Migraines and menstruation: is there a connection?

by Mary Calvagna

Every month, many women experience unpleasant symptoms before the start of their menstrual cycle, including mood swings, backaches, fatigue, and bloating. A study published in the journal Neurology (see Resource below) found that migraines can be added to the list.

Women suffer migraines three times more than men and many women report that their migraines feel more severe around the time of their monthly periods. Menstruation has long been thought to be a powerful trigger for migraines. Therefore, these researchers wanted to confirm the possible connection between the occurrence of a migraine and the monthly onset of menses.

The dull ache that becomes a pulsating pain

Migraines usually begin as a dull ache and then develop into a throbbing and pulsating pain. A migraine attack can last several minutes to several days and may be accompanied by nausea, vomiting, and sensitivity to light and noise. Some women also experience altered sight, taste, touch, hearing, or smell.

What causes a migraine is still unknown, although recent research has been able to pinpoint certain triggers for such attacks. Suspected culprits include:

  • Strong odors, such as perfumes or cigarettes
  • Foods, such as wine, aged cheeses, soy sauce, chocolate, processed or cured meats
  • Stress
  • Excessive noise or bright lights
  • Menstruation

A possible connection is studied

Eighty-one women were enrolled in a 98-day diary study. The diary was used to record onset and duration of the menstrual cycle, headache days, and associated headache features, such as symptoms, pain intensity, and attack duration.

Researchers found that women were more likely to experience migraines two days before the start of menstruation and during the first five days of their periods. The highest risk occurred during the first two days of menses.

"That's important news," says Stephen Silberstein, MD, an author of the study. "If women have a better idea when they'll get a migraine, they have a better chance to prevent [the migraine]."

Attempting to prevent the pain

Although there is no sure-fire way to prevent migraines, steps can be taken to lessen the likelihood of their occurrence. If the pattern of attacks suggests that a trigger may be initiating the migraine, try to avoid this trigger. In addition, the American Medical Association offers these lifestyle tips to help increase resistance to migraines:

  • Be consistent in sleep patterns
  • Eat a healthful diet and don't skip meals
  • Exercise regularly
  • Stop smoking
  • Relax and meditate