Migraine is characterized by throbbing pain that typically affects one side of the head, often accompanied by nausea, mood swings, and visual disturbances triggered by movement, light, smells, and sound (acute sensitivity).
Menstrual migraines are one type of migraine that tends to strike about 2-3 days before the start of your period, often due to hormonal changes. Here are 7 ways to prevent or treat menstrual migraines.
7 ways to stop menstrual migraines
1. Nonsteroidal anti-inflammatory drugs
Acetaminophen, ibuprofen, and naproxen can help prevent menstrual migraines or make them less severe. Take them twice a day, starting 2-3 days before your period begins and then for another 3-5 days after it starts.
Triptans help prevent menstrual migraines if administered 2 days before your period and continued for 6-7 days after your period. They can be used as oral, injectable, and nasal sprays. Side effects include nausea, dizziness, a stuffy nose, cramps, and rebound headaches when overused.
- Axert (almotriptan)
- Relpax (eletriptan)
- Frova (frovatriptan)
- Amerge (naratriptan)
- Maxalt (rizatriptan)
- Imitrex (sumatriptan)
- Zomig (zolmitriptan)
3. Calcitonin gene-related peptide receptor antagonists
- Ubrelvy (ubrogepant)
- Nurtec ODT (rimegepant)
4. Estrogen pills, gels, or patches
A steady dose of estrogen throughout the menstrual cycle may prevent the dip in estrogen levels that acts as a triggering factor.
5. Magnesium supplements
Some studies have linked the onset of a migraine to low levels of magnesium.
Magnesium supplementation is typically started on the day 15 of the menstrual cycle until the start of your period. It is a versatile and safe intervention for women without regular cycles because it is not necessary to have regular cycles to time this prevention.
6. Preventive drugs
Preventive drugs used to stop menstrual migraines before they start include the following:
- Tricyclic antidepressants
- Ant-iseizure medications
- Beta-blockers (propranolol) and calcium channel blockers (verapamil)
- CGPR monoclonal antibodies
- Aimovig (erenumab-aooe)
- Ajovy (Fremanezumab-vfrm)
- Emgality (Galcanezumab-gnlm)
- Vyepti (Eptinezumab-jjmr)
- Keep a diary tracking your symptoms for at least 3 months, recording both migraine attacks and menstrual cycles
- Try to get 7-8 hours of sleep every night
- Minimize stress and practice relaxation techniques such as yoga and meditation
- Eat several small meals throughout the day to avoid getting too hungry
- Avoid triggering foods such as caffeine, alcohol, and processed foods
- Exercise on regular basis
What causes menstrual migraines?
According to the American Migraine Foundation, 1 in every 5 women experience migraine. Nearly 2 out of every 3 women with migraine get attacks that coincide with their periods.
Menstrual migraine is caused by several factors. One is fluctuations in hormone levels, especially estrogen, which affects the gray matter of the brain, blood vessels in the central nervous system, and the central pain pathways (midbrain), which during their lifetime can bring on new migraine symptoms and changes in symptom severity. The role of estrogen in menstrual migraine involves the following mechanisms:
- Estrogen deficiency leads to abnormal neural impulses in the midbrain (brainstem) due to disturbed physiology of the trigeminal nerve, which supplies the structures of the face and neck and innervates the blood vessels of the brain.
- In the midbrain, the abnormal neuronal firing causes a massive release of vascular inflammatory substances, such as calcitonin gene-related peptide, cytokines, and prostaglandins, which causes hyperalgesia (increased sensitivity to painful stimuli) and allodynia (pain produced by normally non-noxious stimulation) at the level of pain receptors in the body.
- Over time, the trigeminal nerve becomes increasingly sensitive to the estrogen fluctuations and inflammatory markers, causing the migraine attack to recur.
- Moreover, estrogen alters neurotransmitters, such as serotonin and dopamine levels, in the brain, which are responsible for mood and pain perception.
- Estrogen deficiency triggers depressed mood, minute changes in blood vessel caliber, and an increase in sensitivity to nociceptive responses to the peripheral and central stimuli, thus lowering the pain threshold.
What are signs and symptoms of menstrual migraines?
Warning signs of an impending migraine may include:
- Increased urination
- Food cravings
- Mood changes
- Frequent yawning
- Sensitivity to light or sound
- Blurred vision
- Flashes of light or zigzag shapes
- Numbness or tingling
During a menstrual migraine, you may experience the following symptoms:
- Throbbing or pulsating headache (mostly one-sided, shifting from one side of the head to the other or affecting the front or back of the head)
- Numbness and tingling
- Difficulty speaking
- Sensitivity to light, noise, and smell
- Visual disturbances
- Blurred vision
- Upset stomach
- Abdominal pain
- Decreased or loss of appetite
- Pale skin
- Neck stiffness
- Dizziness or lightheadedness
- Feeling warm (increased sweating) or cold (chills)
Watson S. How to Prevent Migraines During Your Period. WebMD. https://www.webmd.com/migraines-headaches/prevent-menstrual-migraines
American Migraine Foundation. Hormonal and Menstrual Migraine: Symptoms and Treatment. https://americanmigrainefoundation.org/resource-library/hormonal-menstrual-migraine/
American Headache Society. Migraine and Contraceptives. https://americanheadachesociety.org/news/migraine-contraceptives/
The Migraine Trust. Menstrual migraine. https://migrainetrust.org/understand-migraine/types-of-migraine/menstrual-migraine/
Top How Can I Stop Menstrual Migraines Related Articles
aspirinAspirin (Aspirin, Arthritis Foundation Safety Coated Aspirin, Bayer Aspirin, Bayer Children's Aspirin, Ecotrin, and many others) is a NSAID used to treat fever, pain, and inflammation in the body that results from forms of arthritis, and soft tissue injuries. Aspirin is also used for decreasing the risk of heart attacks and strokes. Side effects, drug interactions, pregnancy information, and pregnancy safety information should be reviewed prior to taking any medication.
black cohoshBlack cohosh is an herbal remedy used to relieve menopausal symptoms, treat menstrual irregularities, induce labor, and treat other conditions including cough, fever, rheumatoid arthritis, and musculoskeletal pain. Common side effects of black cohosh include nausea, vomiting, gastrointestinal upset, weight gain, feeling of heaviness, abdominal pain, diarrhea, shortness of breath, slow heart rate (bradycardia), central nervous system (CNS) disturbances, headache, dizziness, rash, sweating, cramping, joint pains, tremors, and visual disturbances. Black cohosh may cause uterine contractions and lead to miscarriage or premature labor. Do not take if pregnant or breastfeeding.
feverfewFeverfew is a medicinal plant traditionally used to prevent migraine headaches, and in the treatment of fevers, rheumatoid arthritis, skin disorders, and other conditions. Common side effects of feverfew include allergic reaction, mouth ulcers, loss of taste, swelling of lips/tongue/mouth, nausea, vomiting, abdominal pain, indigestion, heartburn, gas (flatulence) and bloating, diarrhea, and menstrual changes. Do not use feverfew if pregnant or breastfeeding, or have ragweed allergies.
Migraine TriggersDo you have frequent headaches? Learn the most common headache triggers for tension headaches, sinus headaches, cluster headaches and migraine. They include red wine, skipping meals, and smoke. Find medical treatments that work, like diet, exercise, massage, and physical therapy.
horseweedHorseweed, or Conyza canadensis, is a flowering weed native to North America, but is now found all over the world. Horseweed has been traditionally used to treat diarrhea, bladder problems, menstrual irregularities, and other ailments, however, there are no scientific studies to support any of its uses. Other suggested uses include dysentery, internal hemorrhage, hemorrhoids, nosebleeds, fevers, cough, and bronchitis. Common side effects of horseweed include contact dermatitis. Consult your doctor before taking horseweed if pregnant or breastfeeding.
How Do You Get Rid of a Migraine Fast?Migraine is a neurological condition that is characterized by recurrent episodes of intense headaches. It may be associated with symptoms such as nausea, vomiting, and other clinical features.
How Many Migraines a Month Is Normal?Migraines of any frequency are not normal. Most people experience migraine episodes 2-4 times a month while others may only have 1-2 episodes a year.
l-tryptophanL-tryptophan supplements are used as an adjunct to antidepressant therapy to treat depressive disorders. L-tryptophan supplements are also used for many other conditions including anxiety, insomnia, teeth grinding (bruxism), premenstrual syndrome symptoms, and migraine headaches. Common side effects of l-tryptophan include nausea, dry mouth (xerostomia), loss of appetite (anorexia), vomiting, stomach pain, diarrhea, rash, hives (urticaria), itching (pruritus), swelling (edema), muscle pain (myalgia), wheezing, dizziness, drowsiness, headache, blurry vision, serotonin syndrome, and sexual disinhibition. Do not take if pregnant or breastfeeding.
Migraine HeadacheMigraine headache is a type of headache associated with a sensitivity to light, smells, or sounds, eye pain, severe pounding on one side of the head, and sometimes nausea and vomiting. The exact cause of migraine headaches is not known. Triggers for migraine headaches include certain foods, stress, hormonal changes, strong stimuli (loud noises), and oversleeping. Treatment guidelines for migraines include medicine, pain management, diet changes, avoiding foods that trigger migraines, staying hydrated, getting adequate sleep, and exercising regularly. Prevention of migraine triggers include getting regular exercise, drinking water daily, reducing stress, and avoiding trigger foods.
Migraine HeadachesIs it a headache or a migraine? Learn what a migraine is, causes, symptoms, treatments, and at-home remedies.
Top Self-Care Techniques for MigraineA migraine can be more than just a whopping headache. Try these self-care tips for relief before and after it hits.
Migraine vs. Headache: Differences and SimilaritiesHeadaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine.
Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain.
Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure.
Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
Migraines and Headaches: Remedies That Can Either Help or Hurt a MigraineWhich home remedies are good or bad for migraine headaches? Some can go either way. Learn more about getting migraine relief at home.
butalbital/acetaminophen/caffeineButalbital/acetaminophen/caffeine is a combination medication prescribed to treat headaches. Butalbital is a narcotic that depresses the central nervous system. Acetaminophen is a pain reliever and fever reducer. Caffeine has pain relieving properties and may boost the action of other pain relievers. Side effects of butalbital/acetaminophen/caffeine are lightheadedness, dizziness, shortness of breath, nausea, dry mouth, increase heart rate, and tremors. Tolerance, dependence, and physical dependence may occur after prolonged periods of use of barbiturates (butalbital). Consult your doctor if pregnant or breastfeeding.
tizanidineTizanidine is a medication used in the management of muscle spasticity, a condition with high muscle tone and stiffness that leads to pain and impaired mobility. Tizanidine is used to treat chronic neck and/or lower back pain, chronic migraine headaches, rebound headaches, regional musculoskeletal pain syndromes, and refractory insomnia in spastic quadriplegic patients. Common side effects of tizanidine include drowsiness (somnolence), dry mouth (xerostomia), weakness or/and fatigue (asthenia), dizziness, slow heart rate (bradycardia), low blood pressure (hypotension), urinary tract infection, infections, constipation, liver injury, and elevated liver enzymes.
What Are the First Signs of a Migraine?The first sign of a migraine is severe eye pain associated with a dull headache. Migraines gradually worsen with physical activity.
What Foods Cause Headaches and Migraines?Foods that can trigger and cause headaches and migraines include chocolate, alcohol, cheese and more. Learn how to adjust your diet to avoid headaches.
What Is the Best Cure for Migraine?The best cure for migraine involves preventive medications and lifestyle changes. Some newer medications and therapies are effective in controlling the symptoms of migraine. Avoiding or controlling triggers may provide considerable benefit. Migraine can be prevented mainly by using medications, avoiding triggers and implementing lifestyle changes.
What Is the Best Thing to Do for a Migraine?There is no permanent cure for migraine headaches, but there are migraine treatments that can prevent attacks and relieve symptoms. When you get migraines, you can ease the pain immediately by simple measures such as resting with your eyes closed in a dark, quiet room, putting an ice pack on your forehead, and staying hydrated by drinking plenty of liquids.
What Is the Most Common Type of Migraine?The most common type of migraine is migraine without aura (common migraine). 70-90% of people with migraine experience this type. The frequency of this type of migraine may range from once a year to several times per week.