You may have noticed that you get a migraine during your period. This isn’t unusual, and it may partly be due to the drop in the hormone estrogen that happens before you menstruate.
Migraines triggered by hormones can happen during pregnancy, perimenopause, and menopause. Learn why this happens and how it can be prevented.
Is It a Migraine or a Headache?
Migraines are different than common headaches. They typically cause high levels of throbbing pain and usually occur on one side of the head. Migraines are categorized as “with aura” or “without aura.”
If you have a migraine with aura, you may experience one or more of the following symptoms in the 30 minutes before your migraine:
- unusual changes in smell
- unusual changes in taste
- unusual changes in touch
- numbness in the hands
- numbness in the face
- tingling sensations in the hands
- tingling sensations in the face
- seeing flashes of light
- seeing unusual lines
- difficulty thinking
The symptoms of a migraine with aura can include:
- sensitivity to light
- sensitivity to sound
- pain behind one eye
- pain behind one ear
- pain in one or both temples
- a temporary loss of vision
- seeing flashes of light
- seeing spots
Common headaches are never preceded by an aura and are typically less painful than migraines. There are several different kinds of headaches:
- High levels of stress and anxiety can cause tension headaches. They may also be caused by muscle tension or strain.
- Sinus headaches often include symptoms like facial pressure, nasal congestion, and severe pain. They sometimes occur with a sinus infection.
- Cluster headaches are often mistaken for migraines. They typically cause pain on one side of the head and may include symptoms such as a watery eye, runny nose, or nasal congestion.
How Do Hormone Levels Affect Migraines?
Migraines can occur when hormone levels are in flux. They can also be caused by some medications, such as birth control pills.
Approximately 60 percent of women who have migraines get menstrual migraines. This can happen anywhere from two days before the start of menstruation to three days after menstruation ends. Migraines may begin when young girls get their first period, but they can start at any time. They can continue throughout the reproductive years and into menopause.
Perimenopause and Menopause
Dropping levels of estrogen and other hormones, such as progesterone, can cause migraines during perimenopause. On average, perimenopause starts four years before menopause, but it can begin as early as eight to 10 years before menopause. Women taking who are on hormone replacement therapy may also get migraines.
Hormone headaches during pregnancy are most common during the first trimester. This is because blood volume increases and hormone levels rise. Women can also experience common headaches during pregnancy. These have many causes, including caffeine withdrawal, dehydration, and poor posture.
What Else Causes Migraines?
Certain risk factors, such as age and family history, can play a role in whether you get migraines. Simply being a woman puts you at increased risk.
Of course, you can’t control your gender, age, or family tree, but it may help to keep a migraine diary. This can help you identify and avoid triggers. These may include:
- poor sleeping habits
- alcohol consumption
- eating foods high in tyramine, such as smoked fish, cured or smoked meat and cheese, avocado, dried fruit, banana, aged food of any kind, or chocolate
- drinking excessive amounts of caffeinated beverages
- exposure to extreme weather conditions or fluctuations
- exposure to extreme, intense levels of light or sound
- breathing in strong odors from pollution, cleaning products, perfume, car exhaust, and chemicals
- ingesting artificial sweeteners
- consuming chemical additives, such as monosodium glutamate (MSG)
- missing meals
How Are Migraines Diagnosed?
Your doctor will do a physical exam and ask about your family history to help them determine any potential underlying conditions. If your doctor suspects something other than hormone fluctuation is causing your migraine, they may recommend additional tests, such as:
- a blood test
- a CT scan
- an MRI scan
- a lumbar puncture, or spinal tap
How to Relieve Migraine Pain
There are several ways to relieve a migraine or prevent migraine pain.
Over-the-Counter (OTC) Drugs
Your doctor may recommend that you try an over-the-counter (OTC) pain medication, such as ibuprofen (Advil, Midol). They may advise you to take these on a scheduled basis, before the onset of pain. If your sodium levels are found to be high during your physical exam, your doctor may also recommend that you take a diuretic.
Many different prescription drugs are available to help relieve migraine pain. These can include:
- ergotamine drugs
- calcium channel blockers
- onabotulinumtoxinA (Botox)
- CGRP antagonists to prevent migraines
If you’re on hormonal birth control, your doctor may also recommend that you switch to a method with a different hormone dose. If you aren’t on hormonal birth control, your doctor may recommend that you try a method such as the pill to help regulate your hormone levels.
Certain vitamins and supplements have also been shown to stave off migraines triggered by hormones. These include:
- vitamin B-2, or riboflavin
- coenzyme Q10
Regular exercise may help relieve migraines triggered by hormones. Other women may find that exercising makes their headaches worse. Stay hydrated, eat a high-protein meal before exercising, and warm up your muscles before exercise to maximize the migraine-busting benefits.
Lowering stress and anxiety may sound easier said than done, but there are simple steps you can incorporate into your daily life. Try a few minutes of meditation or yoga after waking up in the morning or before going to bed. Practice deep breathing exercises during difficult situations.
Identifying your triggers and experimenting with different treatments can help you reduce or manage your migraines. If OTC medications aren’t working for you, make an appointment with your doctor. They may be able to recommend alternative treatments or prescribe a strong medication to help alleviate your symptoms.