The term “menstrual migraine” refers to migraine episodes that appear to be connected with the menstrual cycle. Many people find that hormonal changes can trigger their migraine symptoms.
Menstrual migraine is not a distinct medical condition. It is a way of describing the episodes a person experiences.
In this article, we explore menstrual migraine in detail, including the causes and treatments.
Migraine is three times as common in females as it is in males. According to the United Kingdom’s National Health Service (NHS), more than half of females with migraine notice a connection between their symptoms and their menstrual cycle.
The term “menstrual migraine” describes episodes that appear to be caused by hormonal fluctuations.
The authors of a 2016 study report that there are two subtypes of menstrual migraine. Those with “pure menstrual migraine” only have episodes during menstruation, and the researchers cite a prevalence of 1%.
The second subtype is called “menstrually related migraine.” In this case, migraine episodes often occur around a period, but not always —menstruation appears to be one of several contributing factors. About 6–7% of people have this type of migraine.
Menstrual migraine can also result from hormonal changes during perimenopause, pregnancy, or a course of oral contraceptives.
- sensitivity to light, sound, or both
- aura — audio-visual disturbances that tend to appear before other symptoms
People with menstrual migraine often experience episodes during or around their periods. According to the NHS, a person with this issue is most likely to experience an episode 2 days before a period or in the first 3 days of a period.
However, these episodes may occur when starting hormonal medication or during pregnancy or perimenopause.
Episodes triggered by these hormonal shifts may be more frequent, severe, or difficult to treat than others.
Generally, doctors diagnose migraine if a person has experienced migraine symptoms lasting 4–72 hours on at least five occasions.
Keeping a symptom diary can help a person tell whether their migraine symptoms are linked with their menstrual cycle or birth control, for example.
Scientists are not entirely sure what causes migraine. However, inflammation may play a role.
Chemicals in the brain can causeTrusted Source blood vessels in the area to swell. If this irritates nearby nerves in the head, it can cause neurological changes and pain.
Hormones influence inflammation levels. They act as messengers and can change how parts of the body behave, including the blood vessels.
Researchers have suggested two possible ways that female sex hormones may influence migraine. The symptoms may be triggered by estrogen or prostaglandins.
Estrogen levels fall just before a period, during perimenopause, and when the person stops taking a medication that contains estrogen. For example, these levels drop during the pill-free week in many birth control regimens.
Estrogen can affect pain sensations, which may be why reduced levels can trigger migraine episodes.
Prostaglandins are chemicals responsible for raising inflammation levels, and the body releases them before a period.
Other things that may increase the risk of developing migraine include:
- genetic factors
- female sex
- underlying health conditions that cause inflammation or otherwise trigger migraine
For some people with menstrual migraine, a period may be the only trigger. Others may have several triggers beyond hormonal changes. These could include: