How hormones affect menstrual migraines

Not only do the ladies get to experience the joy of cramps and bleeding and mood swings every month, many of us also prone to major headaches at the same time.

Overall, women suffer migraines three times more frequently than do men — and menstrual migraines affect 60 percent of those women.

waking up with a headache

Too many menstrual migraines

According to an online survey conducted by the National Headache Foundation (NHF), 87% of respondents reported that their headaches increase in frequency and/or severity before, during or immediately after their menstrual cycle.

There are two types of menstrual headaches: Menstrually-Related Migraine (MRM) and Pure Menstrual Migraine (PMM). A menstrually-related migraine is a headache of moderate to severe pain that happens during a certain window of time around the period and at other times of the month as well.

A pure menstrual migraine is similar in every respect, but occurs during the time around a woman’s period only. Menstrual migraine has been reported more painful, lasts longer and comes back more often when medication wears off than non-menstrual migraine.

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What causes menstrual migraine headaches

Menstrual migraines are primarily caused by estrogen, the female hormone that regulates menstrual cycle fluctuations throughout the cycle. Seventy-four percent of survey participants note the frequency and/or severity of their headaches increased after puberty. When the levels of estrogen and progesterone change, women will be more vulnerable to headaches. Survey respondents stated that 49% are more likely to experience headaches prior to their menstrual cycle.

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The NHF online survey found that pregnancy and breastfeeding can have a positive effect on a woman’s headache condition. Fifty-nine percent of sufferers who took the survey indicated that the frequency and/or severity of their headaches decreased during pregnancy; with 51% noticing the most significant difference during their first trimester. On a related note, 49% found a decrease in frequency and/or severity of their headaches while breastfeeding.

While pregnancy and breastfeeding have shown a decrease in migraines, the opposite can be true for women’s peri-menopause phase. Seventy-eight percent of survey respondents believe that they experience more frequent headaches in the years leading up to menopause.



“Women are impacted by menstrual headaches during the most productive phases of their lives. It is important to know that it is not “normal” to have a headache with one’s period,” says Suzanne Simons, executive director of the NHF. “Therefore, if a woman finds she is experiencing headaches at this time, she should see her healthcare provider.”

The National Headache Foundation, founded in 1970 is a nonprofit organization dedicated to serving headache sufferers, their families and the healthcare providers who treat them; promoting research into headache causes and treatments; and educating the public to the fact that headaches are a legitimate biological disease and that sufferers should receive understanding and continuity of care.

Treatment options for menstrual headaches

Most sufferers of menstrually-related migraine are treated with acute medications. When attacks are very frequent, severe, or disabling, preventive treatment may be required. (Remember that all medications have side effects, and you should discuss them with your healthcare provider.)

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Acute treatment
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Dihydroergotamine (DHE)
  • Triptans
  • Combination of aspirin, acetaminophen and caffeine
Short-term preventive treatment
  • DHE
  • Triptans
  • Ergotamine
Hormonal manipulation
  • Oral contraceptives
  • Contraceptive patch


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