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If you suffer from migraines, you may notice they often occur around your period. You’re not alone: As many as two-thirds of the women who get migraines experience menstrual cycle headaches.

Wondering what triggers hormonal headaches and how to avoid them? Read on to find hormonal headache relief and learn how to prevent hormonal headaches before your period.

What Are Period-Related Migraines?

Period-related migraines are headaches that happen right before or during your menstrual cycle. They can feel debilitating, both physically and emotionally.

Migraines are more common in women than in men due to the relationship between migraine and hormone fluctuations in different phases of a woman’s lifetime.

Every month, right before your period, the levels of the hormones estrogen and progesterone drop. This change in hormone levels can trigger a migraine. Doctors sometimes call them estrogen withdrawal migraines. Fluctuating hormones during pregnancy and perimenopause can also lead to migraines.

Hormonal migraines become less frequent when you reach menopause and your hormones stabilize.

What Are the Symptoms of a Hormonal Headache?

A hormonal headache is a type of migraine. Migraines are different from the more common tension headache (also called a stress headache).

The pain of a migraine is more severe than a regular headache. It tends to feel like a throbbing or pulsing pain on one side of the head.

A migraine may also cause:

An “aura” when the migraine begins. An aura may look like flashing lights, sparkles, or zigzag lines across your field of vision.

• Dizziness.
• Fatigue.
• Loss of appetite.
• Nausea.
• Sensitivity to bright lights and loud noises.
• Vomiting.

Common Questions About Hormonal Headaches

What’s the difference between hormonal headaches and regular migraines?

Hormone-related headaches may feel more severe and last longer than migraines at other times. Otherwise, the symptoms are the same.

Is it important to know how to track hormonal migraine patterns?

It’s helpful to keep a “headache diary” where you write down the days when you have migraines. You can note the severity of symptoms and how long they last. Sharing this information with your doctor can help you develop a treatment plan.

You may notice a regular pattern to your migraines. In addition to your menstrual cycle, triggers might include certain foods, stress, lack of sleep, or alcohol and caffeine. Knowing your triggers can help you take measures to stave off or lessen the discomfort of menstrual migraines.

Can birth control help with menstrual migraines?

Possibly. There’s a connection between birth control and menstrual migraines. Some birth control pills can reduce the severity of migraines by stabilizing your hormones.

Is there a connection between perimenopause and migraines?

Yes. Hormonal migraine triggers include more than your menstrual cycle. More women experience migraines during perimenopause (the years leading up to menopause) due to shifting hormones.

Some women experience migraines for the first time during pregnancy. Again, changing hormone levels are to blame.

Menstrual Migraine Treatment Options

You can ask your primary care provider (PCP) for advice on how to manage migraines during perimenopause or any other time. They may refer you to a headache specialist.

You may find you can’t prevent every headache. But a combination of medications and lifestyle changes can help reduce the severity and frequency of hormonal migraines.

The best medications for menstrual migraines include:

• Birth control pills — Hormonal birth control can keep estrogen levels stable in the days leading up to your period and beyond.
• CGRP inhibitors — These medications specifically target migraine pathways by blocking the release of calcitonin gene-related peptide (CGRP). This protein contributes to migraine pain. CGRP inhibitors come in pill and injection form.
• Hormone therapy — Formerly called hormone replacement therapy or HRT, these estrogen supplements can help prevent the drop in hormone levels that triggers migraines. They come in patch, pill, and vaginal gel form.
• Nonsteroidal anti-inflammatory medications (NSAIDs) — These over-the-counter (OTC) medications, such as Advil and Motrin, can help ease headache pain.
• Triptans — These drugs are common treatments for migraines. They come in tablet, injection, and nasal spray forms.

How to Treat Hormonal Headaches Naturally

For many women, simple lifestyle changes can help ease the discomfort of hormonal headaches. These habits are good for managing migraines in general. You can:

• Avoid known triggers — If habits like eating cheese or drinking alcohol trigger your migraines, stay away from them. It’s especially important to do so on the days before and during your period.
• Drink enough water — Your body needs adequate hydration to work properly.
• Ice — Applying cold compresses to your head can ease the pain of a migraine.
• Improve your quality of sleep — Irregular sleep or sleep deprivation can trigger migraine. Develop a healthy sleep schedule of going to bed at the same time every night.
• Manage stress — Relaxation techniques like meditation, yoga, and gentle stretching can help keep stress levels low. A regular exercise routine (walking, jogging, swimming) is often a great stress reliever.
• Take supplements — Talk to your doctor about whether vitamin B2, vitamin D, or magnesium supplements may help ease your period headache symptoms.
• Track your cycle — Knowing when a migraine is likely to happen can help you prepare.
• Try complementary therapies — Some people find relief from migraines through acupuncture or massage therapy. Talk to your doctor about these methods.

You may not prevent every menstrual headache. But maintaining healthy habits can lessen your chances of having a bad migraine.

When to See a Doctor for Menstrual Migraines

If you get migraines frequently with your period, you should see your PCP or, if they advise it, a headache specialist. Other reasons to call your doctor include:

• Your headache pattern changes.
• Your headaches are interfering with work, school, or daily life.
• You’re getting more headaches than before, or they’re more severe.
• You’re having new or more severe side effects.

You should call 911 or head to the nearest emergency department if you have any of the following symptoms:

• A bad headache that comes on suddenly.
• You experience numbness or a tingling sensation with the headache.
• You feel like you’re having “the worst headache of my life.”
• You have a seizure.
• You have difficulty speaking or blurred vision.
• You have trouble balancing or feel confused.
• You’re pregnant and have a bad headache, which is a possible sign of preeclampsia.

Other concerning symptoms include swelling of the face or hands, changes in eyesight, and sudden weight gain.