Breaking the Cycle: Easing Menstrual Migraine Pain

What do migraine headaches and menstrual cycles have in common? They both show up uninvited and can greatly disrupt a good time. Some women brace for more than mood swings and minor cramps as their monthly period rolls around. The sudden onset of throbbing head pain triggered a few days before or during a menstrual cycle can feel like a strike from Thor’s hammer! 

Experiencing the agony of migraines can get in the way of daily routines and quality of life for anyone. Even a superhero would likely need to withdraw to a dark, quiet place to rest and potentially take medication until it subsides. Changes in hormone levels can intensify migraine attacks, but effective treatments and ongoing research are leading to options for the relief of this severe and difficult-to-treat condition. 

What is Menstrual Migraine?

Migraines that hit a few days before or after your period starts are likely caused by a natural rapid drop in estrogen levels that occur with a menstrual cycle.

The symptoms of menstrual migraines are similar to other types of migraines but may feel much more severe; they include: 

• Throbbing or pulsing head pain, often on one side
• Nausea, vomiting, or upset stomach
• Sensitivity to light, sound, and smells
• Loss of appetite

Fluctuations in hormone levels during a woman’s menstrual cycle can impact the way she experiences migraine headaches. Attacks can last from hours to days. Some people who suffer from menstrual migraines describe the pain as incredibly debilitating, with symptoms bad enough to interfere with family and work demands. 

Who is Affected?

Nearly two out of three women who suffer from migraines experience attacks at the same time as their menstrual cycle. Menstrual migraines interrupt the life routines of the women who experience them and, in turn, also affect the people close to them. Not feeling well enough to function regularly leads to difficulty planning work schedules, traveling, and making arrangements around a monthly schedule of anticipated uncontrollable pain.

Tracking Pain Patterns

If you think you are suffering from migraine attacks related to your menstrual cycle, you may fear you’ll never recover. The good news is that there is hope for relief. The most accurate way to tell if you have menstrual migraine is to keep a headache journal to track:

• days and times your migraines occur
• first and last day of your period
• severity of pain and any response to treatments
• what you eat and drink
• if headaches get worse or more frequent when taking medications that affect hormones, like birth control pills or hormone replacement therapy

Track both headaches and your menstrual cycle for at least three months. If the attacks are happening between two days before and/or up to three days into your period, and occur at least two out of three consecutive menstrual cycles, then there is a good chance your migraines are hormonal. 

Prevention and Self-care

You don’t have to wait until menopause to manage the pain. There are certain strategies to try to prevent migraine triggers or soothe symptoms naturally, such as: 

• Good quality sleep. Lack of sleep is a well-known trigger for migraine. Aim for 7-8 hours per night.
• Manage stress. Release tension through mindfulness, deep breathing, or relaxation practices.
• Physical activity. Walking, yoga, and swimming are low-impact exercises that can help as part of a headache prevention plan.
• Stay hydrated. Drink plenty of water, or sip herbal tea to avoid dehydration that can trigger migraines.
• Foods to eat and avoid. Foods and the chemicals in them may spark migraine attacks, but there is no definite list, and sensitivities may differ for people. If you identify a potential trigger food or beverage, try removing it from your diet. 
• A cold cloth or an ice pack. Once a headache has already hit, wrapping a towel over ice held against the painful area on your head or neck can help. 
• Over-the-counter pain relievers. It may help to take NSAIDs (Nonsteroidal anti-inflammatory medications) such as Ibuprofen or aspirin two to three days before your period starts or at the onset of symptoms.

When to Seek Medical Treatment

If you have tried self-care and your headaches are still a problem, see your healthcare provider to suggest the best treatment options for you. Your doctor can help manage these headaches with common medications, including:

• Oral Birth Control Pills. If you are currently taking oral contraceptives, your doctor may suggest a change in the type or dosage. 
• Oral Tablets, Injections, or Nasal Sprays. Triptans are a common medication to treat migraines when symptoms start.
• Magnesium. Magnesium oxide is frequently used to prevent migraine. It is generally considered safe but can result in some side effects or lead to dangerous buildup levels, which should be discussed with your doctor.
• Hormone Therapy. Estrogen supplements can help regulate hormone changes.

Research as a Potential Road to Relief

When menstrual migraines are relentless, research is a potential care option for people with certain eligibility criteria. Clinical research is committed to improving the lives of women living with menstrual migraine, which are usually more severe, longer lasting, and less responsive to treatment than typical migraines. If you are living with intense migraines during your menstrual cycle, you may be able to participate in clinical research to help yourself and others by advancing the understanding of newer treatment options for menstrual migraines.

By Amy Cohen

Sources:

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Breitowich, A. (9 October, 2022).  What does a migraine really feel like? 14 people explain. Women’s health [Website]. https://www.womenshealthmag.com/health/a41449033/what-does-a-migraine-feel-like/

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