These attacks are challenging to treat. Some of the medicines that relieve the pain of regular migraine symptoms don't work on menstrual migraine. That's why it's best to stop them before they start.
You can try a few different approaches to preventing your menstrual migraine. Work with your doctor to figure out which one is best for you.
Keep a Diary
A diary where you document your symptoms can help you learn more about your migraine. Watch for patterns. You'll start to notice whether your headaches are tied to your menstrual cycle and if they start before, during, or after your periods. If you know ahead of time when they’re likely to start, you can take steps to prevent them.
Write down in your diary:
- When your symptoms begin -- the number of days before or into your period
- How often you get migraine
- How long they last
- What they feel like (throbbing, aching, etc.)
- What other symptoms you have
Share your diary with your doctor. This symptom record will help you get the right diagnosis and treatment.
Medicines That Prevent Menstrual Migraine
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Pain relievers such as ibuprofen and naproxen prevent menstrual migraines or make them less severe. You typically take them twice a day starting 2 to 3 days before your period begins, and then for another 3 to 5 days after it arrives.
- Estrogen pills, gel, or patch. A dip in your estrogen levels happens before your period triggers menstrual migraine. You can prevent them by taking a steady dose of estrogen throughout your menstrual cycle. If you're already on a hormonal birth control pill, switch to a continuous dose. Take estrogen during the days when you'd normally skip pills or take inactive ones. If you have migraine with aura, talk to your doctor before you start taking estrogen -- it may raise your odds for a stroke.
- Triptans. Your doctor can prescribe these drugs to treat a migraine once it’s started, but they also prevent menstrual migraine headaches. You start them 2 days before you usually get a migraine and keep taking them for 6 to 7 days total. Triptans can cause side effects like nausea, dizziness, a stuffy nose, and cramps. They might also lead to rebound headaches -- new or more severe headaches that happen when you overuse medication.
- Magnesium. Some research has linked the onset of a migraine to low levels of this mineral. To help prevent a menstrual migraine from occurring, start taking magnesium on the 15th day of your cycle. Keep taking it until you get your period.
If your periods don't come on schedule or you also get migraine headaches at other times in your menstrual cycle, you can take preventive medicine every day. Drugs that prevent migraine headaches include:
- Some types of antidepressants
- Some types of antiseizure medicines
- Blood pressure medicines such as beta-blockers and calcium channel blockers
- CGRP inhibitors, these are a new class of preventive medicine
Devices which may be used for treatment or prevention include:.
- Cefaly, a small headband device that sends electrical pulses through the forehead to stimulate a nerve linked with migraines
- Spring TMS or eNeura sTM, a device for people who have an aura before migraine headaches. You hold it at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain.
- Noninvasive vagus nerve stimulator (nVS) gammaCore is a hand-held portable device placed over the vagus nerve in the neck. It releases a mild electrical stimulation to the nerve's fibers to relieve pain.
More Menstrual Migraine Prevention Tips
A few other things you can try at home to prevent menstrual migraines:
- Exercise every day. Moderate exercise, like a walk, bike ride, or swim, could help you have fewer migraine headaches and make them less intense. Be careful not to work out too hard, though. Sometimes strenuous exercise can trigger migraines.
- Get 7 to 8 hours of sleep each night. A lack of rest can set off migraine attacks.
- Relax. Stress leads to migraine for many people. Try techniques like deep breathing, yoga, and meditation to take the pressure off.
- Watch what you eat. Avoid foods that trigger your headaches. Some foods that are common migraine triggers include: chocolate, caffeine, alcohol, aspartame and other artificial sweeteners, processed meat, and cheeses.
- Graze throughout the day. Hunger can give you headaches. Eat several small meals and snacks instead of three big ones.