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Migraine Triggers: My Period

I wish I could tell my middle school self how lucky I was to be a late bloomer.

These days, girls are getting their periods at 10 or 11 (something that was discussed at the June National Headache Foundation meeting in Chicago); in the early 1990s, I had to wait til I was 14.5. My period came later than most of my friends’, and once I realized I was the last in the line, I made no effort to announce to my girlfriends that I was still not a woman—officially speaking.

Though my first migraine attack came at age 13 (that’s my best guess), as I recall the episodes didn’t get more frequent until my period was a part of my life. I now consider myself lucky to not have gotten it younger—who knows when the menarche-related migraines would’ve begun?

To this day, I have some pretty obnoxious periods. Here’s where the TMI starts—feel free to tune me out, especially if you’re squeamish. My periods last a full week, complete with crampy spotting a couple of days before the “real” period sets in. My periods are heavy and painful; cramps have gotten worse over the last few years. I also started experiencing ovulation cramps since hitting 30—doctors call this by a word that is gross enough to fit the phenomenon well: mittelschmerz.

My period is one of those migraine triggers I cannot avoid. Two days before my period starts, the migraine—if left to its own devices—starts in. Without treatment (or if I’m already in the middle of a really rough migraine flare-up), the migraine can last over a week. Recently I’ve decided to pick up a preventive regimen I’d let fall by the wayside—I take approximately 500 mg of naproxen sodium (Aleve) beginning two days before the start of my regular menstrual-related migraine and continue taking the naproxen every 12 hours until the period is over. More often than not, the migraine shows up at the very end of the period, but at least by then the cramps have subsided. At least there’s some sign that what I’m doing is affecting my body in a positive way, at least for a few days.

I also try to be very careful around my period when it comes to other triggers. I pay special attention to my sleep regimen—I try to resist invitations to stay up late (even if it means watching just one more Dexter episode with Jim on the couch) and say no to alcohol. When I’m able, I make strong attempts to make my smoothie and take my daily vitamins—both of these elements build up my system and make it harder for the attack to come on. In theory I should be having the smoothie and vitamin regimen daily, but I often skip. It’s important for me to remember to incorporate any preventive, healthy measures I can.

Here’s a question for those of you with menstrual-related migraine or menstrual migraine: how do you cope with this monthly problem? Any tricks that work for you?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Molly Sweeny
    8 years ago

    anyone know of good ways to control the hormone fluctuations? I’ve read about birth control, natural hormones, herbs, etc – not sure where to start?

  • Janet Marie
    8 years ago

    Yes, my time of the month is a major trigger for me for migraines usually a day or so before my period starts, then sometimes during, then a few days after my period is finished. Horomones grrrr

  • Georgia Gallucci
    8 years ago

    i would eat foods with iron and potassium in them…spinacha nd bananas and such

  • sydneypaige
    8 years ago

    My chronic migraines have become so bad that I actually got a hysterectomy (I had some other issues, as well). I still have very bad migraines, but it definitely improved around my menstrual cycle triggers. My migraines started when I was about 12 – same time as my period, and I think that by now (age 35) they’ve become so bad that I just couldn’t completely stop the headache cycle.

  • Holly Baddour moderator
    8 years ago

    three words: continuous birth control. no more periods- no more menstrual migraines. i’m on kariva/mericet specifically for migraines for this purpose and it helps tremendously. i suffer from chronic daily migraines, but am grateful to not have the punctuation of menstrual migraines any more every month. those are always the most incapacitating ones for me.

  • Heather Zanitsch
    8 years ago

    I too, have very debilitating menstrual migraines. They kick in about 2 days prior, and run for approximately 11 days. I am lucky in that during my actual flow – TMI- sorry, I have only an initial 24 hours’ worth of cramps and nausea, but I get wicked bad legs cramps for the duration. But the migraines…the migraines last and last, are very persistent, and never responded well to any triptans or OTCs or any combination thereof.

    Since I had Botox injections about 7 weeks ago, I have seen a decline in overall migraine (I was having them about 28 days/mo), and even my menstrual migraines are easier to control with medications thanks to Botox. I take DHE injections for those, usually.5cc and I wait to see if it works, if it doesn’t, I can have another.5cc IN.

    Since I track my cycle, and since the Botox has broken my intractable migraine (I am still chronic, however, having them 15+ days/mo), I have also discovered that I have menstrually-related migraines around the time I should be ovulating. So for two more days out of the month Mother Nature graciously lets me know I’m still a woman, as if I didn’t already get the message.

    Migraines are hell in and of themselves, but menstrual migraines are another entire level of terrible. I am just grateful that the Botox is working and I am having more good days now, but funnily enough it almost seems harder to have a migraine now than it did before Botox. Before the Botox I was always used to the migraine monster riding me constantly (as used to it as one can get), but now my head has a chance to calm down before the next one. So, instead of my migraines building upon one another and skipping the refractory phase, I am going through the hangovers more often, and they really hit hard.

  • Charla E Welch
    8 years ago

    My menstrual migraines have come and gone over the years. It’s part of the reason I started on the “4 periods a year” cycle, which works well for me. I did go through a time, just a few years ago, when my migraines were more frequent than ever before and I had menstrual migraines with every period. I am lucky enough to have a lower pain level with most of my migraines. Since then, I have become more active and am completely off my daily preventive medication. I suspect that my migraines have always been related to my poor circulation, and my cardiovascular health has greatly improved the past couple years. I still have to watch myself when I get my period, and make sure I don’t overdo it. I will have at least one day where my energy level is in the negatives. I watch myself for migraine signs more closely when I’m close to my period.
    I also have experienced ovulation cramps for years now. Since college, I think (30 now). Even while on birth control, I still sometimes get that sharp pain around ovulation time.

  • Molly Sweeny
    8 years ago

    may i ask about the ‘4 periods a year’? what birth control did you use? thx

  • Louise M. Houle
    8 years ago

    I have daily migraines, but the menstrual ones are the hardest to control with my usual abortive and rescue meds. If I’m going to get a full-blown migraine that doesn’t respond to meds, this is the time. It usually happens on the 4th or 5th day of my period. I can’t for the life of me figure out why. I usually take 2 Amerge + 1-2 Ketoprofen per day during this time; sometimes I have to add an Ultram and in severe cases, a Fiorinal. Like you, Migraine Girl, I try to pay particular attention to my triggers, especially making sure to get extra sleep. Just wish I could be better at resisting the sugar cravings and toning down the voracious appetite – ha ha!

  • Rebecca Kisner
    8 years ago

    I so feel your pain. I have suffered from menstrual migraines since I was 15. As with Julie the only time I had relief from them was when I was pregnant with my two kids. I have been on a regimen for over 15 years of an anti depressant and blood pressure medicine. It does not always work though and I have found that the only over the counter medicines that work is Exedirine. I also have a prescription for Maxalt for the really rough ones. I have tried the Imetrex shots but only lasts for a couple of hours. I could not imagine having to suffer from migraines anymore than I do.

  • Cathy Jones Heim
    8 years ago

    Definitely have hormone related migraines! I have to be extra careful to avoid food triggers during this time of the month. I had an ablation done about 4 years ago and it has helped with duration but because I don’t get a period any more I never know when the migraine will strike. I basically assume that when I get the migraine is when I would be having a period so I avoid certain foods during the rest of that week.

  • Julie Gendron
    8 years ago

    wow so I am so glad I am not alone in this. I’ve had menstrual related migraines sinc 2002 when I was 18, I’ve had 4 kids in the past ten years and that 40 months or so of life was bliss because I finally got a break. Now, I finally have a doctor who asked me “haven’t you ever heard of Imitrex?” sadly, the doctors before her, were always, take 2-3 advil. Which didn’t work, and I knew they wouldn’t, instead they made everything worse to the point of thinking I was dieing and panicking.
    I take and Imitrex daily for day 2-3 of my period and then again on the last day day 7 of my period. I usually get another migraine when ovulation is through 12-17 days later.
    So far Imitrex works for me, I hate that it makes me very slow, tired and lethargic, left arm tingley and numb and frequently take naps, having 4 kids, it makes it rough on those days, but also inspirees me to seize the days when I feel myself again! thanks for sharing your story and I hope as we age, it gets better for us.
    i have to add though, I have my period this weekend, I recently turned 28, and this was the first time since 18 ( I am on day 4 of my cycle) and have yet a headache or migraine at all! I am so greatful, said a prayer and have enjoyed camping with my family befores school starts, I am hopeful maybe this a sign and will stick around, perhaps the migraines are dieing down as I age? fingers crossed!

  • Julie Gendron
    8 years ago

    i didnt realize this was posted on fb

  • Lesa Cole Perry
    8 years ago

    Hooray for relief.

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