Dr Clare Morrison

Article by Dr Clare Morrison

Hormonal Migraines

Menstrual migraines affect half of all women who suffer from migraines. Hormonal migraines are linked to falling levels of oestrogen and the normal release of prostaglandin during the first 48 hours of menstruation. Research shows that migraines are most likely to occur in the two days leading up to a period, and the first three days of a period.

There are two patterns:

  • Pure menstrual migraines – occur when migraine attacks happen only around periods.
  • Menstrual-associated migraines occur around periods as well as during other times.

How do I know if I suffer from menstrual migraines?

There are no tests available to confirm the diagnosis. The only accurate way to tell if you have menstrual migraine is to keep a diary for at least three months, timing your migraine attacks and the days you have your period. This will also help you to identify non-hormonal migraine triggers. It is also important to address your diet and exercise regularly.

Menstrual migraine treatment

If you have migraines and heavy periods, the following can help:

  • Triptans – such as Sumatripan.
  • NSAIDS – or anti-inflammatory painkillers, like Mefenamic Acid. This is considered to be helpful in reducing migraines associated with very painful periods. A dose of 500 mg can be taken three to four times daily, two or three days before your period is due to start. Another example is Naproxen – which is effective in doses around 500 mg once or twice daily around the time of menstruation.
  • Oestrogen supplements – top up naturally falling oestrogen levels just before and during your period. This could help if your migraine occurs regularly before your period. Oestrogen can be taken in several forms, such as skin patches or gel. You put the patch on your skin for seven days, starting three days before the expected first day of your period.
  • Contraceptives are a useful option if menstrual migraines are a problem and you also need contraception.
  • Magnesium supplements can also help.

Why diet is important

Oestrogen levels require stricter regulation in comparison to other hormones in your body to ensure the natural rhythm runs smoothly. The liver metabolises oestrogen, if it is overloaded with medications or artificial substances, this can affect the metabolisation of oestrogen. Research shows that diet can attribute up to 90 percent of all factors affecting hormones.

Certain food ingredients act like toxins which can contribute to your migraines. These include:

  • Carbohydrates
  • Refined sugars
  • Processed foods
  • Migraine-trigger foods – such as cheese and coffee.

Menopause and migraines

In the run up to menopause, oestrogen levels go on a crazy ride and many women see their headaches worsen during this period. The menopause can be a difficult time for women with migraines. The irregularity of periods can make it difficult to cope with migraines as they become harder to predict. The problems that can be experienced at the menopause – hot flushes and night sweats – result in disturbed sleep and add to stress levels, boosting the likelihood of experiencing a migraine. However, when periods stop, migraines will likely stop too.

For more information about migraines contact one of MedExpress’s team – you can also purchase migraine treatments.


Dr Clare Morrison
Dr Clare Morrison
Experienced General Practitioner in Hampshire since 1995, with particular interest in Nutrition, Obesity and Smoking Cessation.
Originally published September 04 2017, updated March 10 2020