If you experience debilitating headaches around the time of your period, you’re not alone. 18% of women in the US suffer from migraine headaches and 60% of these women are affected by menstrual migraines. This type of migraine headache occurs before, during, or immediately after a period, and sometimes during ovulation.

Symptoms and Types of Menstrual Migraine Headaches

Menstrual migraine headaches are similar to migraines without aura. They typically start as a one-sided, throbbing headache accompanied by nausea, vomiting, or sensitivity to bright lights and sounds. In order to be classified as menstrual migraines, they need to occur during about 60% of your cycles.

The Two Types of Menstrual Migraines:

Pure Menstrual Migraine

Some women only get migraine headaches exclusively during the one to two days before or after the onset of their periods. They don’t suffer from migraines at any other time during their cycle. Pure menstrual migraine only occurs in about 10% of women who suffer from menstrual migraines.

Menstrual-Related Migraine

Some women suffer from migraine headaches during other times of their cycles in addition to the few days right around their periods. The migraine headaches that occur one to two days before or after the onset of their periods are called menstrual-related migraines.

Causes of Menstrual Migraine Headaches

Menstrual migraines are triggered by hormones, specifically estrogen, which regulates the menstrual cycle. Women are more prone to headaches when the level of estrogen and progesterone fluctuate during the menstrual cycle.

Anything that affects the hormonal balance can increase the likelihood of developing menstrual migraines. This includes the use of oral contraceptives, which influence hormone levels. In addition, women who are progressing towards menopause are more prone to menstrual migraines because they experience more fluctuations in their estrogen levels.

Common Treatments for Menstrual Migraine Headaches

Some women have found that resting in a cool dark room or drinking something with caffeine is enough to ease their menstrual migraine. Others may need medications to relieve the headaches.

Before discussing treatment options with your doctor, it’s recommended that you track the occurrences of the headaches in relation to your menstrual cycle to help your doctor determine if you’re indeed suffering from menstrual-related migraines. You should also pay attention to see if there’s any specific trigger that worsens the headaches.

Some common treatment options for menstrual migraine headaches include:

Acute treatment: pain relievers and anti-inflammatory agents are taken when symptoms occur. First-line medications include aspirin, acetaminophen, Ibuprofen, and other NSAIDs. If these don’t work, your doctor may prescribe stronger migraine-specific medications.

Preventive treatment: if you experience frequent and severe migraine attacks, preventive therapy administered around the time of menstruation can help prevent menstrual migraine headaches.

Hormone therapy: medications that reduce hormonal fluctuations can help minimize the occurrence of menstrual migraines, especially pure menstrual migraines. These treatments include the continued use of oral contraceptive or the use of supplemental estrogen taken either orally or administered as a transdermal patch.

Behavioral therapy: if your menstrual-related migraine headaches tend to be triggered by stress and tension, you can explore the use of behavioral therapies such as relaxation therapy, biofeedback, or cognitive-behavioral therapy to help control your stress level.