Managing Menstrual Migraine


If you believe migraines timed to your menstruation are simply something you need to suffer through month after month, reconsider.

” Menstrual migraine is a typical phenomenon and there are extremely helpful treatments to make this a more comfy time,” states Huma U. Sheikh, MD, a headache expert and CEO of New York Neurology Medicine.

How can I inform if it’s menstrual migraine?

If your migraine begins anywhere from 2 days prior to your duration to 3 days after, you have menstrual migraine. You can likewise get migraines at other times, like when you’re ovulating, Sheikh states.

Menstrual migraine attacks tend to be more extreme and last longer. And you’re usually more conscious light around this time than with other migraine attacks.

If there appears to be a connection in between migraine attacks and your menstruation, hormonal agents are the most likely cause. “Using a headache journal or app can be useful in identifying if there’s a clear pattern,” Sheikh states.

Why do I get a migraine throughout my duration?

It’s everything about hormonal agents. “During the course of a regular cycle, your estrogen levels increase till about day 14 of your cycle,” states Steven A. Rabin, MD, a gynecologist in Burbank, CA. That’s when you begin to ovulate and make more progesterone.

Around day 27 or 28, both hormonal agents hang back down to a typical level. “The abrupt drop of estrogen can activate a migraine headache for numerous females,” Rabin states.

What aids with menstrual migraine?

There are great deals of methods to handle and treat your menstrual migraines. These consist of mini-preventive treatment, severe treatment, and hormone treatment.

Mini-preventive treatment

You can often stop menstrual migraine attacks prior to they begin or decrease how serious they are with avoidance methods.

” This is called mini-prophylaxis or mini-prevention, or taking everyday or routine medication around the time of your menstruation,” Sheikh states.

One choice is taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or fenoprofen calcium (Nalfon) 2 times a day for 5-7 days. Do this 2-3 days prior to your duration begins and throughout.

Another alternative is estrogen supplements. You can utilize a tablet, vaginal gel, or spot prior to and throughout your duration to stop the natural estrogen dip that sets off migraine.

” We provide clients a really low dosage of plant-derived natural estradiol,” Rabin states. It can be found in the type of a prescription spot. Each month, you put the spot on your skin about 1 day prior to your migraine usually begins.

” It’s crucial to track your cycle and discover this day so you can get what I call the estrogen parachute, which avoids your estrogen levels from falling off a cliff and setting off the migraine,” Rabin states. You use it about 3-4 days, then take it off.

Other mini-prevention methods consist of taking magnesium beginning on day 15 of your cycle and taking triptan medication 2 times a day throughout your duration.

Acute treatment

If you’re in the middle of a menstrual migraine attack, you can take medication to reduce the discomfort. It’s most reliable if you take it early.

Your physician might advise a fast-acting triptan or selective serotonin receptor agonist. Many triptans are tablets. Some are readily available as injections under the skin or as nasal sprays and powder.

Options consist of:

  • Almotriptan (Axert)
  • Eletriptan (Relpax)
  • Frovatriptan (Frova)
  • Naratriptan (Amerge)
  • Rizatriptan (Maxalt)
  • Sumatriptan (Imitrex, Tosymra)
  • Zolmitriptan (Zomig)

Your medical professional may likewise recommend taking an NSAID with the triptan. Taking a multitreatment method might assist, too, Sheikh states. You take a discomfort reducer while likewise utilizing a heating pad to handle other duration signs.

CGRP (calcitonin gene-related peptide) villains are another alternative. CGRP is a particle associated with triggering migraine discomfort. CGRP villains obstruct the results of CGRP. They consist of rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy).

Continuous avoidance

If you’ve attempted other approaches and they do not work, or if your duration is irregular, your medical professional might advise constant preventive treatment.

One kind of constant avoidance is taking contraceptive pill without breaking for a regular monthly duration. Rather of taking a placebo tablet for 7 days, you keep taking active tablets. This keeps your hormonal agents from dropping and activating migraine. You can likewise do this with a vaginal ring. After you take the ring out, put a brand-new one in right now rather of waiting till your duration is over.

Your medical professional might suggest medication that modifications hormonal agent levels, like leuprolide (Lupron). Or they might recommend utilizing the most affordable possible dosage of estrogen in your hormone birth control.

Botox is a great choice, too. It’s FDA authorized for migraine and works by obstructing discomfort signals in the nerves. It can require time to work, so you might require more than one treatment. Your physician might recommend this if other preventive treatments do not work.

Neuromodulation treatments can be utilized throughout an attack or to avoid one. They send out signals to your brain and nerve system utilizing electrical or magnetic waves or heat to relax brain activity. Some are portable; others are surgically implanted.

What should I prevent?

You can handle your discomfort much better by preventing triggers or things that make you feel even worse. Attempt keeping a migraine journal to recognize triggers and level of sensitivities. Alcohol, dehydration, and tension prevail ones. Heat and light might likewise make you feel even worse.

Avoid alcohol around your duration. Attempt to consume 1.5-2 liters of water every day. If you have light level of sensitivity or heat level of sensitivity, attempt remaining in a cool, dark space.

Can way of life options assist menstrual migraine?

” Regular workout and a healthy diet plan have actually been revealed to minimize total menstrual signs and can assist with migraine attacks,” Sheikh states. A great, constant sleep schedule can likewise assist. Attempt restricting coffee and energy beverages if they trigger issues with your sleep.

Learn to handle tension much better. Attempt relaxation strategies. “Yoga and mindfulness can be an actually practical tool to assist control your hormonal agents and make this time much easier,” Sheikh states.

Which menstrual migraine treatment is ideal for me?

Your physician can assist you choose which choices are best for you. It might be a mix of methods, consisting of mini-prevention, severe treatment, and way of life modifications. Or they might advise constant contraception.

” You have numerous beneficial alternatives and the majority of them are safe,” Sheikh states. Everybody’s various and it depends on lots of elements. “It’s crucial to take a specific method,” she states.

Photo Credit: Stockbyte/ Getty Images


Steven A. Rabin, MD, gynecologist, Burbank, CA.

Huma U Sheikh, MD, New York Neurology Medicine.

American Migraine Foundation: “Menstrual Migraine Treatment,” “Botox for Migraine,” “Neuromodulation for migraine treatment: An introduction,” “ORAL AND INTRANASAL TRIPTANS FOR MIGRAINE.”

Cleveland Clinic: “Menstrual Migraines (Hormone Headaches).”

Johns Hopkins Medicine: “Headaches and Women: What Do Hormones Have to Do With It?”

American Migraine Foundation.

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