Many female migraineurs have reported that their menstrual cycle is a trigger to their migraine attacks.

While rare, some women may actually have a condition called menstrual migraine, which is characterized by migraine attacks directly linked to the menstrual cycle.

What Exactly IS Menstrual Migraine?

Menstrual migraines are directly associated with your period.  That means that instead of your cycle being a trigger for your migraine, the migraine is a symptom of the cycle.  Studies have indicated the following facts regarding these migraines:

  • They generally come on two to three days before the start of menstruation.
  • They last longer than other types of migraines.
  • They generally do not come with an aura
  • They occur in about 10% of women

There are two accepted theories as to the cause of these menstrual migraines:

  1. The declining levels of estrogen, a natural occurrence during menstruation.
  2. The release of prostaglandins in the first two days of the cycle.


menstrual MigrainesHow Menstrual Migraines are Diagnosed and Treated

The most valuable tool in your box is a diary.  I highly recommend keeping one to track your migraine symptoms, the days you menstruate, as well as your food intake and activity levels.

This kind of self-monitoring will give you an in-depth understanding of what your body is doing and why.  Then, you can march that diary to your provider and start discussing treatment options.

I believe that personalized medicine is the only way to truly help someone reach optimum health; however, it is still important for you to know and understand the treatments that have worked for others in the past.  My goal is to help you learn as much as possible so you can work with your provider to make an informed medical decision.


These drugs, especially mefenamic acid and naproxen, are probably the most popular for treating menstrual pains and migraines. The patients who claimed benefits have reported heavy and very painful periods.

Estrogen Supplements

This is an option for those whose drops in estrogen levels are the cause of those menstrual migraines.  Boosting your levels just before you start your period may help prevent or reduce migraine symptoms during the cycle.  This is also an option that is used for people who have irregular periods.  It all depends on your unique chemistry and what your body needs and can tolerate.


This is an extremely invasive and aggressive way to treat menstrual migraines.  If your menstrual migraines are caused by decreasing estrogen levels, this surgery could make that worse because you will experience a further drop in estrogen, although you will be prescribed a supplement.  In fact, many doctors feel a hysterectomy is not sufficient for migraine treatment, and they may recommend removal of the ovaries as well, since they are responsible for the estrogen drop.  I have seen patients go further down the rabbit hole following a hysterectomy.  This is a highly controversial treatment for migraines.

How to Prevent Menstrual Migraines

Now that I’ve probably scared you a little with the above treatment methods, let’s talk a little about what you can do to prevent these migraines.

Some things that will help you prevent menstrual migraines include:

  • Dietary changes, like avoiding well-known food triggers
  • Lifestyle changes, like exercise and getting enough sleep
  • Homeopathic remedies that keep your estrogen and progesterone levels balanced

I want to focus on diet.  Dr. Alexander Mostovoy once said, “Nothing else affects our health more than what we eat.”

Diet is especially important for menstrual migraineurs, because it is likely that your attacks are caused by hormone imbalance.  Estrogen is hard to balance, though, so this will take some research and time to develop a diet plan.  Avoid or eliminate specific ingredients and foods like:

  • MSG
  • Aspartame
  • Hydrolyzed Vegetable Protein
  • Simple carbohydrates
  • Processed foods
  • Refined sugar

To determine if diet is the cause of your woes, check out articles on:

Menstrual migraines may be rare, but that may be because the condition is grossly underdiagnosed. The important thing is to keep a close eye on your symptoms around the time of your cycle.  Keep a diary of those symptoms, your menstruation days, as well as diet and activity levels.  There are a few treatments for migraines, but you can always start with diet and lifestyle changes.  As always, you’ll want to talk to your provider before making major medical changes.



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