Migraine strikes more women than men.  Women suffer from migraine three times as often as men. 1 This is because of the difference in hormonal make-up between men and women. More than 50% of the women who suffer from migraine report an association between their migraine and their monthly cycle. 2This type of migraine that has a direct correlation to the woman’s menstrual cycle is called as menstrual migraine.

What causes menstrual migraine

Women are on a hormonal roller coaster ride most of their lives with continuous ups and downs in hormonal levels. The hormones estrogen and progesterone play important roles in regulating the menstrual cycle. When the monthly cycle is due there is a dip in the levels of estrogen and progesterone.  The reduction of estrogen triggers a burst of electrical activity in the brain which cascades to a pounding headache.

When does it occur

In most women, the peak incidence of migraine during the menstrual cycle occurs on the days directly before and after the first day of menstruation. 2

What are the symptoms of a menstrual migraine

How to predict that the migraine is a menstrual migraine

The best way to diagnose that your migraine is a menstrual one is by keeping a record in a migraine diary for 6-8 months of your menstruation dates and of your migraine attacks and discussing these with your doctor. If you get a migraine attack around your menses every time or even most of the times, it might be a menstrual migraine.

Fewer than 10–20% of women report migraine exclusively with menstruation and at no other time of the month. 3

The relationship between migraine and PMS

Some women experience a variety of psychological and physical symptoms some days before menstruation, this is referred to as premenstrual syndrome or PMS. One of these symptoms may be a throbbing migraine. 4

Effect on quality of life

Many women report that menstrual migraines are more severe than regular bouts of migraine. Women may experience a gamut of negative emotions like guilt, anxiety and  depression due to migraines.

These excruciating menstrual headaches can disrupt their routine and hinder their quality of life. The pain of a menstrual migraine can be disabling and make them miss out on work commitments and family outings. If this happens every month, it can cause cracks in their relationships too.

How to prevent menstrual migraine (Part 2)

Since the cause behind menstrual migraines is hormonal, it might be difficult to avoid them. Some doctors recommend pills with low levels of estrogen some days before the period.


Menstrual migraine treatment 5, 6

The advice of a pain specialist can give you menstrual migraine relief to help deal with menstrual migraine symptoms.

Some menstrual migraine medication can also reduce the pain and length of a migraine. Others can cut down the frequency of attacks. But unfortunately, there is no migraine cure.

Only a neurologist can rightly determine which menstrual migraine medication regimen best suits you depending upon several factors like the regularity of your menstrual cycle, whether you have regular, heavy or painful periods.

Alternate ways to manage your menstrual migraine

Many women have found that acupuncture can give menstrual migraine relief. Since stress has a vital role to play in increasing hormonal headaches, stress management with proven methods like yoga, meditation and deep breathing can also help.

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  2. Ther Adv Neurol Disord. 2009 Sep; 2(5): 327–336.
  3. Current Pain and Headache Reports, December 2008, Volume 12, Issue 6, pp 468–474
  4. Neurol Sci. 2012 May;33 Suppl 1:S111-5. doi: 10.1007/s10072-012-1054-5.
  5. Headache. 2017 Feb;57(2):194-208.
  6. Neuropsychiatr Dis Treat. 2006 Sep; 2(3): 281–291.
  7. Rev Obstet Gynecol. 2010 Spring; 3(2): 55–65.
  8. Trials. 2013; 14: 374.

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