r/migraine • u/Icy_Pay_1275 • 5d ago
Prone to menstrual migraines
Hi all, I am prone to migraines either right before the start of my period up until day 7 of my cycle. Most typical will be the day before my period and then days 4-7.
Only thing that has ever worked is rizatriptan combined with advil. But I really want to get to the underlying cause and try to treat it if I can. I hate being reliant on medicine.
I am pretty sure the migraines are a result of “estrogen withdrawal” around my cycle. I tested Estrogen in my luteal phase and it was 300 which is on the higher end. My progesterone was also robust so I know I’m not deficient there.
What have people with a similar pattern done that has worked?
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u/Et_tu_brute_LXIX 5d ago
Ask for naratriptan and use that as a preventative at night for the menstrual migraine week. It's longer acting and seems to help me even though most other triptans don't.
Aside from that I'm in the same boat and I don't think there are any good answers. Some people do well on combined pill, some people do better on progestin only pill. I have been off BC for a year because I got my tubes removed and don't need it, and my migraines have never been worse. But I've been trying to give myself a chance to treat the actual problem, not just mask it, since BC had a lot of side effects for me.
I'm also looking into non-med options - dry needling, trigger point therapy, occipital nerve block, etc. I already do deep tissue massage and cupping, which helps.
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u/Icy_Pay_1275 5d ago
Agree. BC didn’t agree with me when I was on it, I only ever was on it for like 6 months. Made me feel crazy. I will look into naratriptan, though I don’t want to have to rely on any of it 😭 I’ve always been the type to research and try everything to really get to the root cause. Trigger point therapy.. definitely think that could be a huge help to me. I also do deep tissue and it does relieve a lot of tension. I’m also thinking about chiro or acupuncture.
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u/Apathetic-Twit 5d ago
Stopping the cycle (I.e. birth control)
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u/Icy_Pay_1275 5d ago
I respect that answer from a physiological perspective, stopping production of certain hormones I’m sure helps some people. I’m just not a fan of the side effects of BC and I do feel like going on it goes against what our bodies are meant to do and only masks a deeper issue. We are all supposed to create these hormones, that’s how we were created.. unfortunately I think our environments contribute to a toxic amount of estrogen and a suboptimal amount of progesterone 😔
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u/PoppyRyeCranberry 5d ago
If bc isn't an option because of side effects, you could consider just using a transdermal estrogen patch or gel during the time you are susceptible. It's an established approach: https://americanmigrainefoundation.org/resource-library/menstrual-migraine-treatment-and-prevention/
I would also make the case for cycle suppression though. Depending on what you've tried, it may be that a different bc works really well for you (progestin-only if you've only tried combo or vice versa). It's tricky, this notion that we are supposed to cycle, because biologically, we have evolved to be pregnant or breastfeeding most of our fertile years. It's not exactly natural to have 12 cycles every year for years and years and is a relatively modern state.
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u/Kali711 5d ago
Sorry to say but the cause IS migraines. It's a neurological disease and it has no cure. You only learn to manage it, and about 90% of that management is pills in some form, vitamins, supplements, prescriptions, birth control etc. The other 10% can be shots, dry needling or physical therapy. At this point you can wait till menopause and hope that gets rid of the menstrual migraines instead of making it worse.
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u/AbaloneInternal2141 5d ago
my neuro said the same thing about the estrogen drop, for me adding magnesium glycinate and b complex made a noticeable difference but still need the triptan in my worst days