PMS Migraines: Symptoms, Causes & Treatments

Have you ever experienced a PMS migraine?

More than 50% of women who experience migraines report that they’ve noticed an association between migraines and the timing of their menstrual cycles. Recently scientists have recognized that menstrual migraines are highly prevalent, and are researching how to treat these potentially disabling attacks.

If you experience migraines that start between two days before your period and the third day of your menstrual flow, it’s likely you are experiencing menstrual migraines or PMS migraines. 

In this post, we’ll explain why PMS migraines occur and give you some tips for treating and preventing them.

What Are the Symptoms of a PMS Migraine?

PMS migraines are more than just bad headaches – even women who get regular migraines report that PMS migraines are more severe than regular migraines, and can be more debilitating. 

The symptoms of PMS migraines are similar to those of regular migraines, including:

• Dull to severe headache pain
• Sensitivity to sound, light, and smells
• Sweating or chills
• Loss of appetite
• Fatigue
• Stomach upset, abdominal pain, nausea, or vomiting
• Diarrhea
• Fever
• A visual aura (temporary visual disturbance) before the headache

In addition, a PMS migraine may also include these symptoms:

• Constipation
• Lack of coordination
• Urinating less
• Joint pain
• Cravings for salt, chocolate, or alcohol

PMS migraines may also be more severe, last longer, and cause higher light sensitivity relative to migraine headaches that occur at other times of the month.

Why Do You Get PMS Migraines?

PMS migraines seem to be caused by the rapid drop in estrogen that happens just prior to your menstrual period. 

In a study published in Therapeutic Advances in Neurological Disorders, researchers reported that women are 25% more likely to experience a migraine in the five days leading up to their period, and 71% more likely to experience a migraine in the two days before menstruation.

Menstrual and PMS migraines can be very difficult to treat, as they do not always respond to the medicines that work effectively on other types of migraines. This may be due to the unique effect of estrogen on other chemicals in the body.

When to Seek Immediate Help for Migraine Pain

You should contact your healthcare provider if:

• The severity or number of your PMS migraines increases.
• You are experiencing new side effects from over-the-counter or prescription medications.
• Your headache pattern changes.
• Your medications don’t seem to be working.

Call 911 or go to the nearest emergency room if:

• You experience a headache that comes on very suddenly.
• You have a headache that feels like the worst headache of your life.
• You have a headache after you’ve gotten a head injury.
• You are experiencing new or different neurologic symptoms like balance problems, mental confusion, vision issues, seizures, difficulty speaking, or numbness in your extremities.

Ways to Treat or Prevent PMS Migraines

If you experience PMS migraines, there are a number of effective treatment options available. 

These treatment options generally fall under three categories: fast-acting acute treatment to use during a migraine attack, preventative treatment before and during your period, and continuous preventive treatment you would use every day throughout the entire month.

Acute treatments for PMS migraines include:

• Oral triptan medications (such as zolmitriptan, rizatriptan, sumatriptan, or eletriptan) in combination with non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen or ibuprofen.
• Injectable medications (sumatriptan or dihydroergotamine) which work faster and can be used even if you are vomiting or nauseous. 
• Nasal spray triptan medications like sumatriptan, zolmitriptan, or dihydroergotamine, which work fast and may be more comfortable and easier to administer than an injection. 
• An over-the-counter combination of aspirin, acetaminophen, and caffeine (for example, Excedrin Migraine)

Mini-preventative treatments (which you would take as a daily medication for 5-7 days, just prior to the onset of PMS migraines) such as:

• NSAIDs like Naproxen, taken twice a day during the 5-7 days around the start of a period.
• Triptans like naratriptan and frovatriptan dosed twice a day, throughout the menstrual window.
• Estrogen supplementation with vaginal gels, patches, or pills during the week of your period, preventing the natural estrogen drop that causes PMS migraines.

Continuous preventative treatments (used throughout the month) include:

• Birth control pills taken continuously without taking the placebo pills.
• Vaginal rings, used continuously instead of have a menstrual period every 3-6 months.

Note: This content is for informational use only, and is not intended to be a substitute for medical advice or professional diagnosis. 

What Else Can I Do to Relieve the Symptoms of a PMS Migraine?

Use a diary to track the timing of your PMS headaches, as well as what makes them better or worse. 

You can also try:

• Changing your diet if you notice that certain foods trigger headaches.
• Keeping your blood sugar stable by eating small, frequent snacks throughout the day and not skipping meals.
• Learning relaxation or meditation techniques.
• Getting enough sleep.
• Learning strategies to help you manage stress in your life.
• Exploring supplements, like magnesium, that can relieve migraines.

In short, while PMS migraines can be debilitating for days every month, there are quite a few prevention treatment options available. 

Bring your migraine diary to your doctor and talk to them about whether you are experiencing PMS migraines or other types of migraines. Find out what treatment or prevention options they recommend for you. 

Magnesium and PMS Migraines

Intravenous magnesium has been used for many decades to treat chronic migraines.

In a study in the Journal of Head and Face Pain, a team of researchers published a study showing the effectiveness of using magnesium to prevent PMS headaches.

In the study, participants started taking magnesium on day 15 of their menstrual cycles and continued until their next period. This timing works even for women who have irregular periods because you only have to count from your previous period.

The results of this study point to magnesium supplementation as a prevention strategy. Compared to those subjects taking a placebo, the number of days with headache was reduced only in the patients who took magnesium. It was also noted that magnesium helped to relieve symptoms of PMS.

In another study on magnesium and headaches, researchers said:

“Research on magnesium has found it to be a potentially well-tolerated, safe, and inexpensive option for migraine prevention, while it may also be effective as an acute treatment option for headaches including migraines, tension-type headaches, and cluster headaches, particularly in certain patient subsets.”

Regardless of whether you choose pharmaceutical treatments for PMS migraines, you can almost certainly use magnesium as well. Talk to your doctor if you are on any medications or have a medical condition. Otherwise, magnesium supplementation is well-tolerated and safe.

Preventing PMS Migraines with Magnesium Citrate

What type of magnesium should you take if you have PMS migraines?

Choose one that’s highly bioavailable, or absorbable. And make it a supplement you’ll love to take because consistency is key in migraine prevention.

Natural Calm® magnesium citrate powder is a gentle, easily-absorbable magnesium supplement that you can take to try to prevent PMS or treat migraines. Dissolved in liquid, it creates a delicious, unique fizzy drink that eases tension and reduces stress. 

As an added bonus, Natural Calm gently and naturally relieves constipation and can help reduce cravings, both associated with PMS migraines.

If you take Natural Calm for PMS migraines, be sure to take it daily. Magnesium is eliminated from the body about every 12 hours. You can take a single dose once a day, or split your dose into two, taking Natural Calm once in the morning and once at night, for example.

Magnesium Balm with Lavender is another great option for destressing and relieving tension during PMS. Rub the balm into your neck and shoulders to relax the muscles and keep tension headaches at bay.

Sources

• E. Anne MacGregor. Review: Menstrual Migraine: Therapeutic Approaches. no. 5, June 2009, pp. 327–36, https://doi.org/10.1177/1756285609335537. Accessed 31 May 2023.
• Fabio Facchinetti, et al. Magnesium Prophylaxis of Menstrual Migraine: Effects on Intracellular Magnesium. no. 5, May 1991, pp. 298–301, https://doi.org/10.1111/j.1526-4610.1991.hed3105298.x. Accessed 31 May 2023.
• Yablon, Lisa A., and Alexander Mauskop. “Magnesium in Headache.” Nih.gov, University of Adelaide Press, 2020, www.ncbi.nlm.nih.gov/books/NBK507271/. Accessed 31 May 2023.