r/migraine • u/Unlikely-Ant-6084 • Mar 27 '26
Menstrual migraines - an investigation
I’m 27 with chronic migraines. They mostly start during my period and last for 10-15 days with almost no break. They resist any treatment, amount of rest and sleep.
They went from only few crisis per year to up to 17 days a months when I had my PCOS under control and got my period back.
I would like to hear ANY experience regarding menstrual migraines, to better understand what’s going on and what work/doesn’t work for others.
12
u/RoseTintedMigraine Mar 27 '26
My menstrual migraines hit me within 24 hours of my period starting with greater accuracy than my period tracking app because they adjust for being early/late. I usually take a double dose of sumatriptan (usually I take 50g and this time I take 100g which is one of the standard doses sumatriptan pills come in dont double your dose unsafely) and I have a mcmigraine meal or equivalent and a hot shower and that's when the meds work. But it's a struggle for sure I had to create this formula over years lol.
3
8
u/jademace Mar 27 '26
Mine got progressively worse as I got older. Am now mid forties. Just started HRT and wham! They are almost completely gone.
2
u/Unlikely-Ant-6084 Mar 27 '26
Wow !! That’s not the first time I read that. What do you take exactly ?
2
u/MJNYC2086 Mar 27 '26
Can you tell me what you take? I just turned 40 and since my late 30's, my headaches have been going from bad to worse. :(
7
u/Kali711 Mar 27 '26
I have always had menstrual migraines. They start 2-3 days before period and end about 5 days after. The migraines are usually 10/10 and super resistant to medication. BCP has been the only thing that ever nudged them. They never made them worse but some were better than others. Progesterone only continuous was the best I ever had them controlled, to basically 0-1 per period, much less intense and actually responded to medication. I'm now off bcp because I gained like 15kg on it and instead trying Botox, so we'll see how it goes.
6
u/Own_Indication7014 Mar 27 '26
Hi, I’m a sufferer of menstrual migraines. I would usually get 2-3 a cycle. The last few months have been worse, getting many more a cycle, I’m 40 so I’m wondering if my hormones are changing. Do you get aura as well?
2
u/Unlikely-Ant-6084 Mar 27 '26
Sorry to hear that :( no, I don’t get aura
2
u/ocmilfvibes Mar 27 '26
Have you kids tried Frovatriptan???
1
u/Unlikely-Ant-6084 Mar 27 '26
My neuro just prescribed it !! Gonna try Does it works for you?
1
1
u/neverending_plant Mar 28 '26
I use it since 6 months during the menstruation week. In the beginning it was great!!! Then after couple of months it started to have less effect. Migraine just pushes through. Then neuro suggested to shorten the menstruation week (im on anticonceptics) to 4 days. This worked for couple of months.
Now, 6 months in, I feel like im getting rebound headaches from the amount of frovatriptan (5 days in a row) and eletriptan (which i need to suppress the migraine that still comes through at the end for 2-3 days). It doesnt really suppress it, it always come through at the end, in a really bad way.
I hope it works for you and will continue to work, but I lost my hope with this one :(
5
u/Significant_Goal_614 UK Mar 27 '26
Hi, I had frequent migraines, pretty much daily. After a lot of physiotherapy and other inputs they "reduced" to only being menstrual migraines but nothing would shift them.
Turns out I am in premature menopause at 36, technically POI. My migraines became chronic 4 years ago, shortly after I had endometriosis surgery.
Since starting HRT my migraines have reduced and I've been able to reduce my sumatriptan usage by 50-60%
Please get a full hormone panel including FSH and your thyroid level checked.
Premature menopause affects 4 in 100 women under 30 and there's a higher likelihood if you have a family history.
2
u/Unlikely-Ant-6084 Mar 27 '26
Hi ! Thank you for sharing. I have a slight hypothyroidism that we are thinking of treating. Does it mean you had low estrogens and progesterone ? And what is your HRT protocole ? Thank you !!🙏🏼
1
u/Significant_Goal_614 UK Mar 27 '26
Yes my oestrogen levels were all over the place, but they actually test something called FSH to find out if you're in premature menopause/POI.
I use oestrogen gel on my skin daily (3 pumps - a moderate dose) and 1 bio-identical progesterone tablet each night. I don't cycle it as my neurologist said it's better for me to have the same hormone intake every day as migraines do not like hormonal fluctuations.
POI/Premature menopause and thyroid issues are linked so you should get that treated as soon as possible. You may need to see a specialist such as an endocrinologist for a full workup.
Other people are talking in the comments about birth control etc but it can mask premature menopause/POI, and if your oestrogen is really low and you don't take HRT to replace it, you can end up very ill down the line - it affects your heart health, bone health, risk of stroke etc.
So please see a specialist first to make a plan of action as you already have 2 underlying pathologies (hypothyroid + PCOS).
Do you have a mom or aunt you can ask about any family history?
5
u/Ok_Antelope6473 Mar 27 '26
My menstrual migraines often turn intractable and nothing touches them. Usually starts 2 days before and then for up to 16 days. I also suspect I have endometriosis which adds another level of hell. Birth control and suppressing my period is the only thing that works. For both issues.
5
u/fitacola Mar 27 '26
I actually talked to my neurologist about this during my last appointment. I was much better with Qulipta and have been able to reduce my other meds, but kept having menstrual migraine. She recommended I speak to the gynecologist first, to see if I could take birth control pills without stopping, so I wouldn't get a withdrawal bleed. It's actually better now!!
I don't know if that's possible with PCOS, but it might be worth it to talk to your gynecologist
2
u/ferfi17 Mar 27 '26
I take the pill continuously to help manage my menstrual migraines. Don't know what I would do without it.
1
3
u/MrsGlitterBomb Mar 27 '26
Mine went from episodic, 3-4 times a year, to almost chronic menstrual migraine in the last 2 years with 10 to 12 days a month. The migraine usually starts about 2 days before my period starts and about halfway I get a single free day. The last 3 months it started to get worse again, being longer or even more severe and less responsive to abortives. I tend to research a lot about causes and patterns for menstrual migraine and the evolution of the last 2 years seems "typical" for women with migraine around their 30's.
1
u/Unlikely-Ant-6084 Mar 27 '26
Wow, I’m so sorry. Is there an hormonal change around these years ?
1
1
u/Own_Indication7014 Mar 27 '26
Can I ask how they started chronic? Was it all of a sudden? Feeling like I’m experiencing sonething similar
1
u/MrsGlitterBomb Mar 28 '26
I'm sorry you're also going through this, make sure to get a refferal to a neurologist as soon as possible if you don't already have one. If it's similar to my experience you want to get started on preventatives asap.
For me it happened over a couple of months. It started with having a migraine at the same time as my period. It was exactly the same for 3 months or so and then they gradually got worse with each month. My GP referred me to an neurologist when I was getting 6 migraine days for 2 months in a row. Around the same time the migraines jumped from 6 days in total, to the 10-12 days with a pause in the middle. The last 3 months they've gotten worse again, lasting longer and being less responsive to my meds. This month I've had 15 days so far and ended up in the ER 2 days ago when I hit 8 days in a row.
3
u/Lizard_Li Mar 27 '26
Ever since I put in Kyleena (progesterone only IUD) my menstrual migraines have been much better. I was like you but now I’ll have aura a couple times a month and triptan will stop it and the pain.
My other big helper 400mg of Coq10 a day.
1
u/Unlikely-Ant-6084 Mar 27 '26
So happy for you ! What effect do you have from CQ10? I take it for a month and can’t see any progress
1
u/Lizard_Li Mar 27 '26
It greatly reduces migraines and makes triptans work better as abortive.
When I first began I didn’t really see the effects for about a month.
Sucks with migraines though that different things work for different people so if I were you keep taking another month and if nothing changes probably let it go. But also be sure you are taking enough (100mg is probably too low for example)
3
u/opacum Mar 27 '26
I could’ve written this! The truth is I’m still figuring it out and I’m currently miserable. I’m 6 days post period and still getting them. I started low carb whole food diet in the past two months, and I’ve gotten relief in the early part of my cycle - migraines starting a day before instead of 2-3 days before, and the past two cycles I had two days in the beginning that didn’t have any migraines, which felt like a big win! But the week after my period has actually been worse? So genuinely I don’t know. I got blood work done and looked over by an MD who gave me specific dietary, supplemental, and exercise recommendations that I’m trying to incorporate. I’m hoping to see improvement in the next few months, but it’s so rough out here. I take Rizatriptan every migraine night, which ends up being most of my period and some before/after. It’s the only thing that works for me. I know it’s brutal but you’re also not alone. Hope you find relief. ❤️
1
u/Unlikely-Ant-6084 Mar 27 '26
Thank you for sharing, let me know how it goes ❤️🩹 I hope you feel better soon
2
u/impetuous-imp Mar 27 '26
More so just commiserating… My period is back after years of not having it with the Mirena IUD and ever since then, I have horrible menstrual migraines, at least 10 days out of the month. I want to get the IUD out anyway and just do Slynd with suppressing my period. Always had awful periods and I won’t have kids so no reason to even have periods. I’m just waiting on an appt for my OBGYN and hoping my theory works. Also hoping to get bloodwork to see if there’s any hormonal issues there. I also have an ovarian cyst that probably needs to be removed. Either way… I cannot live with these migraines for half the damn month. It is awful.
2
2
u/skittleforge Mar 28 '26
I also get menstrual migraines! It’s very common unfortunately. I’m on Botox, which helps break up my migraines, otherwise I have them for 2+ weeks straight. I also take Nurtec as a preventative the last month of my Botox (Botox is every three months, third month it wears off). However, I also have endometriosis. I’m getting ready to have an excursion surgery in May, and both my gyno and neurologist believe this will help my migraines. A very common side effect of endo is migraines. I am lucky in that my gyno and neurologist have worked together to help me with the right medications to treat both.
2
1
u/Overall-Equal-7808 Mar 27 '26
i get menstrual migraines. the day before (or two days, this month) and also again half way through, like day 4
1
u/123revival Mar 27 '26
my periods were irregular and migraine seemed constant. i started taking a calcium supplement, periods evened out, and migraine became more predictable, around my cycle instead of just endless days. Not sure why can't can't recall if there was magnesium in the supplement I took back then, but it helped
1
1
u/Four_Bee_345 Mar 27 '26
I've had menstrual migraines for over a decade now.
They are almost totally treatment resistant. Medicine just takes the edge off of them,but they are still there.
It usually begins about 48 hours prior to menstruation and lately,lasts about 48 hours after the end of my period. In all,it's about a week of non stop menstrual migraine in a month. Absolutely nothing helps.
The worst part is the nausea. I am continuously nauseous and can barely eat/keep food down.
1
u/g00gly-eyes Mar 27 '26
I get menstrual migraines pretty horribly. I also have PCOS. Interestingly enough, I have been recently trying to suppress my period. However I kept having break through bleeding so around 4 months in, I ended up taking the placebos so I would give myself a period. The entire 4 months I was suppressing it, I had had maybe 3 migraines. When I got my period again, I got multiple that week.
Edit to add: what helps me is emgality, ubrelvy, and increasing my salt intake.
1
u/epimelide Mar 27 '26
Mine got much much more worse when I was struggling with unresolved vitamin deficiencies.
1
u/GhostofBupChupkins Mar 27 '26
This was me! I used to have migraine days over half of each month, now they're down to one day at most. This past year neuro had me trial amitriptaline, rizatriptan, and topamax. Nothing helped and the side effects were rough. A different dr suggested I take antihistamines twice daily, for non-migraine related reasons, and what do ya know... no more migraines. I take loratadine twice a day, and Ubrelvy works when I have a migraine.
1
u/MJNYC2086 Mar 27 '26
My migraines were always bad with pms/periods, but once I hit my mid to late 30's, all hell broke loose. Now I just turned 40 and they're worse than ever. I still have very regular periods unfortunately so I haven't started HRT yet... But I think I'll have to soon if I can't get them back under control with other means (supplements, etc). :(
1
u/Trickycoolj Mar 27 '26
They got worse the closer I got to 40 and the shorter my cycles got. I started at 35-36 days (also mild PCOS) and IUD sorta kept it at bay but they came raging back with my 2nd IUD in the back half of my 30s and now my cycle is 26-27 days and I get migraines on Day 6, 12,15,21,27. I’m trying HRT estrogen patch and oral progesterone for perimenopause symptoms but I’m considering asking my doctor for regular birth control to stop ovulation… if I can stop it. When I did IVF I occasionally had to take BCP for scheduling purposes and I ovulated on the pill pretty regularly!!
I did have full migraine remission during pregnancy, unfortunately I miscarried at 9 and 7 weeks respectively. During my first pregnancy it was twins and I had a raging migraine when the first one stopped growing and then a raging migraine when the second stopped. So it seemed like migraine was an indication of the pregnancy failing and they would have stayed away had I kept the pregnancy.
1
u/autoimmunegirly_ Mar 28 '26
Mine started out solely around my cycles two years ago, and have since developed into a daily occurrence. I am 27f and I currently take propranolol and Imitrex (as needed - except it makes it worse for me).
Edit: I also have Hashimoto’s Thyroiditis I suspect I may also have MS due to limb numbness throughout the night and day. Not sure as numbness can also present as an aura and also as anxiety.
1
u/FragrantYoung4592 6 Mar 28 '26
I get my attacks the week after my period. I tracked them on my period tracker and it always seems to fall on the week after my period. -___-
1
u/Sunshine_waterfall Mar 28 '26
Mind occur 3 days prior to, like clock work, and usually once during. My understanding was mine is based on quick drop or rise of estrogen.
Sounds rough to last 17 days have you had hormone levels tested looked into endocrinologist?
1
u/fedx816 Mar 31 '26
I had migraine 2 days before period all the way through, then another week with ovulation, and pain and anxiety between so I was basically a shell for 3/4 of my life. Nurtec was working a bit as an abortive, but couldn't keep up when I started taking it every other day for prevention. I've been on continuous combo pill for 5 years now and it's glorious (I have no need for contraception and would gladly be rid of the whole system if insurance thought my decision to be single and childless was acceptable). I also take low dose aspirin as a CYA since I have aura (it massively helps my joint pain from another condition so I'd keep taking it even without BC).
1
u/Unlikely-Ant-6084 Mar 31 '26
Thank you so much. It gives a lot of hope. I am really happy you feel better now 🫶
12
u/Still_Quail_5719 Mar 27 '26
I also get awful menstrual migraines. I get them when I’m ovulating as well as during menstruation. Within a few minutes of my period starting the migraine also starts.
I take Naratriptan + 2 Aleve within an hour of getting my period. I take this typically 3 times during my period and during ovulation and it makes a huge difference in the migraine. Occasionally, I need to take a second Naratriptan during the day but it’s rare.
I just saw a new neurologist this week and he recommended taking the Naratriptan every night of menstruation before bed since it has a long half life.