It is estimated that nearly 25% of women suffer from migraines during menstruation. These are very disabling situations which, according to experts, need more attention.
Menstrual migraine is a very debilitating pathophysiological phenomenon that can be accompanied by vomiting and dizziness. On average, it appears a few days before menstruation and is still present about 48 hours after it begins. As a result, many women may find themselves spending nearly a week feeling very limited.
Given the distress of this experience, it is common to turn to primary care. However, doctors often prescribe medications that don’t always have the expected effect. In these cases, it is the gynecologists and neurologists who are best able to offer the best treatment in these circumstances.
In general, this type of migraine is much more problematic than the symptoms associated with the rule. This means that a multidisciplinary approach is needed to offer a more accurate answer.
It is common to have headaches during PMS. However, there are women who experience the impact of intense migraine attacks every month.
What is menstrual migraine?
As we well know, migraine is directly associated with abnormal stimulation of the trigeminal vascular system (TVS). It is a neurological problem that occurs with inflammation of certain nerves in the brain that causes a throbbing headache, as well as photophobia or vomiting. So if we’re basically dealing with a vascular problem, what does that have to do with menstruation?
It actually has a lot to do with it. To begin with, migraine is a condition that appears to a greater extent in women. Menstruation and the hormonal changes experienced during those weeks are a trigger for this problem. So, something that recent studies like those published on The Lancet they tell us is that more research is needed to understand this medical condition.
Even today the mechanisms that orchestrate menstrual migraine itself are unclear. However, it is a type of pathophysiology that it affects a very large segment of the population and, therefore, more effective treatments are needed.
What are the symptoms?
It is important to first differentiate menstrual migraine from tension headache which can also appear before and during the period. The latter, for example, cause pain on both sides of the head and what one basically feels is a feeling of understanding, as if we were wearing a helmet.
- Not, menstrual headaches only appear on one side of the head and the pain is throbbing.
- At the same time, it is important to note that it appears a few days before menstruation and does not tend to decrease until a couple of days after the start of menstruation.
- The pain does not go away with analgesics and intensifies with food and drink such as coffee, chocolate, wine, cheese, sausages, industrial pastry…
- Feeling of extreme heat or sudden cold.
- Tiredness.
- Episodes of diarrhea.
- It is common to experience dizziness and vomiting.
- Greater sensitivity to light and also to sounds.
- Menstrual migraine can occur with or without an aura. That is, migraine with aura is characterized by the fact that, before the headache appears as such, the woman already feels some symptoms such as vision problems, tingling, etc.
Menstrual migraines can last a few hours or, in severe cases, last days. In these latter situations, the woman is very limited when it comes to being able to lead a full life.
What are the triggers of this type of migraine?
As we explained earlier when talking about the study The Lancet, the truth is that the triggers of menstrual migraine are not exactly known yet. To date, the following hypothesis is still being studied:
- This type of headache is associated with a decrease in female hormones, such as estrogen and progesterone.
- A few days before menstruation and just during the first days during their onset, these hormones decrease dramatically.
- Also, there’s something obvious. Women who already have migraines have more flare-ups during their periods.
- On the other hand, factors such as stress or poor nutrition can also exacerbate this phenomenon.
- Migraine always has a family history.
How is menstrual migraine treated?
Research papers, such as those conducted in 2002 at the City of London Migraine Clinic, suggest two approaches to the problem.
On the one hand, in milder cases, you can opt for non-steroidal anti-inflammatory drugs (NSAIDs). On the other hand, it is also common to resort to triptans, selective agonists of the serotonin receptor. These are drugs that are used in acute migraines.
However, as we have already indicated, these approaches do not always give the expected result. In general, contraceptive strategies can be used and thus regulate the entire hormonal aspect. On the other hand, it is also important to take care of your diet and stressful situations. All those foods that contain amines such as cheeses, sausages, chocolate, as well as food additives tend to increase inflammation.
Finally, do not hesitate to consult experienced professionals. Following medical treatment and taking care of our lifestyle is essential to reduce the impact of migraine.
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All sources cited have been thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography for this article has been deemed reliable and of scholarly or scientific accuracy.
- Ashina, M., Møller, H. J., Phu D. T., Melo-Carrillo, A., Burstein, R., & Moskowitz, M. A. (2019). Migraine and the trigeminovascular system—40 years and counting. The Lancet, Neurology, 18(8), 795-804. https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30185-1/fulltext
- Grota, V. M., & MacGregor, E. A. G.(2021). Menstrual migraine: a distinct disorder needing greater recognition. The Lancet, Neurology, 20(4), 304-315. https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(20)30482-8/fulltext?rss=yes
- Hormone headaches. (2021, September 23). National Health Service. Accessed 19 April 2023. Available at: https://www.nhs.uk/conditions/hormone-headaches/
- Menstrual migraine. (2022, May 31). National Migration Center. Accessed 19 April 2023. Available at: https://www.nationalmigrainecentre.org.uk/understanding-migraine/factsheets-and-resources/menstrual-migraine/
- Menstrual migraine treatment and prevention. (2021, November 05). American Migration Foundation. Accessed April 19, 2023. Available at: https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/
- Menstrual migraines: Treatment, pain relief & symptoms. (2021, March 03). Cleveland Clinic. Accessed April 19, 2023. Available at: https://my.clevelandclinic.org/health/diseases/8260-menstrual-migraines-hormone-headaches