How do I stop period headaches? If you have ever noticed a pattern of headaches that always seems to happen around your period, you’re not alone! Many people experience what’s referred to as hormonal headaches or menstrual migraines. These essentially mean headaches/migraines that occur cyclically around the same time in the menstrual cycle each month. Generally, these headaches happen right before or during menstruation due to hormonal fluctuations. Hormonal headaches are so common that 50% of people with periods report their headaches overall to be linked to the timing of their periods¹.
What’s the Difference Between a Hormonal Headache vs. a Migraine?
Headaches are common and generally characterized by pressure on both sides of the head ranging from mild to moderate pain. It can feel like a tightening around the head, or throbbing/aching pain.
Migraines are less common and typically characterized by localized pain on one side of the head (though not always). They are often very intense in pain and can also bring on symptoms like nausea, vomiting, sensitivity to light/sound, and occasionally visual auras.
What’s the Link Between the Menstrual Cycle and Headaches?
It’s thought that hormone fluctuations are to blame for cyclic menstrual headaches.
Right before the period begins (when many people experience PMS) there is a drop in estrogen levels, this drop is thought to be part of what may trigger these headaches.
Another theory is that the hormone prostaglandin, which is released during a period, may be a contributing factor as it causes inflammation and spasms within the tissues².
Both theories show that hormone changes could be affecting blood vessel constriction, inflammation, and pain sensitivity.
It’s also helpful to note that some people may find their cyclical headaches occur mid-cycle during ovulation when there is also a large fluctuation in hormones. Menstrual-related headache/migraines just happen to be the most common timing of cyclic headaches experienced.
Pharmaceutical Treatment/Prevention of Menstrual Migraines/Headaches
Note: Pharmaceuticals come with their own benefits, side effects, risks, contraindications, and drug interactions. These medications are what science has deemed the most effective through studies. It’s important to discuss with your trusted health provider what the best options are for you.
Some physicians recommend birth control for those who get menstrual triggered headaches. This is because studies show that steady levels of estrogen in the body can help prevent and reduce headaches3. Birth control acts to suppress large fluctuations of estrogen by stopping ovulation, thus keeping a more consistent level of estrogen flowing. Some doctors may even recommend taking birth control continuously to skip periods all together to reduce the incidences of hormonal headaches/migraines if the headaches are greatly impacting someone’s quality of life.
Triptans are often prescribed to prevent and treat menstrual headaches and migraines by physicians. Triptans are a family of medications that work to calm down overactive pain receptors thus helping with pain, nausea/vomiting, and the sensitivity to light/sound that some experience with migraines⁴.
Non-Steroidal Anti-Inflammatories (NSAIDs) such as naproxen may be a physician's recommended treatment for hormonal headaches as well. These act by reducing inflammation and pressure, thus minimizing the pain of the headaches⁵.
Nausea Medication and Anti-Emetics are often prescribed to alleviate symptoms of nausea/vomiting as a result of menstrual migraines. Let your health provider know if you experience vomiting more than once in a menstrual week since frequent vomiting can be dangerous as it may result in dehydration.
Non-Pharmaceutical Treatment/Prevention of Menstrual Migraines/Headaches
While non-pharmaceutical treatments are often referred to as natural or holistic period treatments, I stay away from those words because there tends to be a value placed upon them, which can negate pharmaceuticals. Let’s remember that what’s considered ‘natural’ is not equated with ‘safe’ and does not work for everyone. Everyone’s body and situation is so different!
Note: While nutritional supplements may be less invasive than pharmaceuticals, they can still carry risks, side effects, and drug interactions. Be sure to check with your trusted health provider before starting new supplements.
While there are limited studies, some emerging research has shown that a regular magnesium supplement reduces both the intensity and frequency of hormonally linked headaches/migraines.
Magnesium helps prevent narrowing blood vessels (constricting), which commonly occurs during headaches and migraines. This is why magnesium is often recommended for headaches as it’s generally the least invasive approach⁶.
It’s been found that regular massage therapy treatments may be helpful for the prevention of headaches/migraines as blood flow and circulation is improved and tension in the tissues surrounding nerves is reduced. Acupuncture may also provide relief to menstrual migraines by calming the nervous system down, which works closely with our pain receptors.
Many people find cold hydrotherapy helpful for hormonal headaches/migraines as it helps to dull the pain and reduce inflammation and swelling inside the blood vessels.
Knowing Your Triggers
Ultimately, the research and data on hormonal headaches and menstrual migraines is still extremely limited. Science doesn’t fully understand why they occur and the absolute best way to prevent and treat them.
By tracking your period cycle, you may be able to link triggers unique to you. For example, maybe heightened stress seems to make your period headaches worse, or weather changes. When you know what may make the headaches worse, you can work to proactively combat them.
Period headaches/migraines can range from mildly irritating to debilitating for people that experience them. Remember that you shouldn’t have to suffer every month and speak to your health provider about the best next steps to take. If your doctor seems unequipped to help you, feel free to ask for a referral and second opinion. It can take time and trial and error to figure out the best way to manage menstrual headaches and migraines due to the limited research we have. Remember: you aren’t alone and that your pain is valid!
MacGregor, E. A., Brandes, J., Eikermann, A., & Giammarco, R. (2004, July). Impact of migraine on patients and their families: the Migraine And Zolmitriptan Evaluation (MAZE) survey--Phase III.
Menstrual migraine. The Migraine Trust. (2021, January 19).
Mayo Clinic Staff. (2020, December 10). Headaches and hormones: What's the connection? Mayo Clinic.
Melinosky, C. (2020, January 8). Triptans (Serotonin Receptor Agonists) for Migraine Headaches. WebMD. https://www.webmd.com/migraines-headaches/triptans-migraines.
Macgregor, E. A. (2009, September). Menstrual migraine: therapeutic approaches. Therapeutic advances in neurological disorders.
Facchinetti, F., Sances, G., Borella, P., Genazzani, A. R., & Nappi, G. (1991, May). Magnesium prophylaxis of menstrual migraine: effects on intracellular magnesium. PubMed.