Menstrual Migraines

Do you experience headaches during your period? Did you know there is actually a relationship between when the menstrual cycle occurs and when you may experience a migraine? Unfortunately these types of migraines, known as menstrual migraines, can last longer, are more painful, and can cause more nausea than your run-of-the-mill migraine. 

Menstrual migraines occur in 33% of affected women, and can occur more prominently in a woman's 40s. It can occur with other symptoms such as: PMS, dysmenorrhea, and nausea. 

Menstrual migraines can occur in premenopausal women, and it's thought that the fluctuating estrogen levels and an estrogen withdrawal effect can trigger the migraines. There are two types of menstrual migraines: menstrually-related migraines and pure menstrual migraines.

What is a menstrual migraine?

Pure menstrual migraines

These migraines typically occur 2 days before and 3 days into the cycle. There is no aura associated with this migraine, and this migraine will not happen any other time within the cycle.  

Menstrually-related migraines 

These migraines usually occur during the premenstrual window (2 days before), on day 1 or 2 of the cycle, and can also occur outside of the cycle. 

How is a menstrual migraine different than a headache?

Other than it occurring around/during your cycle, common symptoms include:

• Unilateral or bilateral head pain - sensation of aching, burning, stabbing or throbbing

• Pain that worsens with movement

• May occur with an aura or other visual disturbances (ie. flashing lights, vision defects)

• Sensitivity to light, noise and smell

• Nausea and vomiting

Natural Treatments for Menstrual Migraines

Unfortunately, not many natural treatments have been specifically studied for this type of migraine. In fact, there are no medications specifically approved either for it. Of course there are many botanical and nutritional options for general migraines that should be considered but no research exists for their treatment in menstrual migraines.

Phytoestrogens

Because estrogen decline is thought to be the reason for these migraines, a few studies have looked at using phytoestrogens as a potential method of prevention. 

One study looked at daily supplementation of soy isoflavones, dong quai, black cohosh for about 6 months. They found a reduction of menstrual-related migraine attacks, starting at week 9. 

Another study looked at supplementing with genistein and daidzen during the premenstrual window (about a week before the cycle is set to begin), and noted that migraine days were reduced, and women did not experience any side effects. 

Where to go from here

Start tracking your migraines - when they begin, how long they last, what helps, what doesn't help, the sensation of pain, the intensity of pain, and any associated symptoms. 

If you suffer from menstrual migraines, and want to get rid of them completely, it may be worthwhile to determine if supplementing with phytoestrogens produces any substantial change. Moreover, since migraines may occur due to a sharp withdrawal of estrogen, it may be necessary to ensure there is a good balance of estrogen and progesterone in the cycle and ensure that progesterone is being produced. 

If you're looking for help in stopping these migraines for good - feel free to book an appointment with me!

References

Allais G, Chiarle G, Sinigaglia S, Benedetto C. Menstrual migraine: a review of current and developing pharmacotherapies for women. Expert Opin Pharmacother. 2017;19(2):123-136. doi:10.1080/14656566.2017.1414182.

Burke BE, Olson RD, Cusack BJ. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother. 2002;56(6):283–288.

Ferrante F, Fusco E, Calabresi P, et al. Phyto-oestrogens in the prophylaxis of menstrual migraine. Clin Neuropharmacol. 2004;27(3):137–140. 

Maasumi K, Tepper S, Kriegler J. Menstrual Migraine and Treatment Options: Review. Headache: The Journal of Head and Face Pain. 2016;57(2):194-208. doi:10.1111/head.12978.

Witteveen H, van den Berg P, Vermeulen G. Treatment of menstrual migraine; multidisciplinary or mono-disciplinary approach. J Headache Pain. 2017;18(1). doi:10.1186/s10194-017-0752-z.