A migraine headache is a neurological condition in which patients experience severe head pain along with sensitivity to light, sound, or smells.
About 2/3 of women who suffer migraines have them around the same time as their period. Migraine attacks that start between two days before a woman’s menstrual period and the third day of flow are usually considered menstrual migraines.
Menstrual migraine attacks, also called “hormone headaches,” tend to be more severe, last longer, and cause greater light sensitivity than attacks that happen during other times of the month.
Some women may be able to prevent menstrual migraines with a mini-preventive treatment by taking medications for 5 to 7 days in a row prior to the onset of the menstrual migraine attacks.
Medications used to prevent menstrual migraines may include those mentioned in the table below.
|Migraine Medication Type||Uses|
Nonsteroidal anti-inflammatories (NSAIDs)
Other Treatment Options
Mini-prevention does not work for every woman to prevent menstrual migraines. For these women, treatment used throughout the month may be more effective. Continuous treatment to prevent menstrual migraines may include hormones.
- Dosing birth control pills continuously so there is no break for a monthly period
- The vaginal ring can be used so when a woman removes the ring, a new one is inserted immediately instead of waiting for the end of the menstrual period
What Are Symptoms of Menstrual Migraines?
Symptoms of menstrual migraine tend to be more severe, last longer, and cause greater light sensitivity than attacks at other times of the month. Menstrual migraine symptoms are similar to migraine without aura.
- Prodrome: warnings before a migraine
- Changed in mood
- Slight changes in sensations such as an abnormal taste or smell
- Muscle tension
- Headache: may last 4 to 72 hours
- Postdrome: some signs may remain after the pain subsides
- Inability to eat
- Problems with concentration
What Causes a Menstrual Migraine?
How Is a Menstrual Migraine Diagnosed?
Doctors diagnose migraine headaches based on a patient’s medical history and the description of symptoms. A physical examination may be done but usually it will not find anything out of the ordinary. A neurological examination is often performed to help rule out other causes of the symptoms.
Additional tests may also be used to help rule out other causes for the symptoms such as:
- Blood tests
- Imaging tests to check for bleeding, stroke, or tumor
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI) scan
- Lumbar puncture for cerebrospinal fluid (CSF) analysis to check for infection or bleeding
How Do I Get Rid of or Prevent Menstrual Migraines?
Menstrual migraines do not always respond to the same medications used to treat migraine attacks that occur at other times of the month. The reason is unclear, but it is thought to be due to the effects of estrogen on the medications.
Treatment for menstrual migraine attacks may include:
- Fast-acting oral triptans (such as sumatriptan, rizatriptan, zolmitriptan, almotriptan, or eletriptan) taken early in a migraine attack in combination with a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin) or naproxen (Aleve)
- Injectable medications that can be taken in the middle of a migraine attack for faster relief, may also be combined with an NSAID
- Sumatriptan, the only injectable triptan
- Dihydroergotamine (DHE)
- Nasal triptans such as zolmitriptan or sumatriptan work faster than pills but not as quickly as an injection
- DHE is also available as a nasal spray
Non-medical treatment for menstrual migraines may also include:
- Home remedies
- A dark room/covering your eyes
- Deep breathing
- Avoiding known triggers, such as
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