What are menstrual migraines?

Published on Jul 19, 2019
Medically reviewed by Feisia Dam, BPharm(Hons)

Menstruation. Periods. That time of the month. No matter how you say it, it can be a blessing, or, perhaps not. For many women, this time brings such things as period pain, acne, mood changes and tiredness. By the end of the female reproductive life cycle, around 40% of women will have experienced a migraine. Unfortunately, gender equality does not extend to this debilitating, neurological condition. Evidence has shown that women are three times more likely to experience migraines than men.

If you get them a couple of days before your period, or during your period—in at least 2-3 consecutive cycles—then you most likely have menstrual migraines. It may help to keep a migraine diary so that you can identify the timing and triggers of your symptoms so that you can show your doctor.

Why do menstrual migraines occur?

During the menstrual cycle, hormones such as estrogen and progesterone fluctuate. These fluctuations are necessary to get the body ready for possible implantation of a fertilised egg, and if this doesn’t occur, it signals the start of menstrual bleeding.

Just before your period, there is a drop in the levels of estradiol, a form of estrogen. Researchers have identified this as the most likely cause of menstrual migraines. These hormonal changes also explain why migraines can improve during pregnancy. During this time, estrogen levels are more stable. Migraines can get worse after birth when levels drop again.

How are they different from normal migraines?

Evidence has shown that compared to normal migraines, menstrual migraines are:

  • Four times more likely to be severe
  • More difficult to treat
  • Usually not associated with an aura
  • Longer lasting
  • More predictable (if you have a regular cycle)

Who can help?

Since menstrual migraines are so debilitating and harder to treat, your GP will likely refer you to a neurologist who specialises in migraines. Make sure to keep a migraine diary so that you can show them. If you are already taking medicines for your symptoms, be sure to advise the doctor if you become pregnant. They can then tailor your treatment and prevention strategies so that your unborn baby is safe.

Find out more about other lifestyle triggers and what you can do.

[1] [2] [3]

References

  • 1. Faubion SS, et al. Migraine Throughout the Female Reproductive Life Cycle. Mayo Clin Proc. 2018; 93(5): 639-645
  • 2. Brandes JL. The Influence of Estrogen on Migraine. JAMA. 2006; 295(15): 1824-1830
  • 3. Harrison's Principles of Internal Medicine, 20e. AccessMedicine. McGraw-Hill Medical. Published 2019. Accessed June 24, 2019.
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