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Menstrual Migraines

By May 2, 2021August 23rd, 2021No Comments


Menstrual migraine (also known as a period headache) treatment should begin with non-prescription medications, and non-steroidal anti-inflammatories in particular. Many women find that these medications relieve headache pain as well as other menstrual symptoms. When basic over the counter medications don’t yield results, the patient should graduate to extra strength aspirin or acetaminophen with caffeine.

Some women have had success staving off migraines by taking over the counter medications as a preventative measure before their menstrual cycle. For women on birth control it is recommended that they begin any non-steroidal anti-inflammatory medicine treatment after the nineteenth day of their period and stop on the second day of their next cycle. The limited duration of menstrual migraines makes them less likely to lead to medication overuse headaches or rebound headaches or gastrointestinal symptoms. If non-prescription methods are not having the desired affect, prescription medications are the next course of action.

Some of the most effective medicines against menstrual migraines are the anticonvulsant, verapamil, the beta blocker, propranalol, and the calcium channel blocker, verapamil. They should be started two days before the menstrual cycle or as soon as it starts when the cycle is less regular. Onset abortive medicines that act like serotonin receptor agonists can be an effective treatment for menstrual headaches.  Ergotamine medicines have declined in popularity with the increased use of Triptan which attacks serotonin receptors but without other medicines’ symptom profiles. Unfortunately, Triptan is more expensive than other medications, even non-generic drugs, and even when covered on an insurance prescription plan.

Anti-depressants can be used to treat menstrual migraines because of their affect on serotonin receptor signals. Particularly effective are selective serotonin re-uptake inhibitors (SSRI). Any patient taking an anti-depressant for an off label use, like headache relief, will benefit from doctor reassurance that the drug’s use is not indicative of mental illness. Awareness of biochemical foundations of the nervous system should be encouraged, especially in relation to those mistakenly thought to be character attributes.


Over the counter medications are the first course of action against menstrual migraines. Non-steroidal anti-inflammatory medications are effective for pain relief as well as relief of associated menstrual symptoms. But as with other non-menstrual related headache disorders, including headaches that strike men, over the counter medications may prove ineffective in some patients. In those cases, compound medicines, like extra strength aspirin or acetaminophen with caffeine, are a good next step.

These medications are taken preventatively by some women before their menstrual cycle begins. Women taking birth control pills can start taking non-steroidal anti-inflammatories on the nineteenth day of their menstrual cycle and continue taking them until the second day of the next menstrual cycle. The limited time of a menstrual cycle allows for the use of over the counter drugs with a reduced risk of gastrointestinal symptoms or the development of overuse or rebound headaches that they sometimes contribute to.

When over the counter medications don’t yield results, there are other prescription options that can be tried. Beta blockers like propranalol, calcium channel blockers like verapamil, and anticonvulsants such as valproate have proven affective in treating menstrual headaches. They should be started within the first two days of the menstrual cycle. Menstrual migraine patients may seek relief from serotonin receptor agonists that block the onset of headaches. The use of ergotamine drugs has decreased for this use. Triptan has taken it’s place since it targets the serotonin receptors but generally produces fewer undesirable side effects than other similar drugs. Triptan’s primary drawback is its high cost, typically higher than even other brand name medications. Due to the role signals passed between serotonin receptors play in menstrual migraines, anti-depressant medication can be an effective treatment. In particular, those in the selective serotonin reuptake inhibitor group (SSRI).


Adequate care should be taken to insure the patient that an anti-depressant prescription to treat headaches is commonplace and not an indication of actual depression or any other mental disorder. Patients suffering from menstrual migraines, or any other headache disorder, could benefit by calling the National Headache Institute today.

We specialize in headaches and neurological disorders and can help you eliminate headache pain. For more information regarding headaches & migraines that affect women, see: