Over 50 percent of women suffer from the effects of menstrual migraines. Of these, most will definitely experience migraine during menses and also during other times of the month. For them, migraines during menses will be little more severe, tough to treat and may reoccur even despite medications.
Unfortunately, most of the women feel they would continue to suffer from menstrual migraines and have resigned themselves to fate. They feel they could do little to reduce their suffering.
There are many options to treat, and also prevent, yes, prevent menstrual migraines. To understand more about the efficacy of these treatments and how they can help, it’s worth understanding what all is going on during the month.
How the menstrual cycle affects migraines
Women who get menstrual migraines are the ones who are more sensitive to hormonal fluctuations. They are mostly experienced just prior to the onset of menstruation when there is sudden drop in the progesterone levels.
The two vital female hormones involved are estrogen and progesterone.
Estrogens are a group of compounds that play an important role in menstrual and reproductive cycles. They are also naturally occurring steroid hormones in women that promote maintenance and development of various female characteristics of the body.
Progesterone is a naturally occurring steroid hormone that stimulates uterus to prepare for pregnancy during menstrual cycle. It also helps a women perform many feminine functions.
These days, estrogens are widely used in oral contraceptive pills and in estrogen replacement therapy for postmenopausal women.
The levels of these two hormones fluctuate during menstrual cycle. In fact, their levels also change in relation to each other.
This happens with all healthy fertile women. All those who experience menstrual migraines are more sensitive to changes in their estrogen levels relative to progesterone.
Once this delicate balance gets derailed, the women may experience so many uncomfortable physical symptoms, such as breast tenderness, PMS, mild headaches, and in some women, migraines.
Timing plays a big role in successful treatment. Below are different hormonal states that can result in your regular menstrual migraine.
It may occur immediately before the onset of menstruation then it may be due to completely natural drop in progesterone levels.
Headache can also occur at ovulation, when estrogen and many other hormones are at peak.
Or it may occur during menstruation itself when estrogen and progesterone are at their lowest.
Understanding when your menstrual migraine attack occurs will help in determining the suitable prevention strategy. A nice way to ascertain when your migraines are occurring is by keeping some record of at least two cycles to track exactly when your migraine occur. It’s important to note the exact days of your cycle.
Once you understand the days of your menstrual cycle when your migraine is occurring, then you’re definitely in the best position to begin treating it.
Menstrual migraine treatments
Menstrual migraines can be managed with many different approaches. Some may involve medicines and others do not. In most cases, it’s a combination of both.
Rest assured, it’s possible to reduce and potentially eliminate your menstrual migraines. But this approach is successful with some knowledge, effort and working with a specialist doctor.
The best treatments for those with menstrual migraines include:
- Lifestyle factors
- Dietary changes
- Hormonal Balancing
- Acute migraine treatments
- Preventative migraine treatments
- Natural & homeopathic therapies
If there’s some imbalance of estrogen in relation of progesterone then you should switch to a healthy diet as a first step. Whatever you eat plays a BIG role in your overall health and well being.
If you’re experiencing migraine attacks, then your diet becomes even more important.
We hear so much from the health community something like “eat a well balanced and varied diet to help prevent ailments”. But it’s been said so many times, we often become numb of this important advice.
To complicate things, some foods may become migraine triggers. Checking foods that trigger your migraines can be cumbersome.
Why proper diet is so important if you’re experiencing menstrual migraines?
Estrogen levels need much stricter regulation as compared to other body hormones to ensure smooth run for the natural rhythm.
Even small variances below or above the normal regulated levels can have a big impact on your health.
Our liver metabolizes estrogen. It does this rapidly if its healthy but once it is overloaded with artificial substances, medications, harmful substances or chemicals from drinks or food, it can have a big impact on the metabolism of estrogen.
The food you eat is the biggest factor affecting overall balance of hormones in your body through exposure to some chemicals in the food products. Research shows that diet can actually attribute up to 93 percent of all factors affecting your hormones.
According to Barbara Holmes, NP, Certified Menopause Clincian
“as compared to other body hormones such as progesterone, the levels of estrogen are tightly regulated for “choreography” to the levels t ensure smooth run as Mother Nature intended-even tiny deficiencies or excesses of estrogen can have a big impact on your well being. A healthy liver can metabolize estrogen rapidly into more benign metabolites. But once it’s bogged down with environmental chemicals, detoxing medications, and harmful substances from drinks or food, it can sometimes over metabolize estrogen into its less desirable forms, which can pose a big threat to your health if allowed to accumulate for long”
There are some food ingredients that may act like toxins and can disrupt body’s hormonal balance, so it is helpful if you can eliminate or at least reduce these altogether. Example of such toxins that you may commonly come across include:
- Hydrolysed Vegetable Protein
- MSG (monosodium glutamate) – found as a flavor enhancer in many processed foods.
Avoid or, if possible, eliminate
- refined sugars
- simple carbohydrates
- processed foods
and avoid all migraine trigger foods.
If in doubt of what food triggers you may have, it may be worth considering some of the following:
- food allergy test
- keep a food diary
- an elimination diet
- see a certified nutritionist or dietician
It’s best to maintain a food diary. Besides record all that you eat, you also need to record other factors that affect your migraines to reduce misattribution of a migraine attack to a specific food or trigger. Uncovering what exactly caused the attack may take time and some patience but the process will equip you with better control over your condition and is often surprising.
In most cases, detoxification will help in cleansing your system of all offending substances but there is no scientific evidence supporting the effectiveness of a detoxification. Maybe it’s a psychological way to somehow push that “restart” button when beginning a completely new eating regime.
If you’re really serious, go ahead and consult a certified health care professional like a dietitian or a nutritionist to help you out. Elimination diets are not easy if you want to do by yourself, and sometimes, they can be fatal. There is a grave risk of malnutrition if you’re not sure of what you’re doing.
To ensure you do this the right way, get qualified professional support. This is also the best way to reduce your attacks without being malnourished or starving.
Another simple dietary preventative includes getting enough hydration through regular intake of liquids, especially during menses.
Some lifestyle factors like exercise and sleep play a big role in migraine management and sustainable remission.
Sleep is a restorative function of body and brain. Besides getting adequate amount of sleep each night, the regularity of your sleep/wake cycles is important. Are you going to bed and waking up at the same time each night? What’s your schedule at weekends?
So, right levels of exercise and sleep are important.
So just in case you needed another reason, your brain actually loves workouts and different forms of exercises. They really work for migraines.
For some exercises can trigger migraines. If you’re one among them, begin slowly and then build gradually. Be sensible about it. It’s not advisable to get up one day and start running five miles. Avoid exercises on days when you’re feeling vulnerable to a migraine attack.
When exercising outside, keep hydrated, wear a hat, and don’t let yourself get too hungry at any stage.
There is increasing evidence of benefits of daily exercise for migraineurs. Here stating small can be a five minutes walk or maybe a short bike ride. So anything in the beginning is okay.
You will definitely feel better for it. Once you decide to take care of your body, it is more likely to take care of you!
Quality of sleep is also important. So the amount of sleep before midnight has more value. Eight hours total sleep starting from 11pm is so much better than 11 hours of sleep starting from 1am.
Do you wake up at the same time each morning?
No person is perfect, but the better you can get into a consistent high quality sleep schedule, the better for your condition.
Exercise also promotes healthy hormonal balance, metabolism, assists in sleep, reduces stress, stabilizes mood and also gives you an overall sense of well being.
Hormones play a BIG role in effective body function.
However, don’t expect miracles by addressing hormones without addressing the underlying lifestyle and diet factors as its akin to drying yourself in a shower while water is still running. It won’t deliver you sustainable results.
To actually asses hormone levels, saliva, blood and urine tests are important to establish a baseline and identify hormonal imbalances that may be contributing to migraines.
Also go for thyroid testing as hypothyroidism is common among migraineurs.
For some women, problems appear due to progesterone deficiency and estrogen dominance. In such cases, bio-identical progesterone in the second half of the female cycle to properly balance the hormones will ensure lasting success.
Another option is to properly address the falling estrogen levels which usually occur before menses. Estrogen topup is possible in many ways such as via gel or skin patches that get absorbed in bloodstream directly. A patch can be applied for seven days beginning three days prior to the first day of your menses. However, if you’re trying to get pregnant this is not the best option for you.
Other possible treatment options include stabilizing hormones by using a low estrogen dose combination pill that has some constant value (monophasic). This may be best for all those who experience irregular cycles.
It’s a good idea to first consult a healthcare professional who has some experience in menstrual migraines and also understands all about female hormones. Opt for a certified gynecologist or endocrinologist who has a good track record with migraine patients.
Preventative menstrual migraine treatments
Preventive migraine treatments can be both non medicinal and medicinal.
Past research shows that magnesium supplementation for people suffering from menstrual migraines can help. Lower magnesium levels lead to a lower migraine threshold. This makes you more vulnerable to attacks and may need much less stimulation and fewer triggers to lead to a migraine attack.
You should take about 450mg of magnesium every day as this is a proven migraine preventative. However, there are no proven tests for magnesium deficiency as it’s the intracellular level magnesium that needs to be improved. The easiest way t see if that works for you is to try it and ensure that you’re absorbing it effectively.
Generically prescribed medicinal treatments to migraineurs regardless of the cause can reduce the severity and frequency of menstrual migraines. If migraine attacks are severe or also occur frequently outside your menses, then a migraine preventative is best for you.
When interested in preventative medicinal treatment, discuss the issue with your doctor who has access to your full medicinal history.
Acute migraine treatments
Most of those who experience menstrual migraines develop a mini prophylaxis strategy in consultation with their doctor where they may take treatments such as NSAIDs (non steroidal anti inflammatory) such as Naproxen, iburopofen, Mefenamic acid during key phase of the cycle in order to prevent recurring attacks.
About 500mg Naproxen twice or once daily can be effective during menstruation.
In fact, many women report that mefenamic acid is effective during heavy or painful periods. You can take 500mg of mefenamic acid 2-3 times daily.
Others can switch to lower triptan doses such as Sumatriptan, Frovatriptan, or Naratriptan.
They can be used during menses without any danger of developing medication overuse headaches. Triptans and NSAIDs are most likely to be effective as min-preventative treatments if you start them 22-40 hours before the expected onset of menstrual migraines.
Natural & homeopathic therapies
Whilst there is limited clinical evidence on the efficacy of homeopathic and natural therapies, they are much safer, have less side effects and offer a completely natural alternative. However, if you fail to get some relief, you’ve wasted your bucks.
Do extensive research before choosing any of these treatments. There is so much information on these treatments on Google.
If you fail to adhere to a well-balanced diet then you may not get the required minerals and vitamins.
Some supplements (offering you a spectrum of vital minerals) may be helpful. Some that have proved their efficacy on migraine sufferers are: Feverfew, Riboflavin, Vitamin B6, Butterbur, Ginger, Magnesium, Coenzyme Q10 (CoQ10) amongst others.
Don’t order the cheapest option on Amazon. Vitamins are actually a medication with far less quality controls and regulation in place. So it’s best to pay extra to ensure safety and quality.
Many vitamins are prohibited for women trying to get pregnant or pregnant ladies.
Can Hysterectomy help menstrual migraine?
Well, the clear answer is no. a hysterectomy done purely for menstrual migraine is invasive, permanent, and yet unproven and quite expensive surgical alternative.
Why it is ineffective?
Menstrual migraines occur due to fluctuation in hormones which is mostly triggered by the ovaries. While menstruation may stop with age or hysterectomy, it won’t stop ovaries from triggering these monthly hormonal fluctuations.
Some non-surgical ways are there to address this hormonal fluctuation problem. You can try hormonal treatment.
Tips to reduce your menstrual migraines
If your migraines occur at the same time every month
- Maintain a diary as it can help you inform your doctor of exactly when the attacks begin during your cycle
- Avoid stress and get quality sleep, consistently
- Address your diet
- Do regular exercise
- Take magnesium supplements
- Stay hydrated, especially during menses
- Consider NSAIDs or try low dose triptan during menses
- If attack is severe, consider preventative migraine treatment options
- Balance your hormones
- Consider homeopathic and natural remedies and other supplements known to help those who get migraines
Mostly, it’s things we do unknowingly or things we eat that exacerbate migraine. Identifying them and then modifying all these factors with good improvement in lifestyle and your diet is where you will be able to get dramatic and sustainable results.