What is Menstrual Migraine?

July 18, 2016

menstrual migraine

While it’s common knowledge that many women suffer from abdominal cramping, mood dysphoria and appetite changes during the time before and during their periods, menstrual migraine is a lesser-known side effect of menstruation. Migraine is already a crippling event for a sufferer – but add period cramps, bleeding and mood changes, and you’ve created the perfect storm of symptoms that can cause absolute, utter misery.

Women suffer from migraines up to three times more frequently than men do and as many as two-thirds of women who suffer from migraines say that their migraines consistently occur before or during their periods. Some women can even pinpoint the moment that their migraines began happening – a time that coincides with puberty. And unfortunately menstrual migraine is worse for many women that migraines that occur at other times of the month – the pain is more severe, more disabling, lasts longer and is less likely to respond to treatment.

How Do I Know If I Have Menstrual Migraine?

The American Headache Foundation classifies a menstrual migraine as a migraine that has an onset two days before to three days after the onset of menstruation. This pattern must occur during two out of three menstrual cycles in order to be classified as menstrual migraines. Women on birth control pills may be more likely to experience menstrual migraine due to the increased fluctuation in hormones like estrogen and progesterone.

Symptoms of a menstrual migraine are similar to a migraine without aura. It may start with pounding and throbbing on one side of the skull and be followed by nausea and vomiting. It is also common to experience sensitivity to light and sound. Most women experience menstrual migraine without aura, but an aura is possible.

Menstrual Migraine Treatment

Menstrual migraines are most likely triggered by a drop in a type of estrogen called estradiol that happens during the menstrual cycle. Many women find that NSAIDs are their best friend during their menstrual cycle. Medications like Aleve and Advil work to reduce the inflammation that causes both migraine and painful periods, offering a two-in-one benefit. However, many women experience menstrual migraine pain so severe that over the counter medications just won’t work.

Because of this association between hormones and migraine, hormone therapy may work as an option for treatment in women with menstrual migraine when standard treatments like NSAIDs or triptans have failed. Hormonal treatment is usually offered in the form of a pill or patch to replace estrogen normally lost during your period. Keeping a symptom diary for several months may be helpful in determining how your migraines are affected by hormones so that you can receive the most effective treatment for your menstrual migraines.


  1. MacGregor, E. A. (2009). Menstrual Migraine: Therapeutic Approaches.Therapeutic Advances in Neurological Disorders2(5), 327–336. http://doi.org/10.1177/1756285609335537
  2. The Migraine Trust. (2014). Menstruation and migraine. Retrieved from http://www.migrainetrust.org/factsheet-menstruation-and-migraine-10883






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