For some people, the pre-period drop in estrogen can cause period migraine attacks. If this is the case for you, talk to your doctor about how to get relief from period migraine.
If you often have a migraine attack right around your period, it’s likely no coincidence.
Monthly migraine attacks that align with your cycle are a diagnosable type of migraine called menstrual migraine, or period migraine. While researchers are still figuring out what exactly causes period migraine, hormones seem to be the culprit.
Here, we’ll cover what period migraine is, symptoms, what causes period migraine, and how to get relief.
What is period migraine? Period migraine, or menstrual migraine, is related to your period.
Clinically speaking, period migraine can be either:
Pure menstrual migraine: Migraine attacks that begin two days before your period starts up to the third day of your period.Menstrually-related migraine : Migraine attacks that occur in the pure menstrual migraine timeframe, or at other moments in your menstrual cycle. Practically speaking, this means that if you have period migraine, you generally experience migraine attacks around your period—but it’s also possible to experience attacks throughout your cycle.
Compared to other types of migraine, period migraine attacks tend to be more severe, last longer, and be harder to treat.
It’s estimated that around 4% to 8% of all menstruating people have period migraine. Among those with migraine, 20% to 25% have period migraine. As this 2023 study notes, however, current diagnostic criteria often misses or misdiagnoses period migraine. That means that more people may have period migraine than we realize.
Symptoms of period migraine While period migraine is already a symptom, you may experience other symptoms during migraine like:
Headache pain Nausea Vomiting Sensitivity to light (phonophobia) Sensitivity to sound (photophobia) Sensitivity to smell (osmophobia) Visual aura, or temporary disturbances in your vision like bright spots or jagged shimmery lines Fatigue Difficulty concentrating You may experience some or all of these symptoms of period migraine. Symptoms can also change from one period migraine episode to the next.
What causes period migraine? Period migraine is caused by hormones.
More specifically, the reproductive hormone estrogen appears to be the culprit. Decades of research have linked estrogen to migraine, and estrogen appears to affect migraine the most out of all headache types.
How, exactly, is estrogen linked to period migraine? It has to do with estrogen fluctuations. Estrogen levels fluctuate throughout the menstrual cycle, and these changes can trigger migraine attacks.
Fluctuations around your period are particularly significant. Estrogen drops dramatically just before your period, then stays at its lowest level throughout your period. This drop in estrogen is precisely what’s believed to cause period migraine.
There are a couple theories as to why the pre-period estrogen drop causes period migraine:
Low estrogen leads to a decrease in levels of the neurotransmitter serotonin . Serotonin is related to pain perception, and changes in serotonin levels are believed to contribute to migraine. Low estrogen and low serotonin lead to high levels of the amino acid CGRP (calcitonin gene-related peptide) . CGRP regulates blood vessel dilation, and high CGRP is also thought to be involved in triggering migraine. Period migraine may improve during pregnancy, leading to fewer attacks. This is thought to be related to the high estrogen levels that occur with pregnancy. After pregnancy, though, period migraine attacks may return more quickly than other migraine types.
Period migraine may worsen during perimenopause , when estrogen fluctuations become more frequent and more unpredictable.
How to get relief from period migraine If you’re experiencing a period migraine attack, make sure to go slow, stay hydrated, and eat as your body allows. When possible, try to rest or sleep in a dark room while you ride out the attack.
Various medications, home remedies, and lifestyle treatment strategies can help you get relief from period migraine during an attack and manage period migraine long-term.
Whatever period migraine treatment you try, be sure to keep your doctor informed about side effects, new or worsening migraine symptoms, and any changes in period migraine frequency and/or severity.
Acute medication When you take medication to ease symptoms while you’re having a migraine attack, it’s called “acute” treatment.
These over-the-counter and prescription medications are just some of the acute treatment options to help you get relief during a period migraine attack:
Triptans Anti-nausea medication CGRP inhibitors Pain relievers, like aspirin or ibuprofen Transcutaneous electrical nerve stimulation (TENS) may also help. TENS devices send mild electrical currents through the skin to stimulate particular nerves and ease migraine pain.
Preventive medication You may need to treat period migraine outside of attacks, too.
When you take medication on a regular basis for long-term management of period migraine, it’s called “preventive” treatment.
Preventive treatment for period migraine includes these prescription medications:
CGRP inhibitors Beta-blockers Anticonvulsants Certain antidepressants Since period migraine is caused by hormones, managing hormone changes may also offer relief.
Combined estrogen-progestogen hormonal birth control, hormone replacement therapy (HRT) , and estrogen HRT may all help stabilize estrogen fluctuations to ease period migraine. For some people, though, hormone treatment may worsen migraine. If you have period migraine with aura, experts recommend avoiding hormone treatment due to a higher risk of stroke.
If you have regular cycles, the mini-prevention method may also help manage period migraine. With this method, you take daily medication starting a couple days before your period through to the end of your period, to lower the risk of an attack. Don’t try this on your own, though—always take prescription medication according to your doctor’s instructions.
Home remedies for period migraine Medication isn’t the only way to get relief from period migraine.
Home remedies may help ease period migraine symptoms, too, such as:
Cold compresses or ice packs Hot compresses, heating pads, or hot water bottles Gentle massage Ginger tea Aromatherapy and essential oils Acupuncture and acupressure treatment may also be helpful for migraine treatment.
Lifestyle strategies for period migraine Incorporating period migraine-supportive lifestyle and dietary strategies may also help you manage period migraine long-term.
As much as you’re able, try to:
Get good sleep, on a regular sleep schedule Exercise regularly Eat meals regularly Avoid your migraine triggers (common triggers include stress, alcohol, caffeine, or processed foods) Consider keeping a period migraine journal to keep track of things like triggers, symptoms, duration, and which cycle days you have attacks. This information can help you and your doctor build and adapt your treatment plan.
At-home hormone tests like the Oova kit and app can also help you monitor changes to estrogen and other hormones during your cycle, and easily share that data with your healthcare provider. The app can record your hormone changes and gives a space for daily notes. From there, you can see how these changes align with period migraine attacks and symptoms.
Period migraine: The bottom line Period migraine is a type of migraine that happens around the time of your period. Symptoms include headache pain, nausea, vomiting, and difficulty concentrating.
Period migraine is thought to be caused by the drop in estrogen levels that occurs before your period.
If you’re experiencing a period migraine attack, rest quietly, go slowly, and hydrate. For relief, try taking acute migraine medications and using home remedies as needed. Options for long-term management include typical migraine medications and hormonal birth control.
Remember that you’re not alone with period migraine. Lean on your support network for help and talk to your doctor about what treatment options may be right for you, so you can get relief.
