Do you suffer headaches before and during your periods? This may be the reason

While Tina was “happy and cheerful” for most parts of the month, she dreaded the days before and during her periods. This, however, wasn’t because of the common stomach cramps most women experience during their menstrual cycles, but due to “severe headaches” that she suffered from for only three to four days every month. Sharing her story, Dr Sudhir Kumar, Neurologist, Apollo Hospitals, Hyderabad wrote on Twitter, “She hopelessly wished that those days never ever came, but that was not possible.”

“She never experienced headaches on other days of the month. She had regular periods and had a 2-year-old child too. Headaches were severe with a score of 7-8 on the visual analogue scale (where 10 is the most severe pain, and 0 is the absence of pain). Tina had nausea, vomiting and dizziness associated with headache. Headaches lasted 24-36 hours and they left her completely incapacitated,” he said.

The medical expert shared that these headaches took a heavy toll on Tina’s personal and professional life. “She was unable to give quality time to her child and husband on those 3-4 days. She was also not in a position to go to the office. She was a software professional and had to routinely take leave on 2-3 days/month,” he wrote.

Neither the painkillers nor yoga and meditation helped her in getting relief. Finally, after studying her lifestyle and medical history, Dr Kumar diagnosed her with pure menstrual migraine (PMM). “Headaches in PMM can occur 2 days prior to menses or during the first 3 days of menses (-2 to +3). Migraine during this period may be triggered by oestrogen withdrawal,” he shared.

Following the diagnosis, she opted to take medical treatment on those five days every month as daily medicines were not needed. “At 1-month review, she reported headache on only 1 day. During the next 3 months, she had 0-1 day headaches per month. Moreover, the duration of the headache was only 12 hours, and the severity too had reduced. Tina’s quality of life improved, and she didn’t require leave from work,” Dr Kumar shared.

What is pure menstrual migraine?

Also known as pure menstrual headache, it occurs in a menstruating woman either on the two days leading up to a period and/or during the first three days of a period, explained Dr Bhagya Lakshmi S, Consultant Obstetrician, Gynaecologist and Laparoscopic Surgeon, Yashoda Hospitals, Hyderabad. “These patients have migraine attacks at no other times of the menstrual cycle,” she added.

Agreeing, Dr Pratima Thamke, Consultant Obstetrician and Gynaecologist, Motherhood Hospital, Kharghar added that this can happen every month.

What causes these headaches?

According to experts, these migraine attacks are due to a decline in estrogen during the menstrual cycle. “The low estrogen levels just before your period may cause these notorious headaches,” Dr Thamke said.

Other causes include oral contraceptive pill usage. “They may experience headaches during the pill-free week due to a drop in estrogen levels,” Dr Bhagya said, adding that headaches usually worsen near menopause and during the first trimester of pregnancy. “It is due to disruption of the normal hormone cycle. The frequency of headaches may be more because of frequent periods in the perimenopausal group. Headaches can get worse during the first trimester of pregnancy due to disturbed estrogen and progesterone balance,” she said.


Some of the accompanying symptoms of PMM may include

*Feeling warm
*Loss of appetite
*Sensitivity to light, noise, and smells

How to prevent it?

Here are some tips to keep in mind:

*Eat small frequent meals. Missing meals or fasting can trigger hormone headaches.
*Have a regular sleep cycle and maintain sleep hygiene.
*Avoid stress and anxiety. Use exercise, yoga, and meditation to combat them.