Up to 25% of women experience migraine headaches during their reproductive years; often migraine headaches may be triggered or exacerbated by hormonal changes. It has been estimated that 7-14% of women experience migraines only during the premenstrual or menstrual phase of their cycles. Another 52-70% experience headaches throughout the month but note increased headache activity before or during menses.
Interestingly, before puberty, the prevalence of migraine appears to be similar for boys and girls. Peak migraine incidence in girls occurs at menarche, and in adulthood females outnumber male migraine sufferers by about 3 to 1.
The reported effects of pregnancy, oral contraceptives and menopause on migraine headache patterns have been variable. It is believed that declining estrogen levels may be an important trigger, and it is thought that progesterone may also play a role. Migraine often, but not always, improves during pregnancy; however, postpartum migraine flares are common. The effects of oral contraceptive use are quite variable: migraines may improve, worsen, or remain the same. Low estrogen dose oral contraceptives usually have no effect or may improve migraine. Estrogen replacement therapy for menopausal women often exacerbates migraines.
Treatment options include aspirin, ibuprofen, or acetaminophen, often combined with caffeine, for mild attacks. Triptans (including sumatriptan) or DHE (dihydroergotamine) may be used for moderate to severe attacks. Migraine prophylactic agents include beta-blockers, calcium channel blockers, tricyclic antidepressants, anti-epileptic agents, and serotonin receptor antagonists. For menstrual migraines, estradiol-containing compounds medications (oral, transdermal or percutaneous gel) may be used to prevent migraines. Progesterone alone appears to have little therapeutic value. In general, it is helpful for a woman experiencing new onset or exacerbation of migraine to seek consultation from a neurologist.
Kimberly H. Pearson, MD
Women’s Mental Health. Kornstein SG, Clayton AH. The Guilford Press: New York. 2002.
Brandes JL. The influence of estrogen on migraine: a systematic review. JAMA. 2006 Apr 19;295(15):1824-30. Loder EW. Menstrual migraine: pathophysiology, diagnosis, and impact. Headache. 2006 Oct;46 Suppl 2:S55-60.
10 Comments
Has anyone else with migraines had a hard time getting their doctor to prescribe the birth control pill? My gynecologist was very concerned about putting me on the pill, but the neurologist said it was fine. Since going back on the pill my headaches have actually gotten better.
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amy Replied:
November 16th, 2009 at 10:57 pm
@Concerned, Yes, it’s because the pill usually increases your chances of getting a stroke. And if you suffer or used to suffer from regular miagraines then your chances are even higher of getting a stroke.
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For the past two and a half years, I have been dealing with Migraines on literally a daily basis. Is there any one else who has had this problem? And are there any solutions? Any help would be appreciated. Thank you.
~jaquie
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For years, I’ve had terrible migraines lasting for days. I notice a connection with my hormones even though I have irregular cycles due to PCOS. My gyno said it was impossible to have headaches throughout the month because of hormones, because the only change is right before your period. Anyone else have this problem?
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I recently(past 2 months) have had migrains on a daily basis, practically 24/7. And I finally got fed up with it and went to the doctor, I almost had myself convinced I had a brain tumor. but my doctor gave me no explanation to why I have my migrains. And my period lasts me a month to two months long, so this kind of makes sense how the two link together. But I was prescribed with a high blood pressure medicine to control my migrains and so far thy seem to be working.
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I have been sufering from hormonal migranes since 11 years old it has been awful. To this day im still suffering, from migranes and usually it happens 2 weeks after my menstrual. Birth control has help alot!
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I get migranes all the time, but have never had the sensation that they are connected with my menstrual cycle! Very informative article here.
Menstrual Cramp Remedies
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I have suffered for years with Menstrual migraines. 5 years ago, I found my cure! For me, removing the salt from my diet from about 2 days before my period through the end of my period and drinking water to “flush” out my system. It works 100%! No salt means no dining out, no packaged foods…I cook fresh food at home so I know whats in it. If I get weak and eat what I crave like sushi or chips, I get a migraine, so I start flushing with water. No pills, no pain, no monthly anxiety. My life has improved!
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I went off the Pill two years ago after 18 years of continual use in order to try and conceive, and my semi-regular migraines seem to have completely disappeared since then. I went to different doctors, tried various OTC and prescription meds over the years, but never made the connection to the hormones in birth control. Still haven’t had a successful pregnancy (2 miscarriages), but I believe it’s more age-related (I’m now 37) than due to medication. Wondering if anyone has had a similar experience…
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I could associate my eating habits with my migraines…I have been dealing with them for over years now. I have noticed acidic foods to trigger my migraine.
Appreciate your share, I will try your easy-to-follow remedy, will be ever grateful if it should work for me too.
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I have been suffering with chronic migraines for over 8 yrs now. I do take immitrex for them but have noticed in the last couple years they are way more prominent around my period. I get them before,during and after… My life is not good for about 1 1/2 to 2 weeks. I”m trying to get pregnant and have had no success yet but doctors say they cant help me since I am trying to get pregnant.. according to them my hormone levels are fine… i dont know.. i beg to differ.. anyone else with this problem?
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