The common complaint is linked to a sudden drop in estrogen. But you don't have to suffer in silence every month. 

By Amanda MacMillan
June 15, 2018

Periods can be annoying enough, even if we’re only talking about symptoms like cramping, bloating, and, of course, bleeding. But on top of that, many women find they also experience headaches at this time of the month, as well—adding yet another layer to an already less-than-pleasant few days.

If you’re one of those women, it may help to know that your recurring headaches aren’t just your imagination. Menstrual migraines and other types of headaches during (or before) your period are a real medical phenomenon, and experts say they’re actually quite common. Here’s what to know about this type of pain, and what you can do about it.

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Why do I get period headaches?

Your hormones fluctuate throughout your monthly menstrual cycle, says James Woods, MD, a professor of obstetrics and gynecology at the University of Rochester. Just before your period begins—assuming you didn’t become pregnant after ovulation—your estrogen levels drop sharply.

“People sometimes don’t realize that our hormones are linked to brain chemicals and to our mental state,” says Dr. Woods. “Any sudden change in hormones can mean changes in mood or anxiety levels, or it can mean experiencing more symptoms like headaches.”

Research suggests that up to 20% of women (and up to 60% of women who get regular migraines) experience a form of migraine tied to their period, known as menstrual migraines. These tend to occur in the two days leading up to a period and the three days after a period starts.

It’s hard to say whether all period-related headaches are migraines, says Dr. Woods, since the definition of migraines has changed and expanded over the years. “But what we can say is that the vast majority of these headaches are linked to this drop in hormones,” he says.

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Menstrual migraine treatment and prevention

Since period-related headaches are fueled by hormonal changes, it can help to prevent large fluctuations, explains Dr. Woods. “A birth control pill that levels out those hormones throughout the month ... can really help,” he says.

Some women will still get headaches during the placebo week of a 28-day pill regimen, Dr. Woods adds. If that happens, he says, doctors may recommend that patients skip the placebo week and start right in on a new pack of pills.

“You can do that for a couple years, and you effectively level the playing field across the whole month,” he says. “If there’s no change in hormones, you’re less likely to get those headaches.”

RELATED: Is It Really OK to Skip a Period Using Birth Control?

Women who are going through menopause often experience menstrual migraines as well. Wearing an estrogen patch or taking estrogen can help keep hormone levels stable during this transition and may help reduce headaches. Once a woman has stopped having periods altogether, those migraines are likely to stop as well.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) and prescription pain relievers (like triptans) can also help treat period headaches and may be good solutions for women who choose not to or cannot take hormonal birth control. (Some types of birth control may not be safe for women who get migraines with auras, for example.)

“Some people benefit from strong coffee, some people take Excedrin, and people increase their doses of their migraine medication,” says Dr. Woods. He recommends talking to your doctor about what type of medication regimen is best for you. 

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Stress can also contribute to headaches, says Dr. Woods. Finding ways to relax during your period—and all month long—may help relieve symptoms. Alternative therapies, like acupuncture, yoga, or hypnosis, may benefit some people as well.

“There’s no one simplistic treatment that works for everyone," Dr. Woods adds. "It’s often a trial of different approaches until we find something that fits.”

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