You probably already use one or more of the many migraine treatments out there. They can work well. But they don’t always.
If you still find it hard to stop or prevent your headaches, you’ll want to know what else there is.
As early as 1966, researchers noticed that migraines may be worse for women who take birth control pills, especially ones with high doses of estrogen. Pills with lower estrogen doses or with progesterone cause fewer side effects.
Drugs called triptans that are used to treat migraines and cluster headaches can also treat menstrual migraines. They shrink blood vessels and fight pain.
You'll probably need to take medicine 1 to 2 days before your period starts until it's over. Some women need to take both a triptan and an NSAID.
Some birth control methods, like pills, patches, or vaginal rings, can help cut the number or the severity of menstrual migraines. You may need to try different types with different combinations and doses of hormones to find what works for you. Or your doctor may suggest using birth control continuously for a while, without a break for a period, to avoid headaches.
But if you have migraines with aura, you shouldn't use hormonal birth control because of a greater likelihood of strokes. Even if you don't have auras, your doctor may not want to prescribe birth control if you're over 35 and you smoke, have high blood pressure or cholesterol, are more than a little overweight, or have diabetes.
Taking a magnesium supplement might make your headaches shorter and your periods easier. But talk to your doctor before you start using it.
It's also a good idea to limit how much salt you eat before your period starts so your body doesn't hang on to water in your tissues, which could create extra pressure. Your doctor can prescribe "water pills" (diuretics) to help you pee out extra fluid and bring down swelling if it's a problem.
If nothing else works, leuprolide acetate (Lupron) drops estrogen levels. But there can be unpleasant side effects because it's affecting the balance of your hormones.