It’s estimated 70 percent of women suffer from migraine headaches. Of those, 50 percent experience an increase in frequency and severity around the time of their periods.
The link between hormone levels and migraine is well established, so it’s not surprising the hormone disrupting nature of the menstrual cycle plays havoc with migraine.
What Causes and Who Gets Menstrual Migraine?
There is a natural drop in estrogen levels around the time of the period. For those taking the birth control pill, which regulates hormones, this drop also happens because combined oral contraceptives have a pill free interval to allow for a period. Other types of pill are taken continuously, but often these are designed to allow a period by having the last week’s supply contain no hormones.
Another hormone associated with migraine is prostaglandin, and this is naturally high during the first few days of menstruation. The complexities of the menstrual cycle, with all the combinations of hormone fluctuations add to the complexity of migraine. Both work on the brain chemicals known as neurotransmitters and alter the effect of estrogen and other hormones, such as serotonin.
Some women only get migraines during their period, while others experience an increase in pain levels, duration and frequency. As menopause approaches, migraines linked to periods can get worse since the normal hormone cycle becomes even more disrupted during this time, and periods are often more frequent. Most women find migraines subside when their periods finally stop.
You can try a few strategies if migraine pain gets worse during your monthly cycle. In all instances, you should speak with your doctor or other care team to work out a safe, effective plan of action.
Revisit Your Diaries
If you’ve been suffering from migraines for a while, you’ve likely let your early journals or diaries lapse. When you’re investigating possible causes for migraines increasing during periods, revisiting those diaries is a good idea. Look especially for triggers that are non-hormonal, such as skipping meals and letting your blood sugar drop or not having a regular sleep pattern, both of which can cause migraine.
Being vigilant about avoiding known triggers can help ward off pain when the body is in a more susceptible condition, such as around menstruation. When you feel an attack coming on, take your medication as soon as possible, as you would normally, and repeat daily as necessary.
It’s important to have your doctor on board during this monitoring time, since they can consider ways to help prevent migraine if your diaries show a spike in suffering as you approach, or during menstruation. Sometimes, medications not intended for migraine treatment can help prevent them during these periods.
Estrogen or Magnesium Supplements
For those not taking hormonal contraception, supplements taken around menstruation can help to counteract the adverse effects caused by the body’s natural drop in estrogen levels. Some can only be taken when the period is regular, however.
For those who need contraception, a continuous hormone strategy could help minimize or prevent migraine attacks. It’s only recommended for women who have migraine without aura. In this strategy, women don’t take the normal break from the pill each month to allow for bleeding. Instead, a continuous hormone level is maintained over several months and bleeding is suspended (although some experience a break-through bleed).
Other supplements you might try include magnesium, since it’s common for female migraineurs to have a deficiency. If you don’t like the idea of taking yet more pills, natural ways to increase magnesium intake include eating more dark green vegetables, seafood, bananas, whole grains or beans.
These medications work on brain chemical receptors, narrowing blood vessels in the brain and helping prevent pain and nausea as well as other aura effects such as light sensitivity.
Since triptans can work pre-emptively to prevent headaches, some women find it effective to start taking them a few days before the period starts and continue for around five days.
Stress Reduction and Exercise
While stress by itself won’t give you a migraine, tension can set up conditions that create a trigger. Easing tension and stress levels can keep you on an even keel throughout the month, although finding a way to maintain a relaxed frame of mind might involve some lifestyle changes.
It could be a simple as making sure you get enough sleep, or might involve building time into a busy schedule to start an exercise routine. It’s been found that women who take part in aerobic exercise three times a week have fewer migraines than those who don’t. An increase in endorphins may be the reason, as these are natural pain relievers.
Since there are various ways of tackling menstrual migraines, your first course of action should be talking to your doctor rather than increasing or changing your medication on your own.