What to Do About Menstrual Migraines

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By Ann Melin, Lead Health Coach for Women’s Wellness Collaborative

Of all of the symptoms that women experience with their menstrual cycles, menstrual migraines are among the most debilitating. Many women who suffer from menstrual migraines report missing at least one day of work per month and many others often have to cancel personal plans and social activities.

I’ve been lucky in that I have only had a few migraines in my life! Unfortunately, those were a few of the worst experiences I’ve had. I remember thinking that I wanted to crawl into a dark corner with a morphine drip… that’s how bad it was!

In all honesty, very few things would make me consider going to an ER. Although I never did for the migraines I had, I thought about it seriously on a couple of those occasions!

So, let’s talk about menstrual migraines. Read on to learn what they are and how to avoid them.

What are Menstrual Migraines?

True menstrual migraines are those that occur anywhere from 2 days prior to menses up until day 3 of the menstrual period. Many women also experience migraines throughout the menstrual cycle that become more prevalent during menses.

Menstrual migraine symptoms often include severe aching, throbbing, or pounding pain on one or both sides of the head. This pain may be exacerbated by light, noise, and movement. Symptoms may also include nausea and vomiting. Some migraines are associated with visual auras or other kinds of visual disturbances, such as temporarily blurred vision or disturbances in visual perception.

What Causes Menstrual Migraines?

Shifting levels of hormones and neurotransmitters are thought to be the primary cause behind menstrual migraine symptoms. In particular, the decline of estrogen towards the end of the luteal phase appears to trigger menstrual migraines in those who experience them.

This is even more common in women who have elevations in estrogen during the follicular phase and lower than normal levels of estrogen during the luteal phase. These wide swings of estrogen appear to be more highly associated with menstrual migraines than having consistently high or low levels of estrogen.

Progesterone levels also drop sharply just before your period, and women’s bodies are more sensitive to the decline of estrogen when progesterone is low. Progesterone can also act as a buffer against high levels of estrogen throughout the month and may offset symptoms of estrogen fluctuations that result in menstrual migraines.

As women enter into peri-menopause, they often experience declines in overall progesterone levels creating a condition of estrogen dominance that can precipitate the onset of menstrual migraines.

Drops in estrogen also lead to decreases in serotonin. We often think of serotonin as the neurotransmitter associated with mood. Indeed, mood dysphoria associated with pre-menstrual syndrome is likely connected to decreased levels of serotonin caused by fluctuations in estrogen.

Additionally, research has shown that low levels of serotonin cause dilation of the blood vessels in the brain thereby initiating migraines. Serotonin regulates GI function and low levels of serotonin are thought to be involved in the common symptoms of nausea and vomiting associated with migraine headaches.

What Helps Migraines?

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The DUTCH Cycle Mapping Test

The DUTCH test for hormones is one of our favorite labs at Women’s Wellness Collaborative and they have a version of their test that is called the cycle mapping test. This test evaluates shifts in estrogen and progesterone throughout the entirety of the menstrual cycle.

This is a great lab to consider if you suffer from menstrual migraines as it could help target variations in hormones that may be driving menstrual migraine symptoms.

Creating more balance in the hormone system can ultimately lead to a reduction in frequency and severity of symptoms, while simultaneously helping you to work towards menstrual migraine prevention rather than symptom management.

This is where health coaching can really help you to access the right labs and to build a customized protocol based on your results.

A Good Diet

Some foods are known to have the potential to trigger migraines, and these foods include:

  • alcohol

  • caffeine

  • cheese

  • ice cream

  • citrus

  • nuts

  • vinegar

  • and chocolate (I know! It’s a crime to tell a woman to avoid chocolate when she has PMS!)

Self Care

Both too little and too much sleep can exacerbate migraine headaches, as can excess exercise, poor hydration, environmental toxicity, smoking, and travel.

Magnesium

Interestingly, one study showed that 45% of women who experience menstrual migraines have a magnesium deficiency and experience significant benefits from supplementing with magnesium. Magnesium also aids in muscle relaxation, which can help alleviate menstrual cramps and tensions associated with menstruation.

Due to declining soil and food quality, most of us do not get enough magnesium and are deficient. We have tried many brands and types of magnesium and this magnesium bisglycinate chelate is one of the best absorbed forms of magnesium.

Fish Oil 

Essential fatty acids are critical for balancing hormones and studies have correlated imbalances in fatty acid metabolism in all of the more troublesome symptoms associated with PMS. Linoleic acids (as found in things like flax oil and evening primrose oil) and EPA and DHA (as found in fish oil) can help the body synthesize prostaglandins which can regulate the body during PMS. Fish oil is also thought to enhance serotonin production which, as mentioned above, may be implicated in the etiology of menstrual migraines.

Herbal Remedies

Natural remedies for migraines commonly include the herbs feverfew and willow bark, which are both wonderful for the reduction of headache pain. In addition, butterbar has been shown to be specifically effective for use with migraine headaches.

Traditional herbalists have also used feverfew for a wide variety of gynecologic issues and the herb has been shown to reduce the nausea that commonly occurs with migraines. Cramp bark and black haw are both herbs that are effective against menstrual cramping in that they work as muscle relaxants. As with willow bark, cramp bark and black haw contain salicylates which alleviate pain and can help with menstrual migraine symptoms.

There are also great phytoestrogenic herbs that can help to regulate estrogen levels. I always prefer to know what the estrogens actually look like through lab testing before adding phytoestrogens; however, some good options include red clover and black cohosh.

Vitamin D

Low vitamin D is something that we see in a large percentage of our clients and there is some evidence that low levels of vitamin D may be one of the common migraine triggers. We recommend getting your vitamin D levels tested and then supplementing appropriately! If you are supplementing with vitamin D, it is important to have your levels monitored with some regularity and to take a bit of vitamin K2 as well.

Overcoming Your Migraines

So, what’s the take away? Yes, menstrual migraines are common and they can be debilitating at times. But they don’t have to be a life sentence! There are tons of natural tools available that can support you in having more comfortable periods.

Sometimes people have to try several things before they land on what works but there are so many wonderful labs and herbs and supplements and dietary options available to try and you deserve to be as comfortable as you can be throughout all parts of every month.

If you’re looking for tested, high-quality supplements, you can find these products in our shop:

Click here to learn about our favorite magnesium and here to learn about our favorite fish oil.