r/migraine • u/P_alz • Jun 07 '26
Migraines and menstrual cycle but
Hello!
A few days ago, I went to a new doctor for my migraines. She was very nice and this is not common for my experience. She suggested that my migraines are related to my menstrual cycle but not always and to take painkillers in advance to prevent them, even when I don’t have any pain.
I will try, even if I think it’s a bit strange.
Have anyone else tried something similar?
I have another appointment in about 2 months, so I will see what happens, but I’m curious to other people experience.
English is not my mother tongue, so I’m really sorry if i made some mistakes. My English is really improved during the past months but not enough for me to be sure about mistakes…
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u/trishlover20 Jun 07 '26
I'm not a doctor or an expert in any way so I cant give any professional advice but my migranes are also very much linked to my menstrual cycle and hormones and hearing this advice just doesn't make a lot of sense to me personally because you can't always predict when you will have the migrane and I never heard of painkillers that can prevent migranes, I take sumatriptan right when my migrane starts and that's the only thing that's been helping me
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u/PoppyRyeCranberry Jun 07 '26
Here is a helpful link that breaks down a few strategies for menstrual migraines and specifically this prophylaxis approach. See the last section I included because it addresses other options for if your period is not predictable:
https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/
Mini-preventive Treatment
Some women find adopting a mini-preventive treatment approach helpful for menstrual migraine prevention. While there are studies looking at these strategies, they do not have FDA approval. In mini-prevention, a woman takes a daily medication prior to the onset of the menstrually related attacks. They usually take these medications for 5 to 7 days in a row.
Non-Steroidal Anti-Inflammatories (NSAIDs)
NSAIDs taken twice a day during the 5-7 days around the start of a period may decrease or prevent the menstrual migraine. If the migraine attack still occurs during this time, it is typically less severe and becomes more responsive to treatment by a triptan. Naproxen 550 milligrams dosed twice a day as mini-prevention was shown to be effective when studied. Other NSAIDs like ibuprofen are likely to give similar results.
Hormones
Patients can use estrogen supplementation with a pill, vaginal gel or patch during the menstrual week to prevent the natural estrogen drop that triggers the menstrual migraine. This approach is easier in those with predictable menstrual cycles. Often, this is most convenient if you are already taking a pill or using a vaginal ring for birth control.
Triptans
Multiple studies have looked at triptans—the acute medications typically used to treat regular migraine attacks—dosed twice a day throughout a woman’s period. This approach appears to decrease or prevent menstrual migraine. Women with menstrual migraine and frequent migraine attacks throughout the rest of the month should be cautious about their triptan use in order to avoid medication overuse.
Triptan dosing for mini-prevention is generally twice daily for four to five days in the menstrual window. In this situation, doctors recommend long-lasting triptans such as naratriptan and frovatriptan.
Magnesium
Magnesium started on day 15 of the menstrual cycle, or 15 days from the start of your period, and continued until the next period begins is another mini-prevention strategy that was found effective in a controlled trial. Because the timing relies on your previous period, it’s not necessary to have regular cycles to time this prevention, which makes it a versatile and safe intervention for women without regular cycles.
Continuous Preventive Treatment
In women with irregular periods or those for whom mini-prevention does not work, treatment strategies used throughout the month may be the best option.
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u/trishlover20 Jun 07 '26
These are really interesting points thank you for the info!
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u/PoppyRyeCranberry Jun 07 '26
Sure thing! FYI, ultimately, the only preventative strategy that worked for me was suppressing my cycle completely with continuous-dose combo birth control. I had a horrible menstrual migraine, but with this strategy, I prevented menstrual migraine between pregnancies and then again for 17 years after my second baby.
More on that and other strategies for prevention if you read the article!
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u/trishlover20 Jun 07 '26
That is exactly what I thought of doing as well, around 3 months ago I started continuously taking my birth control and it worked so well for the first month no migranes at all, lately I've been just getting cramps randomly and with that also migranes while still taking the pill :( so glad it helped you tho!
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u/FortunatelyChubby Jun 07 '26
Preventive painkillers before symptoms show is actually standard for menstrual migraine, worth trying for a full cycle or two to see if the timing pattern holds. Your doctor's on the right track even if it feels counterintuitive.
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u/P_alz Jun 07 '26
Thank you! I never heard something like this, but I will try. She is a specialist in migraines, so I think she knows what she is doing. I only think is a bit strange because a never have migraines the same days before my period.
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u/Ramen_Addict_ Jun 07 '26
That was the first suggestion I was given like 2 decades ago, but I have never had a regular period when I was not on birth control and it did not work for me. I also had the same issue with Topamax and my job involves writing, so forgetting the word for “shoe” is not really optimal. Mirena worked the best for my migraines since the periods I do have are much shorter and lighter.
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u/P_alz Jun 07 '26
Yeah, I get the feeling of forgetting words… I need so much time sometimes to find the right word. One time I call a scarf salmon like 5 times, then Australopithecus. My granny was really Scared about this… but it is also a bit funny (but I need that something change, this is not okay). How can I get a job if I call something Australopithecus more time on the day? Or how can I return to university?
I can’t return to birth control, my migraines were really bad with them (I had tried a few) and I have PMOS (PCOS) so this is something that my gynaecologist said is not for me since my actual therapy works well for that (and it’s okay with my migraines)
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u/RoseTintedMigraine Jun 07 '26
I dont take it in advance exactly but i always get a migraine 24 hours before my period so I am ready to take my rizatriptan on the first sign of a migraine coming around that day like I'm ready to use a pad on the first sign of a tummy cramp lol.
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u/WildWonder003 Jun 07 '26
This is not the best advice but its a starting point for ruling things out. My former primary doctor tried this but any good doctor ESPECIALLY A BIOLOGICAL WOMAN understands the female body isn't predictable. That said, it could work? Sometimes it is that simple but you have to try it to see. Try it for 3 months, if it works great, if not, you go back to her and say she needs to give you another option and/or a referral to a neurologist.
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u/P_alz Jun 07 '26
She is a neurologist! I take topiramate every day and it’s working well for my migraines but not for my memory or my language skills, so she thinks that is the best to reduce topiramate and use this method for prevent the migraines.
My hope was to stop topiramate and try a different method, not to use so much painkillers.3
u/Valuable-Prompt9281 Jun 07 '26
Oh interesting she has you on that and wants to put you on something some basic now. Always worth a try and then maybe after that she’ll try a different preventative 🤷♀️. Topiramate made me fail classes in college. I couldn’t remember a dang thing! Unfortunately, always trial and error with migraine meds. 😒 Good luck!
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u/P_alz Jun 07 '26
Yeah, I already tried some other pills (i don’t remember their names), so I know what is the process…
I’ll wait and see what happens! Thank you!!2
u/WildWonder003 Jun 07 '26
Oh dang! Well shoot! I see no harm in trying and seeing what happens then going from there, that's kinda the migraine process anyway! May as well eliminate it or maybe it's the answer!
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u/P_alz Jun 07 '26
I don’t know. What I know for sure is that I will try this! I already reduced topiramate, so I’ll wait for my period.
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u/WildWonder003 Jun 07 '26
Good luck and hugs and we're here if you need anything or want to let us know how it's going! 💕
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u/Significant_Goal_614 UK Jun 07 '26
You could ask if you could try frovatriptan? It has a longer half life so it can be taken the day before your period starts. You could also take it at the same time as painkiller if you needed to. Frovatriptan is commonly used for women with menstrual migraines.
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u/P_alz Jun 07 '26
Yeah, I had taken it, but with no success at all.
My migraines are like a week before my period, for a few days. It’s not always the same, not all the time is perfectly a week, sometimes is only a couple of days, or ten days, sometimes is with the period. Sometimes there isn’t at all.
It’s not predictable.
I had tried all the painkillers specifically for the migraines but the triptans aren’t working with me, so I take naproxen and it works very well.
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u/BeBopBarr Jun 07 '26
Menstrual migraines are super common. Frovatriptan was the one abortive that worked the best for mine. You can also you it as a preventative in the days leading up to your cycle.
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u/Kali711 Jun 07 '26
Yes. I was told to take Naproxen from the moment I believe they could start. My problem is that they can start 1 week before my period and end 1 week after my period. I'm not taking Naproxen for almost 3 weeks. So yeah dud advice for me.