An Introduction To Periods And Headaches
Periods and headaches often go hand in hand. Many women just accept that this is a normal part of the menstrual cycle, but is this the case? And if so, why is it happening?
Headaches can occur for a number of reasons so it is important to try and determine how much influence your hormones are having. Try keeping a period symptoms diary, then after say 3 months, you can refer back to it and see if there is a pattern forming. If you find you have a headache 2 days before your period each month it suggests falling levels of hormones are likely to be the cause.
However, its not as simple as just oestrogen and progesterone exerting their effects as we touch on in the next section there may be other players involved!
Menstrual headaches can be severe they can impact on your life, they can last for several days and they are often accompanied with other unpleasant symptoms such as sensitivity to light or nausea.
On this page I discuss how menstrual periods could be causing your headaches and how diet, lifestyle, herbal remedies and conventional treatments can help. However, if your headaches are severe or unexplained, it is advised you pay a visit to your GP.
What Causes Menstrual Migraine
There is a link between migraine and falling levels of the hormone oestrogen. The natural drop in oestrogen levels before your period starts is linked to menstrual migraine. Women who have heavy and painful periods have higher levels of prostaglandin , which has also been identified as playing a role in a menstrual migraine.
Is Your Birth Control Causing Headaches
Headaches are sometimes a side effect of hormonal birth control . In one study, taking oral contraceptives affected migraines, with 24% of people experiencing increased frequency of migraines .
Estrogen-withdrawal headaches are a type of headache that people get during their âpill-freeâ or âsugar-pill weekâ when they are taking oral contraceptives. This type of headache usually goes away within 3 days, but then will return during the estrogen-free week of the next cycle .
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How Can My Doctor Help
If your headaches appear at the same time each month, for three months or more, and home and herbal remedies fail to help, it might be time to visit your doctor.
Hormonal contraceptives are a possibility, for example progesterone-only options such as the mini pill or the implant. By minimising oestrogen, it is possible you can reduce some of the fluctuations which can trigger a headache.
Anti-inflammatory or painkillers can be bought over the counter to treat headaches once they have arrived. However, beware of the side effects of these medications. Ensure you dont take too many at once and you should always seek advice if you plan to take these preventively.
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Why Do Some Women Get Period Headaches
Blame estrogen, says Sheeva Talebian, MD, a board-certified reproductive endocrinologist at CCRM in New York and a Womens Health advisory board member. Most menstrual-related headaches are due to the rapid drop in estrogen right before the onset of your period, she says.
A mini menstruation lesson: When you ovulate , your estrogen peaks and your ovary makes progesterone. For a while, your womanly hormones stay up. But if youre *not* pumping pregnancy hormones a week or so later, your body halts estrogen and progesterone production, triggering your period, Dr. Talebian explains.
That sudden drop in estrogen tweaks chemicals in your brain that affect how you experience pain, and up goes your sensitivity, the U.S. Department of Health & Human ServicesOffice on Womens Health explains. Add to that constricted blood vessels, which happens to some women when theyre low in estrogen, et voilà: the dreaded period headache.
Other potential factors that can play into period headaches? Dehydration, blood loss , and poor sleep, Dr. Talebian notes. Already prone to migraines? Then theres a 60 percent chance youll suffer from menstrual migraines as well, per the National Headache Foundation . And if youre on birth control, that can bring on more headaches when you switch to your sugar pills and your estrogen levels tank .
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Work With Your Doctor To Come Up With A Mini
Lets say a woman has regular periods every 28 days, and she knows that the day before her period begins, her headache starts. Her doctor might advise her to take an over-the-counter medication like Aleve or a class of prescription medications for migraines, called triptans, two days before her period starts, Halker says.
If she takes it right then, it can help her avoid that headache completely, Halker said.
How Are Menstrual Migraines Treated What Medicines Can I Use
A menstrual migraine is usually treated with nonsteroidal anti-inflammatory medications . The NSAIDs most often used for menstrual migraine include:
- Ketoprofen .
These drugs should also be started two to three days before your period starts. Continue taking them throughout your menstrual flow.
Because fluid retention often occurs at the same time as your menses, diuretics have been used to prevent menstrual migraines. Some healthcare providers may recommend that you follow a low-salt diet immediately before the start of your menses.
Leuprolide is a medication that affects your hormone levels. Its used only when all other treatment methods have been tried and havent worked.
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Can Birth Control Help Relieve Migraine Attacks
For many women, birth control actually helps prevent migraine attacks. Consistent, correct use may prevent or reduce attacks by providing a stable estrogen level throughout the month, and decreasing or eliminating the pre-period estrogen plunge thatâs a trigger for many women.
When youâre not on hormonal birth control you experience a surge of estrogen during your menstrual cycle that causes your body to ovulate and release a mature egg. Then if the egg isnât fertilized, estrogen levels drop dramatically before you get your period. The hormones in all combination birth control methods, whether pill, patch, or ring, keep estrogen levels steady to stop an egg from being released, which prevents pregnancy while also preventing the estrogen surge and plunge that can lead to attacks.
Need help finding a birth control that can help you avoid migraine attacks? The Pill Club can recommend the right birth control for your needs and deliver it to your door.
Herbal Remedies To Help
There are some herbal remedies which could help to keep your headaches under control.
If you suspect elevated levels of oestrogen are to blame and you suffer from other symptoms such as sore breasts, water retention, irritability and mood swings, Agnus castus may help to address some of these issues. Please note, if you are taking hormonal contraceptives such as the pill, hormone-balancing herbal remedies may not be suitable for you.
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How Do You Know If Your Birth Control Is Causing Your Migraine Headaches
If headaches or migraine attacks start or get worse when you start a new birth control method, after an increase in dosage, or improve after a reduction in dosage or stopping the birth control, it’s quite likely that birth control hormones are to blame.
It’s normal to experience an increased frequency and severity of headaches when you first start birth control, but this often improves with time. However, any neurologic symptoms, such as aura symptoms, or severe or debilitating headaches, are not a normal birth control side effect, and you should notify your healthcare professional if you experience them.
Hormones And Head Pain: Whats The Deal
As with most things period related, hormones are to blame. Before your period, estrogen and progesterone levels rise. Then, those levels come crashing down as a signal to your uterus to let that lining go.
This fall in estrogen can trigger headaches. Since birth control regulates this hormonal roller coaster, for some people it can decrease period headaches. For many, birth control makes period headaches worse.
If you have a NuvaRing, headaches during periods are even more common.
Pro tip: If youre already prone to migraines, you should not use the NuvaRing, as it increases your chances of blood clots and continued headaches.
If youre on a hormonal pill based birth control, sometimes skipping the placebo week can get rid of period headaches .
If you noticed your headaches got much worse after starting hormonal birth control, talk to your doctor. You may need to switch pills or your method of birth control to keep headaches at bay.
Though hormones are a background cause of all period headaches, there are four types of menstrual brain pain that are all slightly different.
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What Is The Relationship Between Migraine Aura And Birth Control Is Birth Control Risky For Women Who Experience Aura
About 20% of people with migraine experience aura, which is typically a warning that the headache itself is about to come on â although sometimes an aura occurs without the headache pain itself.
An aura can include unusual sensory changes such as seeing flashes of light, lines, zigzags or other visual changes, which is called a visual aura, unusual smells or sensations, and sometimes even numbness or weakness in their face, an inability to speak or understand words, and other unusual sensory symptoms.
Women who experience âmigraine with aura,â or any changes in vision before or with their headache, should not use any form of birth control containing estrogen, as the estrogen may increase the risk of stroke for these women.
But there are many safe birth control options for women who experience aura, including progestin-only pills , birth control shots, an intrauterine device , a contraceptive implant, or barrier methods like condoms, spermicides, a diaphragm, or a cervical cap.
But many women who suffer migraine attacks without auras can safely use all birth control methods, including combination hormonal methods like birth control pills, the patch, and the ring.
When To See A Doctor
If period headaches interfere with daily life, talk to a doctor.
When PMS is the underlying issue, a range of treatments can help, including hormonal contraception, antidepressant medication, and calcium supplements.
The right course of treatment will depend, in part, on the severity and specific symptoms.
Healthcare professionals can recommend ways to help prevent menstrual migraine headaches. They can also prescribe stronger pain relief medication, when necessary.
In pregnant women, a persistent headache can be a symptom of preeclampsia. Anyone who thinks that they may be experiencing this potentially serious issue should seek medical attention.
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How To Prevent And Treat Period Headaches
“Unfortunately, since menstrual headaches are usually related to a decrease in estrogen and progesterone, there is nothing you can do to change the physiological aspect of what is happening in your body,” says Dr. Edokpayi. However, there are steps you can take to manage period-related headaches.
“I usually encourage my patients to have a balanced diet, drink plenty of water, exercise, and find better ways to handle stressors in life to try to decrease the severity of menstrual headaches,” says Dr. Edokpayi.
And, if you aren’t already taking a birth control pill, you may want to talk to your ob-gyn about starting, since again, the pill can help equalize those estrogen fluctuations that cause period headaches in the first place.
Taking a magnesium oxide supplement may also be able to help since some research shows they can be effective at preventing menstrual migraines, adds Dr. Rauenhorst.
If a period headache hits, you can manage pain by simply popping an Advil or Tylenol like you would with any other headache. “Nonsteroidal anti-inflammatory drugs , like ibuprofen and naproxen, and acetaminophen are helpful for treating period headaches in many women,” says Dr. Rauenhorst. While NSAIDs alone are effective for some women, more intense menstrual migraines may require additional medication, such as triptans, which can help reverse the changes in your brain that caused your migraine and inhibit over-active pain nerves, adds Dr. Edokpayi.
What Causes Period Headaches
Unsurprisingly, it’s all about hormones. “Estrogen is the female hormone important in triggering headaches in women,” says Kristina Rauenhorst, M.D., a gynecologist at Mayo Clinic Health System. “Headaches are thought to occur when levels of estrogen drop, which happens before the menstrual period starts each month.”
Here’s how it works: The drop in estrogen levels cause chemical changes to occur in the brain, resulting in dilation of the vessels in the brain. Some of the nerves in the head are also more sensitive during this time related to the drop in estrogen, explains Dr. Rauenhorst, meaning pain can be felt in a more intense way during this time.
And even if you’re on a hormonal birth control pill, which levels out your hormones throughout the month, you *can* still experience period-related headaches while on an estrogen-containing BC if you miss any of your pills, or during the hormone-free interval during the last week of your birth control pack, adds Dr. Rauenhorst.
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Enhancing Healthcare Team Outcomes
Coordinating care between healthcare professionals is an important aspect of patient care, especially when modulating a patient’s pharmacological therapy. Whether a woman’s menstrual headaches are being managed by a neurologist or in the emergency setting, it is important to coordinate with all clinicians. Patients should see the same clinician or, at the very least, see a provider in the same health network where other specialists can easily access the electronic medical record. Having old records is an invaluable tool to see if there are any changes in medication regimen, differences in history, or physical exam findings.
Whether it is a neurologist, an emergency clinician, or another specialist currently treating the patient, improving care coordination with the primary care clinician would minimize adverse effects from new interventions given. For example, if a woman with an acute migraine presents, and she does not know that she has an underlying cardiac problem, and she is given triptan therapy, this can lead to fatal coronary vasospasm.
The importance of communication between the interprofessional team cannot be undervalued as patients that are started on combined hormonal contraception can have serious adverse effects. Patients being treated for acute migraines that have worsened may need to change their long-term treatment regimen but not before clinicians coordinate therapies.