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Why Period Headaches Happen and How to Avoid Them

Why Period Headaches Happen and How to Avoid Them

  • Sonia Easaw, M.S., MPH
    Reviewed By: Julie Lamonoff, CNM, OBGYN-NP, Shannon DeVita DNP, FNP-BC, CPNP-PC
    Updated:

If you're experiencing headaches around the time of your period, you're not alone. Menstrual migraines are pretty common, especially if also you get migraines at other times of the month. But that doesn't mean you need to live with them. Here's what to know about period headaches and how to prevent and treat them.

Short answer: What's the deal with period headaches?

Period headaches—also sometimes known as menstrual migraines—can happen right before, during, or after you have your menstrual cycle. We don't know exactly how they're connected, but what we do know is this: period headaches happen because of the changes in your hormone levels around that time.

You don't have to just live with them, however; medicines, lifestyle changes, or other home treatments can help keep you from getting period headaches and reduce the pain. What makes period headaches different from the other types of migraine headaches is their timing: period headaches happen right around the time of a woman's period, either before you get your period or while you have it.

Migraine headaches, however, are an actual disease with severe symptoms like throbbing pain on one side of your head. What causes headaches during periods?

Researchers think that the drop in your body's estrogen levels, which happens as a natural part of your menstrual cycle, is a big reason why people get period headaches.

Hormones and headaches

Here's how your menstrual cycle can affect estrogen levels:

  • Estrogen levels are at their highest in the middle of your menstrual cycle.

  • Estrogen levels are at their lowest when you're on your period. The levels drop immediately before your menstrual flow.

  • Premenstrual migraines happen when estrogen and your other female hormone, progesterone, drop to their lowest levels.

The concept behind hormonal birth control can help illustrate how much power you have over the menstrual cycle because you can artificially change estrogen and progesterone levels in your body. That's essentially what taking birth control pills does to your menstrual cycle: while you take the active pills, your body receives low doses of estrogen and progesterone. When you take the placebo pills, which contain no active hormones, your hormone levels drop, and you get your period.

What are the symptoms of menstrual migraines?

You can think of migraines as headaches that tend to happen again, either around a woman's menstrual cycle or during another time of the month. Some women have chronic migraines, which they experience at least 15 days per month.

So how can you tell the difference between a menstrual migraine from a migraine that could happen at any other time of the month? Menstrual migraine symptoms are similar to other migraines without aura, that phase of a migraine where you might see flashing or bright lights. (It's important to tell your healthcare provider if you experience auras during migraines).

You might experience some of these migraine symptoms during a period headache:

  • One-sided, throbbing headache

  • It starts as a dull ache and then gets worse within minutes to hours

  • Nausea and vomiting

  • Sensitivity to bright lights and sounds

  • Sweating or feeling cold (chills)

  • Loss of appetite

  • Feeling tired (fatigue)

  • Dizziness and blurred vision

Other types of headaches

You might be wondering about the difference between symptoms of a period migraine headache and another type of headache, like a tension headache.

While period headaches are sex hormone-related migraines connected to your menstrual cycle, tension headaches have different symptoms—most commonly:

  • Dull pain that's all over the head (not just one side)

  • Usually does not cause nausea or vomiting

  • It could be worse in the scalp, temples, or back of the neck

Both fatigue and stress can bring on either a tension or a migraine headache, but migraine attacks can be triggered by altogether different factors, such as certain foods, hormone levels, or even the weather!

When do you get period headaches?

Since period headaches happen at precise times during the menstrual cycle, researchers say menstrual migraines can happen between 2 days before your period starts to the 3rd day of menstrual bleeding.

If you're experiencing migraines around your period, keeping a headache diary could help. Then, you'll have specific information to share with your healthcare provider or OB-GYN doctor.

Hormonal migraines and life stage

When and whether you get hormonal migraines can also depend on your life stage. Menstrual migraines happen because of estrogen levels; when a woman goes through pregnancy or menopause, estrogen levels also change significantly. Researchers have found that most women who have a history of menstrual migraines see a significant improvement during pregnancy. When it comes to menopause, some women may find migraine attacks getting worse when leading up to menopause.

How do you get rid of a period headache?

Doctors say that you don't need to suffer from menstrual migraines since there are treatments available. Unfortunately, there is no cure for migraines. The strategy is to treat symptoms right away when they happen and then do what you can to prevent symptoms right before your period and throughout the month.

Over-the-counter pain relievers for menstrual migraine

The Office on Women's Health says that over-the-counter pain relievers like ibuprofen, under the brand names Advil™ or Motrin™ (a family of medications called NSAIDs), can help with mild migraine pain.

Another NSAID medication you may have heard of is called naproxen or Aleve™. Some research has shown that naproxen sodium may help; participants in studies have shown a slight decrease in the migraine's intensity and duration. Other pain relievers like acetaminophen (brand name is Tylenol™) may help as well.

Editor's Note: When it comes to taking new medications, read the directions and take as directed. We recommend that you talk to your doctor or health care provider if you're currently on other medicines, have a health condition, or if you're not sure the medication is safe for you.

Prescription medicine for menstrual migraine

If over-the-counter pain relief isn't working for you, your doctor may consider prescription medicine. One type of medication for migraines is the family of triptans, which help balance chemicals in the brain. Your doctor may prescribe frovatriptan (Frova™), which has shown to be better tolerated than other triptans and can offer significant improvement.

Combination birth control pills

Doctors also say that using combination birth control pills (pills that contain estrogen and progestin) to skip your period can help to reduce menstrual migraines. Your typical pack of birth control pills has a week of placebo pills, which is when you'd expect to get your monthly period. Using the pills continuously means you would skip that week and therefore not get a monthly period.

However, if you experience migraines with aura, using combined birth control pills to skip your period is not recommended. Instead, if you have migraines with aura, your doctor might recommend a hormonal IUD like Mirena or Kyleena. Using an IUD can greatly reduce the frequency of periods or eliminate them altogether over time.

Preventive strategies

You can also make lifestyle changes to help manage menstrual migraines. The National Library of Medicine recommends:

  • Better sleep habits (like going to sleep at the same time every night and waking up at the same time)

  • Not skipping meals (to keep your blood sugar levels up, eat small meals or snacks frequently)

  • Avoid stress as much as you can

Recap: Period headaches and how to stop them

Period headaches ormenstrual migraines can be awful. They happen because of the drop in estrogen levels right before your period. But the right treatments, such as over-the-counter pain relievers or prescription treatments, as well as preventive lifestyle changes, can help.

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