Keep Your Glutamate Levels Low
Glutamate has been implicated as one of the main migraine triggers since the 1970s. Our brain has glutamate scavengers that help clear of any excesses of glutamate. One study published in Biology of Reproduction found that estrogen and progesterone are neuroprotective and serve as glutamate scavengers. When these hormones drop dramatically close to the last and first days of the menstrual cycle, glutamate can build up in neurons, causing damage. Avoid any large sources of glutamate or synthetic forms found in eggs, milk, wheat, and soy products.
Can Hormone Imbalance Cause Headaches And Dizziness
Persistent headaches, chronic pressure, increasingly severe tension in your head is an indication that hormonal dysfunction may be occurring. Your hormonal levels may be inconsistent and the fluctuations are causing the pain you are experiencing. Contact us at Eagles Landing Ob/Gyn to discuss dizziness and headaches.
Ways To Manage Bad Headache During Period
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Fats For Progesterone Support
Progesterone is a key hormone that both men and women need which has a large regulation role. It keeps estrogen and testosterone in balance. Some of the best foods to support progesterone are fatty fish such as salmon, sardines and mackerel, cruciferous vegetables and sulfur containing foods like the onion family and mushrooms, shellfish, oysters and other mollusks, high vitamin C foods like camu camu, sweet potato, strawberries, kiwi, papaya, pumpkin and orange, and super foods like liver.
Prescription Medicine For Menstrual Migraine
If over-the-counter pain relief isn’t working for you, your doctor may consider prescription medicine. One type of medication for migraines is the family of triptans, which help balance chemicals in the brain. Your doctor may prescribe frovatriptan , which has shown to be better tolerated than other triptans and can offer significant improvement.
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Natural Treatments And Lifestyle Adjustments For Menstrual Migraines
Lifestyle treatments are always tricky to study, since they are hard to control and not as well-funded as pharmaceutical medicine.
Magnesium: Thereâs some evidence that magnesium can relieve migraine pain . In a small preliminary trial, participants took magnesium supplements three times per day starting from Day 15 of their cycle until the start of their next period . This treatment helped decrease the participantsâ total pain and also improved their PMS symptoms . In a randomized control trial where participants received either a placebo or a drug containing magnesium, vitamin B2, and coenzyme Q10, the severity of migraines was lower among those taking the drug, though the number of days in which migraines were experienced was not statistically different from the placebo .
Get More Iron In Your Diet
If you suffer from heavy periods and regularly have headaches at the end of your menstrual cycle, the iron deficiency caused by blood loss could be to blame. When you’re iron deficient, your brain doesn’t get enough oxygen, which then causes the brain’s blood vessels to swell and cause pressure and pain. To get more iron in your diet, you can take supplements or eat foods including:
-
red meat
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How Do Periods Affect Migraine
For some women, migraine attacks occur during or just before menstrual periods. The cause or trigger of the migraine is thought to be the fall in the level of oestrogen that occurs at this time in the cycle. Oestrogen is one of the chemicals that control the menstrual cycle. The blood level of oestrogen falls just before a period. It is not a low level of oestrogen that is thought to be the trigger but the drop in the level of oestrogen from one level to another.
Menstrual migraine occurs when you have a migraine attack around most periods that starts at any time from two days before to three days after the first day of a period. There are two patterns:
- Pure menstrual migraine occurs when migraine attacks happen only around periods and not at other times. This occurs in about 1 in 7 women who have menstrual migraine.
- Menstrual-associated migraine occurs when migraine attacks happen around periods but also happen at other times too. About 6 in 10 women who have menstrual migraine have this type of pattern.
Symptoms of menstrual migraine usually improve if you become pregnant, because during pregnancy there is a constant high level of oestrogen. As you approach the menopause, menstrual migraine attacks may become more frequent because your level of oestrogen tends to go up and down at this time. Once past the menopause, you have a constant stable low level of oestrogen, and menstrual migraine attacks tend to reduce.
Treatment Menstrually Related Migraine
As you review these, remember that all medications have side effects, and you should discuss them with your doctor.
In general, MRM can be effectively managed with strategies similar to those used for non-MRM. Behavioral management is an important concept in menstrual as well as nonmenstrual migraine. Menstruation is one of many factors that put women at risk for migraine disease. Hormonal changes are just one of many potential trigger factors.
Most women living with menstrually related migraine are treated with acute medications. When attacks are very frequent, severe, or disabling, preventive treatment may be required.
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Preventative Menstrual Migraine Treatments
Triptans: This medication can also be taken to prevent future migraines from happening. In one study, using triptans for a few days before the start of the period helped reduce both severity and frequency of menstrual migraine headaches .
Hormone stabilization techniques: Preventative treatment using hormone therapy may help to decrease the frequency of severe menstrual migraines. In one study, researchers looked at how two treatments with hormonal contraception affected migraines. The majority of participants were prescribed combined oral contraceptives and additionally took estrogen during the week of their withdrawal bleed , which helped to make the drop in estrogen less severe. Fewer participants used the estrogen patch during their normal menstrual period to prevent the drop in hormones. Among all participants, eight out of 10 people reported a decrease in their menstrual migraines and were able to reduce their pain-medication use by half .
Continuous birth control: Using a form of continuous/extended-use birth control may be an option to decrease menstrually related migraine attacks or headaches. People who took extended use combined oral contraceptives had fewer headache symptoms, and were more productive . Talk to your healthcare provider about extended use hormonal birth control, though this may not be the right therapy for everyone, especially those with migraine with auraâsee the section below on hormonal birth control for more info.
Foods For Estrogen Support
Women should support their estrogen levels by eating specific foods that help create and regulate it. Some of the best foods for estrogen support are seeds like flax and sesame, fibrous fruits and vegetables, ginseng, carrots, and sauerkraut. Equally important is avoiding synthetic sources of estrogen including products we put on our skin, household cleaning products, packaging of our foods, or certain cooking tools.
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Treatment Options For Menstrual Migraine
There are several treatment options depending on the regularity of your menstrual cycle, whether or not you have painful or heavy periods, menopausal symptoms or if you also need contraception.
If you have regular periods your doctor may suggest taking medication for a few days around the time of menstruation .
There are different options available and your doctor should suggest the option that suits you. It could include non-steroidal anti-inflammatory drugs such as naproxen or mefenamic acid, oestrogen supplements or triptans.
- Frovatriptan tablet
- Zolmitriptan tablet
What Questions Should I Ask My Healthcare Provider About Menstrual Migraines
- Am I experiencing a menstrual migraine or another type of migraine?
- Should I change any of the medications Im taking?
- What treatment do you recommend?
- What medications should I take?
A note from Cleveland Clinic
A migraine is more than a bad headache. Not only can menstrual migraines get severe, but women have reported that they can be even worse than a migraine that occurs when theyre not on their period. Talk to your healthcare provider about your symptoms. There are preventative measures and treatment options. A menstrual migraine might not be something you just have to live with every month.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2021.
References
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Medicines That Prevent Menstrual Migraine
Talk to your doctor about whether these medications might help you stop your headaches before they start.
If your periods don’t come on schedule or you also get migraine headaches at other times in your menstrual cycle, you can take preventive medicine every day. Drugs that prevent migraine headaches include:
- Some types of antidepressants
- Some types of antiseizure medicines
- Blood pressure medicines such as beta-blockers and calcium channel blockers
- CGRP inhibitors, these are a new class of preventive medicine
Devices which may be used for treatment or prevention include:.
- Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked with migraines
- Spring TMS or eNeura sTM, a device for people who have an aura before migraine headaches. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.
- Noninvasive vagus nerve stimulator gammaCore is a hand-held portable device placed over the vagus nerve in the neck. It releases a mild electrical stimulation to the nerve’s fibers to relieve pain.
Causes Of Headache During Period
The main trigger might be the drop in the hormone estrogen that happens before you menstruate.
Birth control pills can worsen the symptoms of a migraine. Your estrogen levels plummet and your headaches get worse when you take placebo pills or no pills at all, during the week of your period. If youre prone to headaches, taking birth control pills that have low amounts of estrogen or only progestin may help.
Genetics are also thought to play a role. Women who have a headache during period tend to have a combination of factors that trigger their headaches.
Menopause and perimenopause are also one of the main causes of a bad headache during period. This is due to the fluctuating hormone levels.
Further causes might include:
- getting too much or too little sleep
- intense lights, sounds, or smells
- severe weather changes
- alcoholic beverages, especially red wine
- too much caffeine or caffeine withdrawal
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Questions To Ask Your Doctor About Migraine:
- What do you think causes migraines such as mine?
- Do you think migraine conditions such as mine are treatable?
- If the drug prescribed doesnt work for me or has too many side effects, what alternatives are available?
Work closely with your doctor to find the best way to better manage your migraines. One way you can assist your doctor in treating your migraine pain is to complete the following MIDAS questionnaire. The purpose of the questionnaire is to help you determine the severity of your migraine pain and the level of disability you experience.
The Migraine Disability Assessment survey consists of a few questions that will help measure the impact headaches have had on your life over the last 3 months. Write your answer in the box below each question, and write zero if you did not engage in the activity in the last 3 months. After you have answered the 5 questions, add up the total number of days from questions 1-5 . If your total is more than 6, we suggest that you make an appointment to see your doctor.
Hormones Affecting Headaches During Pregnancy
Because of the link between hormones and headaches, women may be more likely to experience migraine headaches during pregnancy.
According to an article published in The Journal of Headache and Pain, estrogen levels can increase 100-fold during pregnancy, which can influence migraine activity.
Also, it is important to note that a headache can be a symptom of preeclampsia, a potentially serious blood pressure disorder that can affect every organ.
Healthcare providers are usually able to detect preeclampsia during regular checkups. If a woman experiences symptoms, they may include:
- a headache that persists
- swelling of the face or hands
- changes in eyesight
Anyone who believes that they may have preeclampsia should seek medical attention.
Treatment
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International Classification Of Headache Disorders Iii
A1.1.1 Pure menstrual migraine without aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.1 Migraine without aura and criterion B below B. Occurring exclusively on day 1 ± 2 of menstruation in at least two out of three menstrual cycles and at no other times of the cycle
A1.1.2 Menstrually related migraine without aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.1 Migraine without aura and criterion B below B. Occurring on day 1 ± 2 of menstruation in at least two out of three menstrual cycles, and additionally at other times of the cycle
A1.2.0.1 Pure menstrual migraine with aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.2 Migraine with aura and criterion B below B. Occurring exclusively on day 1 ± 2 of menstruation in at least two out of three menstrual cycles and at no other times of the cycle
A1.2.0.2 Menstrually related migraine with aura
A. Attacks, in a menstruating woman, fulfilling criteria for 1.2 Migraine with aura and criterion B below B. Occurring on day 1 ± 2 of menstruation in at least two out of three menstrual cycles, and additionally at other times of the cycle
What Are The Treatment Options For Period Migraines
The good news is that there are plenty of treatment options if youre having period-related migraines. The first line of treatment recommended typically involves things you can try at home. Always, my first approach is to minimize lifestyle triggers that could be exacerbating the migraines outside of hormones, says Phillips, such as avoiding stress , cutting out foods that you already know can trigger your migraines, correcting irregular sleep patterns, and staying away from second-hand smoke.
Sekhon takes a similar approach. I would start with lifestyle alterations: improving sleep hygiene, nutrition, staying well-hydrated, eating regular meals, getting regular exercise, and avoiding triggers such as alcohol and certain foods that make it worse, she says. She also recommends tracking what you eat and drink, as well as your activities so that if you do get a migraine, you can identify potential triggers. Over-the-counter, nonsteroidal anti-inflammatory drugs, like naproxen or ibuprofen, can treat menstrual migraines and also help reduce pain from cramps.
If doing these things isn’t enough, it may be time to chat with your doctor. They can help you figure out the best course of action to take. According to Phillips, some patients take prescription-strength triptans a few days before their period starts to prevent or reduce migraine symptoms. Hormonal therapy with oral contraceptives or an estrogen patch might provide relief, says Phillips.
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