Migraines around my period — What's up with that?

Dear Reader, 

Migraines aren't fun for anyone, and rest assured that you’re not alone — 70 percent of migraine sufferers are those assigned female at birth, and 70 percent of these migraines are caused by their menstrual cycles. The likely reason that you’re experiencing migraines at the beginning of your period is because of one hormone in particular — estrogen. The short answer to your question is that right before your period begins, estrogen levels drop quickly, which causes migraines. Read on to understand more about estrogen and its role in the menstrual cycle, and how that influences migraines! 

Estrogen is one of the primary sex hormones in the body and it's responsible for puberty and the development of secondary sex characteristics such as breasts and widened hips. During menstrual cycles, estrogen works to prepare the body for fertilization and pregnancy by thickening the lining of the uterus. At the end of the luteal phase, if fertilization doesn’t occur, estrogen levels drop, causing the body to begin menstruation. This drop in estrogen levels is what causes migraines just before and at the start of menstruation. 

The cycling of estrogen levels across the menstrual cycle and across the lifespan (from puberty, reproductive age, and menopause) is what causes these period-related headaches, as estrogen can affect the headache-related chemicals in the brain. When estrogen levels are stable, migraine symptoms decrease. This is why despite the fact that those assigned male at birth also produce estrogen, they don't experience migraines as frequently because their estrogen levels remain stable over their lifetime. 

Another hormone that plays a key role in the migraine process is prostaglandin. Prostaglandin is a hormone-like compound that regulates the menstrual cycle and is also involved in nervous system functioning. People who experience severe cramps during their period typically have higher levels of prostaglandins in the body, which can also lead to increased migraines during the menstrual cycle. Prostaglandin levels increase dramatically over the menstrual cycle (up to three times!), and as estrogen levels drop, the body becomes more susceptible to prostaglandins. The presence of prostaglandins can lead to neurogenic inflammation, a biological process that's been linked to causing migraines in addition to a drop in estrogen levels. 

Now that you know what's behind those pesky period migraines, you may be wondering how to treat them. To find out what treatment option works best for you, it's recommended that you keep a log of your migraine symptoms and when your migraines happen so you can work more effectively with a medical provider to determine the best treatment plan for you. Additionally, some period-related migraines can be a symptom of a menstrual disorder, so talking to a health provider may be especially helpful. 

There are an assortment of treatment options available for migraines as well. Some of them include: 

• Over-the-counter (OTC) medications: These include ibuprofen, acetaminophen, aspirin, and naproxen sodium.
• Prescription medications: Your medical provider may prescribe you a medication that can be used for an acute migraine. These can range from pills, injections, or nasal sprays to stop migraines. There are also preventative medications that can be taken up to seven days before your period.
• Hormonal birth control: Birth control pills, patches, and rings have been used as migraine treatment options because they stabilize estrogen levels. If you experience migraines with auras (light flashes, blind spots, and tingling sensations in the body), birth control isn't recommended as a treatment.
• Injectables: Oftentimes, medications can take hours to provide migraine relief. That's why your medical provider may prescribe you injectables that will provide more instant relief when having a migraine attack. 
• Magnesium: If magnesium supplements are taken daily from day 15 of the menstrual cycle until the next menstruation, it's shown to reduce migraine symptoms.

Even though migraines are a pain, there are a lot of treatment options out there. Mayo Clinic has some strategies to ease migraine pain as well. Here’s to hoping that you find what works best for you and that you’ll be having migraine-free periods sometime soon!