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How does a female's cycle affect a migraine?

For some women, migraines occur during their cycle​​ or just before, when the hormones, estrogen and progesterone, drop to their lowest levels.  The strict definition of menstrual migraine is for the migraine attack to start at any time from two days before, to three days after the first day of a female's cycle.  There are two types of patterns:

  • Pure menstrual migraine occurs when migraine attacks happen only around cycles​ and not at other times.  This occurs in about 1 in 7 women who have migraines.
  • Menstrual-associated migraine occurs when migraine attacks happen around cycles​, but also happen at other times too.  About 6 in 10 women who have migraines have this type of pattern. 

​Symptoms usually improve if a woman becomes pregnant.  As a woman approaches menopause, the migraine attacks may become more frequent as the level of estrogen tends to go up and down at this time, but once a woman is past menopause, she has a constant stable low level of estrogen, and migraine attacks tend to reduce.  ​

​How can menstrual migraine be diagnosed?

​Sometimes a woman's cycle and a migraine attack occur at the same time, by chance.  In order to make the diagnosis, your physician may ask you to document your migraines for a period of time, which helps see the pattern of the migraine attacks, and whether you have menstrual migraine.

​What are the treatment options for menstrual migraine? 

​​The treatment options are the same for other migraine attacks which includes:

  • Abortive medications.  Medications, prescribed by your physician, that act on specific receptors in both the brain and the blood vessels in the head, stopping a headache once it is in progress.
  •  Rescue medications.  Medications purchased over the counter, such as pain relievers, to diminish or stop the headache.
  •  Preventive medications.  Medications prescribed by your physician that are taken daily to suppress the onset of severe migraine headaches.​​​