Menstrual Migraines


According to the National Headache Foundation, women suffer migraines three times more frequently than their male counterparts, and menstrual migraines affect 60% of the women who experience migraine headaches. A menstrual migraine is a severe headache that occurs before, during or immediately after a woman’s menstrual period, or during ovulation. It is brought on by fluctuating hormone levels in the body.

The hormone Serotonin is the primary hormonal trigger in migraine headaches for men and women alike. However, for women, the way that Serotonin interacts with other female hormones in the body is what causes menstrual migraines. Menstrual migraines are primarily caused by the hormone Estrogen. Estrogen is the female sex organ that specifically regulates the menstrual cycle. When the levels of Estrogen and Progesterone change, women are are more vulnerable to headaches.

The symptoms of a menstrual migraine are the same as a regular migraine, without the aura.  Most menstrual migraines begin with a one-sided throbbing headache and may be accompanied by nausea, vomiting or sensitivity to bright sounds and lights.  Individuals may experience aura directly preceding the migraine.

The treatments available to deal with menstrual migraines are very similar to the ones used to treat regular migraine headaches. There are basically two types of treatments that can be used: acute treatment and preventative treatment. Acute treatment is used at the onset of the headache to deal with the current symptoms. Acute treatments include NSAIDS, dihydroergotamine (DHE), the triptans, and the combination of acetaminophen, aspirin and caffeine. Preventative treatment is used for women who experience frequent and particularly severe menstrual migraine headaches. In this case, Naproxen Sodium, the triptans or DHE can be taken daily immediately before the menstrual cycle begins.

If preventative treatments fail to provide relief for menstrual migraines, hormone therapy may be considered. This may involve the use of a supplemental estrogen taken perimenstrually either by mouth or in a transdermal patch. Estradiol (0.5 mg tablet twice a day, or 1 mg patch) is the preferred form of estrogen because it does not convert to the other active forms of estrogen.

If you experience migraines around the time of your menstrual cycle, you may be suffering from menstrual migraines. Talk to your OBGYN today about the lifestyle changes and other treatments that can be used to help you find relief.