Migraine with aura and hormone treatment

This page is reference information compiled from the cited sources. It is not medical advice. For any decision about health, diagnosis or care, consult a qualified professional.

What it is

Menstrual migraine is the term used to describe both pure menstrual migraines and menstrually related migraines. Pure menstrual migraines are when migraines occur only at the time of menstruation. Menstrually related migraines are when a person experiences migraine attacks throughout the menstruation cycle with an increased number around menstruation. These migraines happen in around a quarter of women who have migraine headaches. The exact causes are not known for sure, but there is a link between falling levels of the female hormone estrogen and the onset of an attack. This fall can occur after bleeding during the menstrual cycle or when external sources of estrogen are no longer taken, such as when stopping birth control pills or hormone pills in hormone replacement therapy.

Key facts

About seven to fourteen percent of women have migraines only at the time of menstruation, which are pure menstrual migraines. Most female migraineurs experience menstrually related migraines. Menstrual migraine attacks usually last longer than other migraine attacks, and short-term treatments do not work as well with menstrual migraine as they do with other kinds. The diagnosis is made by keeping track of when migraines occur for at least three months, with attacks usually occurring between two days before and three days after the start of menstruation in at least two out of three consecutive cycles. A headache diary is helpful for tracking migraine timing and symptoms. The Menstrual Migraine Assessment Tool is a simple three-question questionnaire that is fairly accurate for diagnosis, requiring a yes to the first question and at least one yes to either question two or three. Preventative treatments should be tried for at least three menstruation cycles to determine effectiveness.

When to seek professional help

Professional help is involved in diagnosing menstrual migraine, which requires tracking headaches over at least three months. Diagnosis involves using tools like the Menstrual Migraine Assessment Tool questionnaire. Keeping a detailed diary of symptoms and peak expiratory flow rates is part of the diagnostic process for associated conditions like premenstrual asthma. Professional care is indicated for determining the effectiveness of preventative treatments, which should be tried for at least three menstruation cycles. The source notes that professional management is for women who do not respond well to acute treatment and where lifestyle changes are ineffective, particularly for predictable menstrual migraines.

Source: Menstrual migraine (CC BY-SA 4.0 (Wikipedia)), retrieved 2026-10-04.