Treatment of Menstrual Headaches

Between 60% and 70% of women experience menstrual headaches with varying frequency and intensity.  Menstrual headaches are typically experienced right around a woman’s period, but some women experience them randomly throughout their cycle.

While painful, menstrual headaches are treatable and sometimes preventable.  Read on to learn about the causes of menstrual headaches and how to keep them from interfering with day to day life.

What are Menstrual Headaches, and What Causes Them?

Menstrual headaches are caused by fluctuations in female hormones like progesterone and especially estrogen.  Other body chemicals such as serotonin, prostaglandin, norepinephrine, and melatonin fluctuate during a woman’s period and may contribute to menstrual headaches as well.

Of the women who experience menstrual headaches, 64% report a total disappearance of menstrual headaches while pregnant or breastfeeding.Some women, on the other hand, will experience their first menstrual headaches or an increase in severity during pregnancy. Even women who continue to experience menstrual headaches during pregnancy almost always cease having them entirely after the first trimester.

Women who experience tough headaches with auras are more likely to continue having menstrual headaches while pregnant or breastfeeding.

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What are Menstrual Headache Triggers?

The following factors may contribute to the severity and frequency of menstrual headaches.

  • Birth Control: Women prone to menstrual headaches should avoid taking oral contraceptives that contain estrogen because they can make headaches worse. Frequency and severity of headaches decreases when women switch to birth control pills that contain less estrogen. Oral contraceptives containing progesterone instead of estrogen have not been found to cause menstrual headaches. Some doctors claim that triphasic birth control pills are much more likely to trigger menstrual headaches and encourage patients to take monophasic birth control instead. However, some women can improve on oral contraceptives, especially when taking continuously without a break.
  • Hormonal Therapy During Menopause: Women using hormonal therapy that includes taking estrogen may trigger menstrual headaches.
  • Magnesium Deficiency:  Magnesium deficiency causes blood vessels in the brain to constrict and cause problems with brain chemicals that can trigger and aggravate hormone headache symptoms.
  • Sex: Because menstrual headaches are caused by fluctuation in hormones, sexual activity, especially during a woman’s period, can trigger hormone headaches.  If a couple knows menstrual headaches are a problem, they can plan intimacy around the woman’s cycle.
  • Irregular Use of Postmenopausal Treatment:  Women who have to take postmenopausal estrogen supplements should take the lowest dose possible and take it daily.  Hormone headaches are often triggered when women take larger doses of estrogen irregularly.

What are the Symptoms of Menstrual Headaches?

Identifying symptoms of a headache is the best way to properly diagnose menstrual headaches as the type of pain currently being experienced. Use the following indicators to aid in proper identification:

  • Location:  The location where the pain is felt depends on where the woman is in her cycle.  At the beginning of her cycle, the pain is often located toward the back of the head and near the neck. Toward the end of the cycle, the pain is located in the middle or front of the head.
  • Type: Menstrual headaches are often associated with a painful throbbing sensation.  The type of pain will often vary depending on where a woman is in her cycle.
  • Severity: Menstrual headaches are often severe. Menstrual headaches are not usually debilitating (but they can be). These headaches most often leave women feeling miserable but functional.
  • Duration: Menstrual headaches vary in duration depending upon the person. Some women experience them for only a few hours, others experience them for several days.

Types of Menstrual Headaches

Headaches that are caused by fluctuating hormones are the only headaches that are considered menstrual or hormone headaches. With this said, hormone headaches may be felt during one’s period, during pregnancy, or during or after menopause.  While these headaches occur during different stages of life, they are all hormone headaches.

Menstrual Headache Risk Factors

Menstrual headaches are typically only dangerous when women self-prescribe medication.  When normal pain medication is not effective, doctors may prescribe steroids or medications such as triptans or ergotamines to treat menstrual headaches.  Medications containing steroids are usually meant to be taken only for a few days unless otherwise prescribed.  Women who continue to take medications containing steroids to treat their menstrual headaches risk such side effects as weight gain, ulcers, diabetes, glaucoma, and osteoporosis.  If women cannot find relief from pain medication that does not contain steroids, they should contact their doctor.

Menstrual Headache Treatment Options

Treatment and prevention of menstrual headaches includes both lifestyle changes involving exercise and nutrition and pharmaceutical methods.  If menstrual headaches persist and are particularly severe, your doctor may prescribe medication to help regulate your hormone levels.

Headache Prevention

Preventing menstrual headaches is difficult but possible.  Lifestyle changes in diet and exercise and stress reduction can often help prevent headaches or reduce frequency and severity of the symptoms.  Changing birth control medication or using preventative medication may help as well.

  • Oral Contraceptives:  If you are experiencing menstrual headaches, avoid using birth control pills that contain estrogen.  Because menstrual headaches are primarily caused by fluctuations in estrogen levels, taking estrogen supplements often triggers headaches.

Consider switching to a oral contraceptive that contains progesterone instead of estrogen.

  • Exercise & Nutrition:  Regular exercise and healthy eating can help prevent menstrual headaches.
  • Relaxation Exercises:  Relaxation exercises reduce stress and thereby help prevent menstrual headaches.
  • Salt:  One simple method to reduce frequency and severity in your headaches is to reduce your salt intake. This includes decreasing foods and drinks that are high in sodium such as soda and fast food.
  • NSAIDs or Triptans: NSAIDs are nonsteroidal anti inflammatory medications.  Triptans are doctor prescribed medications that block pain signals in your brain.

Women can take NSAIDs or Triptans a few days before and then throughout their period (up to two weeks) to prevent hormone headache symptoms.

Immediate treatment

  • Icing:  One simple way to relieve the pain is to ice the parts of your head and neck that hurt.
  • Relax: Lowering stress not only helps prevent menstrual headaches but helps relieve them once they’ve set in.  Try relaxation exercises to reduce stress.
  • Acupuncture: Acupuncture can help relieve pain and relax your body to reduce stress.
  • Triptans: Triptans are a doctor prescribed medication that block pain signals in your brain.  Consider using triptans if your symptoms include vomiting.

Pain Medicine: The fastest and most effective method to treat menstrual headaches is a powerful, steroid-free and caffeine-free medication such as Migralex.  Migralex relieves headaches and is able to reduce the throbbing pain associated with hormone and menstrual headaches.  Migralex can not only relieve hormone headache symptoms but also prevent them from returning.

Menstrual Headache Resources