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PMS Migraines

Understanding PMS Migraines

by Dr. Daniel J. Heller
Dr. Daniel J. Heller Dr. Daniel J. Heller

Dr. Heller is a family practitioner who specializes in helping patients with hormonal conditions like PMS & PMDD; diabetes and prediabetes; and other chronic diseases. He is the founder, formulator, and clinical director of PMS Comfort. [more]


Migraine headaches can be downright incapacitating on their own; when they are part of the spectrum of premenstrual syndrome symptoms, the combination can be truly debilitating. In fact, migraines may make PMS symptoms worse. Ordinarily, PMS symptoms are bad enough: bloating, moodiness, and cramping can really take a toll, especially when they occur month after month. Add headaches or migraines to the mix, though, and it can be hard to function.

There are two kinds of migraine headaches that are labeled menstrual migraines. The most common is menstrually-related migraine: this PMS migraine can occur during the few days before the period and the first few days of the period itself, as well as during the rest of the month. Pure menstrual migraines, in contrast, occur only during that time period. Menstrual migraines are defined as "migraines without aura," meaning they don't have the typical pre-migraine onset symptoms.

Up to two-thirds of the 20 million women with migraines in the United States find their headaches get worse around the time of the period. For these women, migraine attacks are two or three times more likely at this time of the month. PMS migraines are more severe, and harder to treat, than other types of migraine headache.

Realistically, though, many migraines that occur around the time of the period won't fit neatly into these categories, either because they occur with auras, or they occur earlier or later than this strict definition. Also, since one hallmark of premenstrual syndrome is an aggravation of a chronic migraine condition, it would be hard to argue that a migraine with an aura that occurs eight days before the period, in the presence of other PMS symptoms, is not a menstrual migraine.

Not all headaches that occur around the time of the period are migraines, however. Tension headaches and a variety of other types of headache can occur before, during, or after the period. As with PMS, any symptom that regularly recurs in a cycle with your hormones is likely caused by some type of imbalance in your body's hormone regulation.

Although several theories have been proposed to explain menstrual migraines, there is clearly a relationship to the changing hormones of the reproductive cycle, and most specifically to the drop in estrogen levels that occurs in the second half of the cycle. However, all women experience some degree of decline in estrogen levels during this luteal phase, but not all get menstrual migraines. And it is not as if women with migraines have a clear deficiency of estrogen or other hormones—blood hormone levels in women with migraines are almost always completely normal.

Migraine Triggers

Therefore, there must be some other susceptibility that causes some women to get migraines. This susceptibility could be genetic, biochemical, hormonal, or nutritional. While we can't know the exact cause of menstrual headaches in every woman, we do know that certain triggers tend to bring on migraines.

Among the more common migraine triggers are:

  • Hormonal birth control
  • Too little or too much sleep
  • Changes in weather (barometric pressure)
  • Missed meals causing blood sugar instability
  • Stress
  • Bright lights, flashing lights, and loud noises
  • Certain foods
  • Exercise (probably because of over-exercise and dehydration).

In addition to the short-term triggers, there are also diet and lifestyle factors that seem to cause, or at least severely aggravate, a predisposition or susceptibility to migraines. Many of these are discussed below.

PMS Migraines Are Not Normal

Unfortunately, most women with menstrual migraine assume it is a normal part of the menstrual cycle, and don't even mention the symptoms to their doctor. So, the first step to overcoming this debilitating problem is to recognize it as a real problem and not just something you have to live with. We've met women who thought their PMS headaches were unavoidable because their mother or aunt or friends also experienced them, when in fact those women may well have needed to address some of the imbalances we discuss below.

Stress and Migraines

Most people with migraines seem to feel that they are often brought on by stress, and a stress response certainly could make migraines worse, or act as a trigger in those predisposed to them. In fact, relaxation training appears to be one of the helpful ways of dealing with chronic migraines. Cognitive behavioral therapy has also been shown to be effective, suggesting that finding better ways to deal with stress can help improve migraines.

When stress combines with fluctuating hormones, not to mention the stressful PMS symptoms that may be occurring at the same time, it can be a hard cycle to break. Nevertheless, finding a way to handle stressful events and episodes so that they don't tax your health and add to your suffering is well worth the effort.

While we often think of a spa retreat or a day with few responsibilities as the best escape from stress, it's important to remember that stressful events can happen anytime, and we can always try to manage how we react to those events. So while a massage can help, the best stress response could lie in remembering to take a deep breath and ask ourselves if, in this situation, it's actually worth "sweating the small stuff." Of course, if migraines are part of PMS, it can make it nearly impossible to control one's reactions to events—in which case the events don't seem like "small stuff" at all! That's why the best approach is to try to deal with, and prevent, the cause of PMS symptoms.

An ongoing pattern of powerful reactions to ordinary events—powerful enough to throw us out of balance and bring on painful and distressing symptoms—can be a sign that things are somehow out of balance in our lives. At times like this, counsel from a professional or from clergy can help us find a better perspective on our lives, allowing more ease and comfort, and less stress.

Not that we would argue with a spa treatment or a massage! Other stress-busting things you can do to regain control of your emotions and stress levels: keep caffeine levels to a minimum; eat breakfast daily; keep sweets and baked goods as an occasional treat rather than a regular part of your diet; get at least seven (and preferably eight) hours of sleep per night. And don't forget regular (moderate) exercise, which is one of nature's best ways to discharge stress.

Real, Natural Relief—So You Can Feel Great All Month Long

PMS and PMDD misery aren't always taken seriously enough by doctors, family, and friends. At PMS Comfort, our whole purpose is to empower and educate you about premenstrual symptoms, and to provide real, natural relief so that you can feel great all month long. Our all-natural doctor-designed programs are based on decades of experience helping thousands of women recover from what you've been going through. Our Herbal Relief formula, when combined with our diet and lifestyle guidance, addresses more than just your symptoms—it can help bring your body and mind back into balance, and help you get and stay healthy. Plus, we're here to support you, every step of the way.

To learn more about your PMS and PMDD symptoms, take the PMS Comfort quiz. Or, start feeling better today, for as little as 89 cents per day.

We want to help. Give us a call at 1-800-731-6327, drop us an e-mail, or send us your question.

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Principal Author: Daniel J. Heller, N.D.
Last Modified: April 3, 2014

Understanding PMS Migraines—Reference Documents and Further Reading


The information and contents contained in this Web site has not been evaluated by the FDA. Products are not intended to diagnose, treat, cure, or prevent any disease. If you are pregnant, intend to become pregnant, or nursing, please consult a physician before taking any dietary supplement. If taking prescription drugs, consult your healthcare practitioner prior to use. You must be 18 years or older to purchase products. Individual results do vary.

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