What Causes Menstrual Migraines?

Migraines During Your Period
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For women during that “time-of-the-month,” the stomach cramps, food cravings, irritability, and fatigue associated with a monthly period can be a major lifestyle setback. Add a migraine to this mix, and you have a recipe for a day in bed. The good news is we have a better understanding of what causes menstrual migraines and what you can do to treat them.

What Causes Menstrual Migraines?

The majority of migraine sufferers are female, and of this group, about 20  to 30 percent have attacks triggered by the menstrual cycle, according to a 2010 article in Current Pain and Headache Reports.

Researchers have found a strong connection between estrogen hormones and migraine headaches, which is why women tend to be more impacted by migraines than men.

Typically, higher estrogen levels will prevent migraine headaches, whereas lower estrogen levels will result in a migraine headache. Because a woman’s estrogen levels are lowest when she is menstruating, its usually the time that migraine headaches are most likely to occur. It's also important to note that fluctuating estrogen levels can cause migraines. In addition, every woman reacts differently to hormones, so a woman may have hormone-related migraines, even when she does not have her period.

Migraines and Menopause

In addition to the menstrual cycle, there are other times in a woman’s lifetime when her hormone levels change drastically, and can impact hormone-related migraines. Many women find that their migraines are greatly reduced or even disappear during pregnancy due to steady levels of estrogen.

It’s thought that this may “protect” the brain against migraines. A dip in estrogen levels after the birth of the baby can trigger migraines once again.

Perimenopause and menopause also impact hormone levels. During this time, the body’s hormones levels tend to rise and drop dramatically, and this fluctuation can trigger migraine headaches.

Many women notice their migraines disappear when they enter menopause and no longer get their period.

It's also important to note that some women take hormone therapy to treat symptoms of menopause —this can also result in an increase or decrease of migraine headaches, depending on how the woman’s body responds to the hormones taken.

How Can I Prevent a Menstrual Migraine?

Because menstrual migraines are caused by lower hormone levels, taking birth control pills that maintain the body’s hormone levels may help ease a woman’s menstrual migraines. Birth control pills that give a woman a menstrual period seasonally may reduce menstrual migraines by eliminating the woman’s period and thus the associated migraines.

It's important to keep in mind that every woman’s body responds to hormones differently, so a woman may need to try a few different birth control methods before finding one that reduces or eliminates her menstrual migraines. Some physicians advise using birth control with fewer placebo days, using estrogen birth control patches during the placebo week, or using progestin only birth control to prevent menstrual migraines.

Women can also take a preventive migraine medication a few days before her period and during the first few days of her period.

Learning to recognize other migraine triggers, such as stress, lack of sleep, or irregular eating, can also help to prevent menstrual migraines.

How Is the Pain From Menstrual Migraines Treated?

Menstrual migraines are treated in the same way as typical migraines. This includes using a pain reliever, such as acetaminophen or ibuprofen. Your doctor may prescribe you a migraine medicine if over the counter pain relievers are not effective, like a triptan. Other care methods that may work to relieve the pain include massage, application of ice, and resting in a dark, quiet room. Consult with a neurologist for treatment methods that might work best for you.

Article edited by Dr. Colleen Doherty on September 8th 2015.


MacGregor EA. Prevention and treatment of menstrual migraine. Drugs. 2010 Oct 1;70(14):1799-818.

Russell MB. Genetics of menstrual migraine: the epidemiological evidence. Curr Pain Headache Rep. 2010 Oct;14(5):385-8.

DISCLAIMER: The information in this site is for informational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for advice, diagnosis, and treatment of any concerning symptoms or medical condition.

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