Effective Ways to Manage Menstrual Migraine

If you think migraines timed to your menstrual cycle are just something you have to suffer through month after month, think again. There are very useful treatments to make this a more comfortable time,” says Huma U. Sheikh, MD, a headache specialist and CEO of New York Neurology Medicine.

If your migraine starts anywhere from 2 days before your period to 3 days after, you have menstrual migraine. But you can also get migraines at other times, like when you’re ovulating, Sheikh says.

Menstrual migraine attacks tend to be more severe and last longer. And you’re typically more sensitive to light around this time than with other migraine attacks.

Using a headache diary or app can be helpful in determining if there’s a clear pattern,” Sheikh says.

“During the course of a normal cycle, your estrogen levels rise until about day 14 of your cycle,” says Steven A. Rabin, MD, a gynecologist in Burbank, CA. That’s when you start to ovulate and make more progesterone.

Around day 27 or 28, both hormones drop back down to a normal level. “The sudden drop of estrogen can trigger a migraine headache for many women,” Rabin says.

There are lots of ways to manage and treat your menstrual migraines. These include mini-preventive treatment, acute treatment, and hormonal treatment.

You can sometimes stop menstrual migraine attacks before they start or lessen how severe they are with prevention techniques. One option is taking nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or fenoprofen calcium (Nalfon) two times a day for 5-7 days. Do this 2-3 days before your period starts and throughout.

Another option is estrogen supplementation. You can use a pill, vaginal gel, or patch before and during your period to stop the natural estrogen dip that triggers migraine.

It’s important to track your cycle and find this day so you can get what I call the estrogen parachute, which prevents your estrogen levels from falling off a cliff and triggering the migraine,” Rabin says. You wear it about 3-4 days, then take it off.

Other mini-prevention techniques include taking magnesium starting on day 15 of your cycle and taking triptan medication two times a day throughout your period. » …
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