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How to Get Rid of a Period Headache (Menstrual Migraine)

  • Sara Hoffman, Pharm D.
    Reviewed By: Shannon DeVita DNP, FNP-BC, CPNP-PC, Alethea Robbins, WHNP-BC
    Updated:

If you regularly experience headaches during your period, then that "time of the month" can feel especially intrusive. We'll share science-backed treatment options for how to get rid of your period headaches so you can decide what to do next (because let's face it—that "time of the month" can be hard enough as it is!).

What is a period headache?

There are different types of headaches, depending on the cause and symptoms. Let's break down how different types of headaches are categorized.

Tension headache:

This is the most common type of headache affecting 80% of Americans. It's often caused by stress, dehydration, or exhaustion. Tension headaches usually cause a pressing or tightening pain on both sides of the head.

Migraine:

This is an intense, throbbing headache that affects 29.5 million Americans. Women in particular are affected, as about 75% of people who get migraines are female. Migraines can cause pain on both sides of the head, but one side, usually in the temple or behind the eye.

Menstrual migraine:

A menstrual migraine or period headache is a type of migraine. It occurs anywhere from two days before to three days after your period begins and may last until your period is over.

Need help finding migraine medication that can help you avoid attacks? Get expert-backed migraine care and receive 50% off your first month of medication from Cove.

Please note that this discount is solely from Cove and not related to The Pill Club or from engaging with The Pill Club website.

Why do you get menstrual migraines?

Throughout your menstrual cycle, estrogen and progesterone hormone levels fluctuate in order to prepare your body for pregnancy. During your period, your estrogen levels are at their lowest. Estrogen plays a role in how sensitive you are to pain, so when estrogen levels are lower, you may feel more pain in the form of migraines, cramps, and back pain.

These hormone level fluctuations may help explain why migraines are more common in women than they are in men.

It can be hard to identify whether a migraine you experience during your period is actually a menstrual migraine, or if it's a migraine happening during your period. However, it was observed in one study that patients with menstrual migraines tend to experience more symptoms associated with migraines for a longer period of time, and have a worse experience overall.

We asked Dr. Sara Crystal, Neurologist and Medical Director at Cove, about why women get migraine attacks around their period.

Dr. Crystal said,

"The worsening of migraine is probably related to the drop in estrogen levels that occurs about 2 days before menstruation. Estrogen has a role in the perception of pain."

What are the symptoms of a menstrual migraine?

The most common menstrual migraine symptom is a throbbing pain that's most often felt on your temples (on each side of your forehead) or behind your eyes. The pain can vary in how intense it feels. It's most on either the left or right side of your head, but can be on both sides.

Unlike a tension headache, migraines can have other symptoms such as

  • Nausea

  • Vomiting

  • Vision changes

  • Pain with a lot of noise, known as sonophobia

  • Sensitivity to light, known as photophobia

One study involving 181 women between the ages of 12 and 55 compared menstrual migraines with migraines not related to menstruation. The menstrual migraine group had longer-lasting headaches, and more nausea and light and sound sensitivity compared to the migraine group.

At-home treatment and natural remedies for menstrual migraines

Your environment can also help decrease migraine symptoms. Here are some things that can help:

  • A quiet, dark room: Avoid harsh noise and light when you have a migraine. Rest in a quiet, dark room if possible. The retinas in your eyes send light to your brain through your optic nerve, and light can be involved in worsening your pain during migraines.

  • Ice packs: One small study showed that ice wraps applied to the carotid arteries of the neck at the start of a migraine and left on for 30 minutes reduced pain by about 32%. Ideally this would be a pack that can be secured around your neck for consistent cold. Hot packs or heating pads might not give you much relief from a migraine, but may help with tension headaches.

  • Acupressure: If nausea is a particularly troubling part of your migraines, acupressure may be worth a try. In one study, 32 women participated and experienced significant nausea relief by using SeaBands, which put pressure on a certain area of the wrist. Pressing on these points can help relieve nausea and vomiting.

For some people, a migraine can be treated at home by taking over-the-counter (OTC) medications. Medications or supplements that have been shown to improve migraines include:

  • NSAIDs and acetaminophen: Acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) are recommended for mild to moderate migraines. Some examples of NSAIDs are ibuprofen (Advil, Motrin) and naproxen (Aleve). These medications work by blocking a certain enzyme in your body responsible for making chemicals that play a role in pain. If you have kidney disease or heart disease (like high blood pressure or heart failure), you'll want to talk to your doctor before taking NSAID medications.

  • Magnesium: Research shows that magnesium levels are lower in migraine sufferers, and that taking magnesium supplements long term may lessen migraine frequency.

  • Ginger powder: You may have heard of ginger helping with digestion issues, but there is also some evidence of its usefulness in treating migraines. One study gave either ginger powder or sumatriptan (a common migraine drug discussed in the next section) to 100 migraine patients. The patients that took ginger powder had similar relief to those taking sumatriptan.

Prescription treatment for menstrual migraines

If OTC medicines and natural remedies are not enough to control your menstrual migraines, a prescription treatment may be the best option for you. Furthermore, menstrual migraines can be more difficult to treat due to the effect of estrogen in your body. You may need a prescription on hand for when you get headaches around your period. Here are some commonly used prescription treatments.

  • Estrogen cream or patches: Remember how we said that a major cause of menstrual migraines is thought to be the drop in estrogen levels that happens during your period? Preventing such a quick and major drop in these hormones can help keep menstrual migraines away. For this, estrogen cream or patches can be used, starting a few days before your period.

While birth control pills can help prevent menstrual migraines, it can take some time for them to work. For more information on starting regular birth control, read our birth control pill guide.

  • Triptans: This is a group of medications recommended for moderate to severe migraines. Sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig) are examples of triptan drugs. These medications are available as pills, injections, or nasal sprays. They work best if taken immediately when you feel a migraine coming on.

  • Dihydroergotamine (DHE): This drug is most commonly used as a nasal spray for migraine treatment. Doctors think this medication works by shrinking the blood vessels in your brain which often become enlarged and cause pain during migraines. The use of DHE has gone down because of side effects such as nausea, chest tightness, and tingling in the legs or arms, but it does show effectiveness in migraines that don't get better with other medications. DHE, however, isn't safe to take if you're pregnant.

  • Newly developing therapies: Some new medications have been developed as doctors learn more about migraines. One group of medications, CGRP receptor antagonists, or gepants, shows promise for short-term treatment of migraines and are currently being studied for the prevention of migraine. Nurtec (rimegepant), Ubrelvy (ubrogepant), and Qulipta (atogepant) are some examples.

Need help finding migraine medication that can help you avoid attacks? Get expert-backed migraine care and receive 50% off your first month of medication from Cove.

Please note that this discount is solely from Cove and not related to The Pill Club or from engaging with The Pill Club website.

How to prevent menstrual migraines

If you get migraines often, you may want something that is taken on a regular schedule to prevent your migraines before they begin. The following are some options mentioned by the American Migraine Foundation as well as some new medications.

  • Birth control: It's worth mentioning again that hormonal birth control is a preventive measure for migraines. Taken regularly, birth control can maintain an even estrogen level, preventing dips that can trigger headaches. Deciding to take birth control pills or other hormonal contraceptives is a decision that extends beyond treating your migraines. Other factors should be taken into account, such as safety considerations, potential side effects, and whether you want to use a daily pill, an injection every few months, or an IUD to prevent pregnancy. See our birth control pill guide for more information.

  • Magnesium: As discussed above, taking magnesium once a migraine sets in won't do much to treat it, but taking it long term as a supplement has been shown to reduce the number of migraines patients experience.

  • Newly developing therapies: Another newer class of drugs called anti-CGRP monoclonal antibodies (mAbs) can help with migraine prevention. The goal is to lower the number of migraines every month. Some examples are Aimovig (erenumab), Ajovy (fremanezumab), and Emgality (galcanezumab). These drugs are given intravenously, or in a vein in your arm, every 4 to 12 weeks in a clinic or at home.

When to see a doctor

If your menstrual migraines, or any migraines for that matter, are causing you to miss days of work or interrupting your daily activities, it is likely time to see a doctor to talk about some higher level treatment options. Prescription medications may be necessary to quickly and effectively treat your migraines.

It's also a good idea to keep a diary or some kind of documentation about when you experience your migraines and whether you can identify any triggers or things that make your migraine attacks better or worse. For example, some people find light, loud sounds, and dehydration to be triggers. This will help both you and your doctor pick out the best solution for you.

Conclusion

While periods can be a hassle to deal with, you don't have to accept severe pain as part of that hassle. Always remember you have different options to choose from when it comes to your reproductive health.

If you experience migraines around your time of the month, and OTC medications with an ice pack aren't cutting it, talk to your doctor about other treatments available to you.


This article was created in partnership with Cove.

Need help finding migraine medication that can help you avoid attacks? Get expert-backed migraine care and receive 50% off your first month of medication from Cove.

Please note that this discount is solely from Cove and not related to The Pill Club or from engaging with The Pill Club website.

You can learn more about Cove at our upcoming webinar Migraines & Periods: A Love Affair, featuring essential advice on menstrual migraine attacks from the medical experts at Cove and The Pill Club and moderated by the health and beauty writer Victoria Moorhouse. This virtual event will take place on Thursday, October 28 at 5 PM EST. Interested? Register here!

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