If you often have migraine attacks during your period, you may have menstrual migraine. This cycle-driven migraine is likely related to hormone changes. Fortunately, there are ways to get relief and manage menstrual migraine long-term. Read on to learn how.
Do you often get migraine attacks around the time of your period? If the answer is yes, your attacks could be connected to your menstrual cycle.
Menstrual migraine is a type of migraine that’s ruled by your cycle. People with this type of migraine consistently experience migraine attacks around their period.
Here’s your guide to menstrual migraine, including what it is, symptoms and causes, and how to get relief.
What is menstrual migraine? Menstrual migraine is a type of migraine that’s related to the menstrual cycle. Doctors categorize it into two types: pure menstrual migraine and menstrually-related migraine.
People with pure menstrual migraine regularly experience migraine attacks that occur around their period only: from the two days before menstruation, up to the third day of menstruation.
People with menstrually-related migraine regularly experience attacks around their period and at other moments. This type is more common . Attacks tend to ramp up in frequency and severity around your period, but they may also occur no matter where you are in your cycle.
Around 4% to 8% of all people who menstruate are thought to have menstrual migraine, but that estimate may be low due to diagnostic errors. Among people with migraine, some data reports that 70% notice an association between their attacks and their cycle!
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Symptoms of menstrual migraine When you have menstrual migraine, you experience migraine attacks. During a menstrual migraine attack, you may have symptoms like:
Headache pain Sensitivity to light (phonophobia) Sensitivity to sound (photophobia) Sensitivity to smell (osmophobia) Nausea Vomiting Digestion issues Visual aura (temporary disturbances in your vision, like bright spots or shimmering lines) Fatigue Brain fog Difficulty concentrating Menstrual migraine symptoms can vary from one attack to the next. You may experience many symptoms at once, or just a few.
Contrary to popular belief, migraine attacks don’t necessarily cause head pain. So if you’re experiencing other menstrual migraine symptoms, you might be having an attack—even if you don’t have a headache.
What causes menstrual migraine? Menstrual migraine is connected to your cycle, so you may be able to guess what causes this type of migraine. Here’s a hint: what else is connected to your cycle?
If you guessed hormones, you’re right. Hormone fluctuations regulate your cycle, and while these are totally normal, they can also cause physical effects—including menstrual migraine.
Decades of research point to the reproductive hormone estrogen , specifically. Estrogen levels drop steeply right before your period, and this dramatic decrease is thought to trigger menstrual migraine attacks.
Doctors are still working to understand why. The reason could be related to the brain chemical serotonin and the amino acid CGRP (calcitonin gene-related peptide). Low estrogen causes serotonin levels to decrease, which then leads to an increase in CGRP. In turn, fluctuating serotonin levels and high CGRP levels may be involved in triggering migraine.
Does menstrual migraine change throughout your life? As estrogen levels change across life stages, menstrual migraine can also change:
During pregnancy : You may experience fewer attacks, as estrogen is high during pregnancy.During perimenopause migraine may get worse , as estrogen fluctuates and declines unpredictably.After menopause How to get relief from menstrual migraine As you may know only too well, menstrual migraine can be one of the worst types of migraine. Menstrual migraine attacks tend to be more painful, longer, and harder to treat compared to other types.
When you’re in the middle of an unbearable attack, feeling better may seem impossible, but there is help.
Multiple effective treatments exist to give you immediate relief from symptoms and manage menstrual migraine long-term. Talk to your doctor to start building a treatment plan tailored to your needs.
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How to get relief during a menstrual migraine attack If you’re having a menstrual migraine attack, try to rest in a dark, quiet place while you ride out your symptoms. Hydrate and eat as your body allows.
You can also take medication for symptom relief. This is called “acute” treatment.
Menstrual migraine acute treatments include over-the-counter and prescription medications, such as:
Pain relievers, like aspirin or ibuprofen Anti-nausea medication Triptans CGRP inhibitors Transcutaneous electrical nerve stimulation (TENS) devices may also help. TENS devices send mild electrical pulses through the skin, targeting specific nerves to ease migraine pain.
Home remedies may offer menstrual migraine relief, too, including:
Gentle massage Cold compresses, ice packs Hot compresses, heating pads, hot water bottles Ginger tea for nausea Aromatherapy and essential oils How to manage menstrual migraine Treating menstrual migraine frequently goes beyond easing symptoms during an attack—it’s also important to manage migraine long-term. Long-term management is called “preventive” treatment.
Your doctor may prescribe typical migraine medication for preventive treatment, like:
CGRP inhibitors Beta-blockers Anticonvulsants Certain antidepressants Preventive treatments specifically tailored to menstrual migraine include:
Mini-prevention method : Taking daily medication beginning a few days before your period and up to the end of your period may help lower the risk of migraine attacks. It’s important to try this method under your doctor’s supervision—self-medicating isn’t safe.Hormonal birth control or other hormone treatment : Stabilizing estrogen levels can regulate hormone fluctuations, which may help manage menstrual migraine. Options include hormonal birth control, hormone replacement therapy (HRT) , and estrogen HRT . For some people, though, hormone treatment may worsen migraine.Acupuncture may also be an effective preventive treatment for managing menstrual migraine.
Lifestyle strategies for menstrual migraine In your day-to-day-life, you can also try adopting migraine-supportive strategies and dietary measures.
Try to:
Keep a regular sleep schedule Exercise regularly Eat regular meals Hydrate Avoid your migraine triggers (common triggers include stress, alcohol, and caffeine) Since menstrual migraine is related to your cycle, you may find it useful to monitor your cycle by tracking your hormones.
At-home hormone tests like the Oova kit allow you to monitor estrogen and other hormones , then easily share that data with your doctor, helping you understand how your cycle influences menstrual migraine. You can also use the app’s daily note space as a menstrual migraine journal, so you can keep track of factors like attack triggers, symptoms, duration, and cycle days.
Menstrual migraine: The bottom line Menstrual migraine is ruled by your menstrual cycle, and thought to be caused by the drop in estrogen that occurs right before your period starts.
During an attack, try resting in a dark and quiet place, taking acute medication as needed, and using home remedies to get relief from menstrual migraine symptoms. To manage menstrual migraine long-term, options include migraine medication and hormonal contraception.
Talk to your doctor about building your migraine treatment plan. With help, you can manage menstrual migraine and find relief.
