proven effective or that are commonly used for the acute treatment of MRM include nonsteroidal anti-inflammatory drugs (NSAIDs), dihydroergotamine (DHE), the triptans, and the combination of aspirin, acetaminophen, and caffeine (AAC). If severe attacks cannot be controlled with these medications, consider treatment with analgesics, corticosteroids, or dihydroergotamine.

Preventive Treatment

Women with very frequent and severe attacks are candidates for preventive therapy. For sufferers taking preventive medications who experience migraine attacks that break through the preventive therapy perimenstrually, the dose can be raised prior to menstruation. For sufferers not taking preventive medication, or for those with true menstrual migraine, short-term prophylaxis taken perimenstrually can be effective. Agents that have been used effectively perimenstrually for short-term prophylaxis include: naproxen sodium (or another NSAID) 550 mg twice a day; a triptan, such as frovatriptan 2.5 mg twice on the first day and then 2.5 mg daily/ naratriptan 1 mg twice a day/ sumatriptan 25 mg twice a day/ or, methylergonovine 0.2 mg twice a day; DHE either via nasal spray or injection 1 mg twice a day; and magnesium, equivalent to 500 mg twice a day.

The triptans, ergotamine, and DHE can be used at the time of menses without significant risk of developing dependence. As with the NSAIDs, these drugs will also be more effective as preventive medications if started 24 to 48 hours before the onset of the expected MRM.

Fluoxetine, especially if the headache is associated with other premenstrual dysphoric disorder (PMDD) symptoms, can be an effective headache preventive between ovulation and menses.

Hormonal Therapy

If standard preventive measures are unsuccessful, hormonal therapy may be indicated. This may involve the use of a supplemental estrogen taken perimenstrually either by mouth or in a transdermal patch. Estradiol (0.5 mg tablet twice a day, or 1 mg patch) is the preferred form of estrogen because it does not convert to the other active forms of estrogen.

For women using traditional estrogen/progesterone oral contraceptives for 21 days per month, the supplemental estrogen may be started on the last day of the pill pack. Another approach for women who take an estrogen/progesterone oral contraceptive is to take it daily – that is, without the monthly break – for 3 to 6 months. This has become accepted as a standard practice, and in Europe this approach has been used for up to a year with safety. The reduction in menstrual periods provides a method of preventive treatment.

Headache on my period

Leave a Reply

Your email address will not be published. Required fields are marked *