The best remedies for menstrual migraines (2023)

Menstrual migraines or menstruation-related migraines can feel like a double whammy. Not only do you experience excruciating pain on a monthly basis, but you also live in fear and anxiety of the impending migraine attack as the days go by and yourperiodgetting closer.

Period-related migraine attacks are thought to be related to the changes in hormone levels that occur around this time of the month, and are therefore sometimes referred to as hormonal headaches.

“It is very common for women to have migraines near theirmenstrual cycle, and we believe it is due to the fallestrogen," diceNada Indian, MD, aheadache specialistand Research Associate at Stanford Health Care in Palo Alto, California. "Once the cycle starts, it's a huge migraine trigger."

menstrual migraine vs. Menstruation-related migraine

There are several types of migraines, and a subset of migraines are menstrual migraines, which, simply put, is when a person hasmigraine attacksright around menstruation, says Dr. hindiyeh.

"There are also period-related migraines, which means that while you certainly get migraines in your monthly cycle, you'll also have migraine attacks at other times of the month," says Hindiyeh.

Most women who have migraine attacks at the time ofmenstruationhave menstruation-related migraines, according to Hindiyeh. “Their menstrual cycle will certainly be a trigger, but they also have other triggers or other times when they will have migraine [attacks],” says Hindiyeh.

Menstrual migraines are difficult to treat

“Menstrual and period-related migraines can be the most difficult type of migraine to treat. [The attacks] can be quite severe, can last several days, and can be quite debilitating,” she says.

Even if you only have migraine attacks around the time of your period, for many women that can still mean five days or more a month, Hindiyeh says. "In that case, it's really time to talk to her doctor about daily migraine preventative treatment options," she says.

Generally speaking, there are many treatment options for migraine and menstrual migraine prevention, says Hindiyeh. Here's a rundown of key medications and lifestyle modifications that can help reduce the frequency and severity of period-related migraine attacks.

1. Triptans May Play a Preventive Role

Triptans are acute medications that are taken when a person experiences a migraine attack, according tomigraine again.

But there are certain types of triptans that work longer, making them useful for preventing a migraine attack or making it less severe, Hindiyeh says.

“Your short-acting triptans, likesumatriptano (imitrex)mirizatriptán (Maxalt)they normally have a half-life of about four hours,” he explains. The half-life of a drug is the amount of time it takes for the concentration of that drug to drop to half of its initial dose in the body, according to a journal article.StatPearls.

“There are also triptans that have a longer half-life. For example,frovatriptano (Frova)has a half-life of 26 hours, andnaratriptan (Amerge)it has a half-life of six to eight hours. The longer-acting ones can often be used as a 'mini prophylaxis' around the time of your period,” she says.

“If you know your period is a big trigger for a migraine attack, you can start taking one of these longer-acting triptans a few days before your period, every day or twice a day for a few days at a time. , depending on the drug. This can help prevent the migraine attack from becoming so severe,” says Hindiyeh.

OAmerican Headache Societyspecifically recommendsfrovatriptan“for the short-term preventive treatment of menstrual migraine”.

2. NSAIDs are another prevention option

Non-steroidal anti-inflammatory drugs orMaterial, ofnaproxen (Aleve), can also be used strategically for menstrual migraine prophylaxis in a similar strategy to triptans, Hindiyeh says.

According to the headache specialistVicente T. Martin, MD, writing to theAmerican Headache Society, 550 milligrams (mg) ofaleveTaking twice a day for six days before and seven days after menstruation has been shown to be effective in preventing menstrual migraines.

Ameta-analysis published inNeurologyreviewed 15 studies that looked atMaterialand complementary therapies, such as various herbal remedies, and concluded that the use of NSAIDs to prevent episodic migraine attacks is "probably effective". But its use specifically for preventing menstrual migraines has not been addressed.

If you think you might try taking an NSAID to prevent menstrual migraine attacks, be sure to discuss this plan with your doctor. There are potential risks with taking NSAIDs, including an increaseheart attack riskand stroke,US Food and Drug Administration, as well asgastrointestinalbleeding andulcers.

3. Oral contraceptives can reduce the frequency of menstrual migraines

There is some evidence to suggest that certain types oforal contraceptive pillsit can actually reduce the frequency of menstrual migraines and menstruation-related migraines,” says Hindiyeh.

This does not apply to all types of orals.contraceptivethen you should talk to yourgynecologist, primary care physician, or neurologist on which ones you want to consider, Hindiyeh says. “There are some details that will keep yourestrogen levelto float so much,” she says.

If you are considering taking oral contraceptives (also known asto pile) as a contraceptive method or to try to improve yourmigraine symptomsTell your doctor about your migraine history, says Hindiyeh.

While most headache experts agree thathormonal anticoncepcionalis safe for most women with migraines, there are cases where it may increase the risk ofAVC,cardiovascular disease, odeep vein thrombosis (blood clot), in accordance withamerican migraine foundation. women who havemigraine with auraPeople, in particular, are advised to talk to their doctors about any additional risk factors for stroke or cardiovascular disease that they may have.

4. Self-care makes a difference in the frequency of migraines

If you have menstrual migraines, it's especially important to take care of yourself and try to reduce your stress level during your period, Hindiyeh says.

“Keep a routinesleep schedule, which means waking up and going to bed at the same time every day. Don't skip meals, try to eat protein with every meal and don'taerobic exerciseevery day for about 20 to 30 minutes,” she says.

"Making these habits a priority will help you decrease the frequency and severity of your migraine attacks," Hindiyeh says.

5. Daily magnesium has a preventive effect

"I really likemagnesiumas a natural supplement to take every day to help prevent menstrual migraines,” says Hindiyeh. There is evidence to support the use of magnesium, although the mechanism of action, or the "why" behind how it improves migraines, is not fully understood, she says. "It could be stabilizing the cells or decreasing hyperexcitability or neural firing, but that's all theoretical at this point," she adds.

Areview published in the February 2018 issue of the magazineHeadachewhich examined five clinical trials of magnesium formigraine preventionconcluded that high doses ofmagnesium citrate"It appears to be a safe and profitable strategy."

while theHeadachereview did not specifically address menstrual migraine,american migraine foundationreports that daily oral magnesium supplementation has been shown to be effective in preventing menstrual-related migraine, especially in women with premenstrual migraine.

A variety of types of magnesium supplements can be purchased without a prescription. You can learn more about the different types on the website.migraine again, and remember that it's always a good idea to talk to your doctor about any supplements you're taking or interested in taking.

6. Regular exercise can help prevent menstrual migraines.

“When we consider all the strategies to prevent migraine attacks, I love it when people choose to make lifestyle modifications that can make a real difference,” says Hindiyeh.

“There is a lot of evidence to suggestaerobic exerciseit can work as preventative medicine on its own, and there are some studies that suggest that yoga and HIIT (high intensity interval training) may also be helpful,” Hindiyeh says.

Areview published in 2020 inCurrent reports of pain and headacheidentified numerous studies showing that aerobic exercise can reduce migraine frequency, intensity, and duration, with higher-intensity exercise having more benefits. But the author noted that low-impact exercises like yoga can also have benefits.

"Not only can regular exercise help prevent migraine attacks in some people, but also, if the headache is mild, a brief exercise can help alleviate the headache that's going on," according to Hindiyeh.

On the other hand, overexertion can be a migraine trigger, especially if you're already having a migraine attack, she says.

“One of the fundamental definitions and characteristics of migraine is that normal activity can make you feel worse. If you're already in the middle of a bad migraine attack, moving around too much will make things worse for you; it's probably not the best time to run or do some aerobic activity,” says Hindiyeh.