For many people with migraine, episodes are linked to the menstrual cycle. This is a diagnosable condition called hormonal migraine.

Migraine itself is a neurological condition that can cause severe head pain, nausea, vomiting, and sensitivity to light and sound. When attacks repeatedly occur around menstruation, it can seriously disrupt your daily life. That’s why it’s important to recognize the pattern and discuss it with your doctor.

In this article, we explore hormonal migraine symptoms, including their connection to migraine, how hormonal migraine is diagnosed, and how it can be treated. We also discuss why recognizing the pattern matters, especially when migraine symptoms are sometimes dismissed as a normal part of menstruation. 

Here’s what you need to know.

What is a hormonal migraine?

Hormonal migraine, also known as “menstrual migraine,” “period headache,” or “hormone headache,” is a subtype of migraine related to hormonal fluctuations that occur naturally due to the menstrual cycle. For this reason, people who menstruate often experience episodes every month at specific times.

The sudden drop in estrogen levels during menses (the period) is a common trigger for symptoms, but other hormonal fluctuations can also trigger an episode.

Hormonal migraine usually causes the same symptoms as other types of migraine. The main difference is the timing of attacks rather than the symptoms themselves. However, not everyone experiences migraine in the same way, and symptoms can vary considerably from person to person.

During an episode, you may experience:

• Moderate to severe throbbing pain on one side of the head
• Nausea
• Vomiting
• Light sensitivity
• Sounds sensitivity
• Chills
• Increased urination
• Fatigue
• Loss of appetite
• Sweating

Around one in four people with migraine also experience aura symptoms as part of their condition.

Visual symptoms, such as flashing lights, zigzag lines, and blind spots, are the most common. Some people also experience sensory symptoms, such as numbness or tingling, as well as difficulties with speech or language. These symptoms usually develop gradually and occur before or during a migraine attack.

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Understanding migraine and your menstrual cycle

Hormonal migraines are connected to natural changes that occur during the menstrual cycle. In many cases, hormonal migraines start at the onset of the cycle during puberty and can last until the perimenopause or menopause later in life.

Estrogen, a sex hormone heavily involved in the menstrual cycle, naturally drops right before menses. This shift is believed to be a common trigger for hormonal migraines.

The release of prostaglandins, a hormone-like substance around menses, is also believed to play a role.

To understand why hormonal migraines tend to occur at specific times of the month, it helps to understand how hormone levels naturally rise and fall throughout the menstrual cycle, which typically lasts for 25–30 days:

• Menses (days 1–5): Also known as the period, menses marks the start of the menstrual cycle by shedding the endometrial lining when there is no pregnancy. Periods can last anywhere from 1 to 5 days, and are marked by a sharp drop off in estrogen. People usually experience hormonal migraine at this time.

• Follicular phase (day 5–13): During this phase, the lining of the uterus grows and thickens, and estrogen levels begin to climb. This makes hormonal migraine less likely.

• Ovulation (day 14): This phase is marked by a sudden increase in the luteinizing hormone, which causes the ovary to release an egg. Estrogen levels are at their highest right before ovulation.

• Luteal phase (day 15-28): After ovulation, the egg travels from the ovaries down the fallopian tubes to be fertilized. Estrogen levels begin to fall, which increases the risk of hormonal migraine. If the egg is not fertilized, menses begin, and the cycle continues.

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How hormonal migraine is diagnosed

Hormonal migraine can’t be diagnosed with a single test. Instead, the process involves multiple assessments from your doctor.

Your doctor will start by determining if your symptoms are consistent with migraine. If they believe you are experiencing migraines, they will then consider whether there is a connection with your menstrual cycle.

Diagnosis often takes months. During this time, you will likely be asked to track your symptoms alongside your cycle to collect data that can reveal or rule out a link.

Tracking is important because diagnosis relies heavily on timing and patterns. Recording when attacks occur, how severe they are, how long they last, and where you are in your cycle can make it much easier to identify whether hormonal fluctuations are playing a role.

If your doctor believes you have hormonal migraine, they will then classify your condition. There are two recognized types of hormonal migraine, and each has different diagnostic criteria:

Treating hormonal migraine

If you get hormonal migraines, you probably have two questions:

• How can I reduce the chances of getting a hormonal migraine?
• What can I do when one happens?

There are two approaches when it comes to managing migraine: prevention and rescue.

Depending on your symptoms and medical history, this may involve a combination of lifestyle strategies, hormonal treatments, preventative medications, and rescue medications.

Lifestyle changes

Good hydration, regular meals, and quality sleep are simple self-care measures that may help support migraine management over time.

Medications to help balance your hormones

One of the primary ways hormonal migraine is managed is through hormone replacement, either from contraceptives or estrogen supplements.

• Oral birth control pills help reduce hormonal fluctuations as you near menses every month.

• Hormone therapy, including oral medications, internal gels, or patches, can be used during specific times of your cycle to reduce your risk of a migraine episode.

Preventative medications

Other examples of preventative migraine medications include:

• Antidepressants, like amitriptyline (Elavil®) and venlafaxine (Effexor®)
• Calcium channel blockers, like verapamil (prescribed in the US) and flunarizine (more common across Europe and Canada)‍
• Antiseizure medications, like topiramate (Topamax®) and sodium valproate (Depakote®)‍
• Beta blockers, like propranolol (Inderal®) and metoprolol (Lopressor®)

Rescue medications

During an active episode, you might take rescue medications to ease your symptoms. We’ve included some of the most commonly used rescue medications in the table below:

Hormonal migraine is a real condition

Migraines are difficult enough to manage on their own. When they seem to appear around the same point in your cycle month after month, it can be frustrating to wonder whether there is a connection—especially if your symptoms are dismissed as “just hormonal.”

Because hormonal migraine is diagnosed largely through timing and patterns, keeping a record of both your migraine symptoms and your cycle can be incredibly helpful. Over time, that information can reveal whether attacks consistently occur around specific phases of your cycle and provide useful context for conversations with your doctor.

The Human Health app makes tracking easy. It even turns your data into shareable resources that make medical appointments more straightforward and productive.

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Frequently asked questions

Are hormonal migraines real?

Yes. Hormonal migraines, also known as menstrual migraines, are a diagnosable medical condition characterized by an increase in migraine episodes during different phases of the menstrual cycle. The episodes are believed to be connected to changes in estrogen levels.

How do I know if I have hormonal migraine?

There is no definitive test to diagnose hormonal migraine. The best way to understand your condition is to track both your menstrual cycle and migraine symptoms over multiple months. Information about the timing of your symptoms in relation to your cycle can be shared with your doctor to help uncover a possible connection and tailor your treatment plan.

Is a hormonal migraine just a headache?

No. Hormonal migraines are a neurological condition that can cause a wide range of symptoms, including a throbbing one-sided headache. Other symptoms, like nausea, vomiting, and sound and light sensitivity, are also common.

Disclaimer: Human Health is a health tracking platform and does not provide medical advice, diagnosis, or treatment. The information in this guide is for educational purposes only and is not a substitute for professional medical care. Always consult your doctor or healthcare provider with questions about your health.

Sources:

1. The Global Burden of Migraine: A 30-Year Trend Review and Future Projections by Age, Sex, Country, and Region (2024)
2. Sex and gender differences in migraines: a narrative review (2022)
3. Migraine, MedlinePlus
4. Migraine With Aura, StatPearls (2024) 
5. Menstrual migraine, The Migraine Trust
6. The Normal Menstrual Cycle and the Control of Ovulation (2018)
7. Pure menstrual migraine without aura, The International Classification of Headache Disorders
8. Pure menstrual migraine with aura, The International Classification of Headache Disorders
9. Menstrually-related migraine without aura, The International Classification of Headache Disorders
10. Menstrually-related migraine with aura, The International Classification of Headache Disorders
11. Menstrual migraine, Cleveland Clinic
12. Menstrual migraine: A review of current research and clinical challenges (2024)
13. Headache and hormones: What’s the connection? Mayo Clinic