Menstrual migraine: what it is, its causes, symptoms and treatment

There are different factors, common to both genders, that have the ability to influence headaches, such as family history and age. However, headaches are much more common in women than in men. Statistically, over a year, women are three times more likely than men to have at least one migraine.

This significant difference in the prevalence of headaches could be explained by the hormonal changes that occur in women during the period. A third of women suffer from headaches caused by menstruation.

These headaches are caused by the two so-called female sex hormones: estrogen and progesterone. These substances, secreted by the ovaries, are primarily responsible for controlling the menstrual cycle. It has been shown that these hormones, in addition to regulating cycle and pregnancy, can influence the underlying chemistry of headaches.

Some studies link the menstrual cycle and hormonal fluctuations – which occur during this cycle – with certain types of headaches. In this article, we will talk in general about the relationship between headaches and the menstrual cycle, and we will describe in depth menstrual migraineone of the most common conditions that occurs during the menstrual period.

    What is menstrual migraine?

    A menstrual migraine is a Debilitating headache that originates in the hormones that regulate menstruation.

    Different headaches can occur during menstruation. Some do not have their origin in hormones, for example, we can speak of tension headache. Tension headache is a headache that is usually derived from stress, pain similar to tightness from wearing a blindfold is described.

    However, the most common headaches that occur during menstruation have a hormonal origin. Hormonal headaches and menstrual migraines are mainly described. The origin of these two conditions is common, hormonal fluctuationbut have symptoms of varying severity.

    We speak of a hormonal headache when the symptoms range from mild to moderate. Although it is a nuisance or discomfort that lasts over time, it does not affect the development of a person’s normal life.

    Menstrual migraine is considered an extreme and debilitating headache. It usually affects one side of the head and lasts several hours or even days. Severe palpitations and severe pain interfere with the patient’s daily lifepreventing him from performing daily tasks.


      Migraine is linked to dysfunctions that affect the cerebral blood vessels. Its origin is multifactorial, both genetic and environmental factors are included to explain why some people suffer from this pain..

      Headaches are caused by inflammation of the meninges (the membranes that line and protect the brain) and widening of the vessels that supply blood to the brain.

      Some studies have shown that this is due to an abnormal nervous system response. In migraine, there is an activation of the trigeminal nerves, which innervate, among other things, the meninges and cerebral vessels, there is also excessive neuronal activation in the brainstem and in the hypothalamic region.

      The triggers of headaches are quite well identified. They are usually the cause of migraines, stress or anxiety, poor sleep hygiene, diet, weather conditions, and exposure to noise or flashing lights, among other known causes. .

      Hormonal fluctuations, which occur over a woman’s lifetime, modulate the onset of migraine and the course of the disease and its symptoms.

      Hormones are chemicals responsible for regulating different functions. They influence cells other than those that secreted them. They act as messengers between the different systems and tissues of the human body.

      Progesterone and estrogen are the hormones responsible for regulating the menstrual cycle and pregnancy. Although this is their main function, they also influence other mechanisms, as they travel through the bloodstream and can reach any part of the body through it.

      A relationship has been shown between molecules that cause headaches in the brain and female hormones. Specifically, changes in estrogen levels have been linked to headache patterns. A stable level could improve symptoms, however, a decrease in this hormone causes it to worsen.

      The menstrual cycle is regulated primarily by two hormones. Estrogen helps in the release of the egg, which usually occurs in the middle of the menstrual cycle. Hormone levels are minimal just before menstruation. Progesterone also plays a key role in the hormonal cycle. After ovulation, the ovaries produce progesterone, responsible for preparing the uterus for possible fertilization. If there is no fertilization, the levels drop again.

      These changes in levels that occur throughout the hormonal cycle (are not stable). They are responsible for headaches. Additionally, headaches can occur in menopausal or pre-menopausal people who experience a decrease in female hormones. Another situation, known and non-pathological, where major changes in these hormones occur is during pregnancy.

        Menstrual Migraine Symptoms

        Menstrual migraine shares a number of symptoms with other types of migrainesoften appear:

        • Severe pain
        • Vomiting and dizziness
        • Sensitivity to sound stimuli
        • Sensitivity to light and sound
        • Decreased ability to concentrate
        • Sweat
        • Stiff neck and shoulders
        • Blurred vision
        • Feeling very cold or very hot

        Menstrual migraine also has symptoms related to menstruation, including:

        • Extreme feeling of fatigue
        • Muscle and/or joint pain
        • Intestinal disorders such as constipation or diarrhea
        • Abdominal pain
        • Cravings
        • Altered mood.

        How to treat menstrual migraine?

        There are different preventative strategies that help in the treatment of menstrual migraine and depend on the situation that is causing them. This is why it is advisable to keep a migraine diary to help identify factors that can cause migraines, some of which include: diet, sleep habits, lifestyle, stress, environmental conditions, etc.

        Lifestyle changes

        All healthy lifestyle changes can significantly affect and decrease migraine symptoms. Yoga, dietary changes, and meditation can help most migraine sufferers. There is no quick fixbut by trying different approaches, it is important to increase the chances of finding a suitable solution.


          Preventive treatment is used to reduce the frequency and symptoms of migraines and influence their onset. This is based on taking nonsteroidal anti-inflammatory drugs, including ibuprofen and naproxen. The taking of medication will mainly depend on the regularity of the cycles. If the cycle is regular, it is advisable to take the drug a few days before menstruation and to maintain the treatment for 15 days.

          If it is irregular, daily pharmacological treatment may be necessary. This treatment can be of a different nature, including anticonvulsants, calcium channel blockers, beta-blockers or antidepressants.

          Hormonal contraceptives

          According to patients, the use of treatments Hormonal drugs, often the birth control pill, to prevent excessive hormonal fluctuations and reduce headaches, have proven ineffective. It is true that in some patients they can help reduce the occurrence of migraines because they influence estrogen levels. However, this practice is recommended only for women in whom other treatments do not workdo not suffer from migraines with aura and do not have altered mood due to contraceptives.


          For people in menopause, taking estrogen can influence headaches. Some get worse, while others show improvement. One of the proposed solutions is the use of an estrogen-based skin patchit provides a stable amount of estrogen and does not affect headaches.


          Menstrual migraine is a type of migraine caused by fluctuating hormones that regulate the menstrual cycle. This medical condition is distinguished from hormonal headaches by the severity of its symptoms, as it affects the daily tasks of those who suffer from it. It shares symptoms with general migraines, and among its manifestations are severe pain and sensitivity to light and sound. Although difficult to treat, there are a number of preventative treatments and lifestyle changes that can help relieve symptoms and reduce their frequency.

          Bibliographic references

          • Zavala, HA; Saravia, BB (2003). Epidemiology and socioeconomic impact of migraine. Revista Neurológica Argentina (Buenos Aires: ResearchGate GmbH), 28 (2): p. 79 – 84.

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