Menstrual Migraines: How to Break the Cycle

If your headaches seem to show up like clockwork around your menstrual cycle, you may be dealing with menstrual migraines. These hormonally driven headaches can be intense, debilitating, and frustrating. The good news is that you're not alone—and you have options.

At Complete Healthcare in Richland, WA, Dr. Richard Lorenzo and Kortney Jones, ARNP, work with women to identify and treat menstrual migraines with personalized care plans that address both hormonal and neurological factors.

What Are Menstrual Migraines?

Menstrual migraines are headaches that occur around the time of menstruation, typically in the two days before a period starts or during the first three days of bleeding. Unlike typical migraines, these headaches are tightly linked to the drop in estrogen levels that occurs as part of the menstrual cycle.

There are two types:

• Pure menstrual migraines: Occur only during menstruation

• Period related migraines: Occur around the period, but also at other times in the cycle

These migraines can include:

• Throbbing pain, often on one side of the head

• Nausea or vomiting

• Sensitivity to light, sound, or smells

• Fatigue and mood changes

Menstrual migraines often last longer than non-menstrual migraines and can be more resistant to typical migraine treatments.

Why Hormones Trigger Migraines

The primary trigger is a sudden drop in estrogen that occurs just before menstruation. Estrogen affects brain chemicals like serotonin, which plays a key role in how blood vessels behave. When hormone levels fall, the brain becomes more sensitive to other migraine triggers, including:

• Stress

• Lack of sleep

• Skipped meals

• Bright lights

• Strong odors

• Certain foods (like wine, aged cheese, or chocolate)

This sensitivity is why migraines around your period may feel more intense or harder to control.

How We Diagnose Menstrual Migraines

At Complete Healthcare, Dr. Lorenzo and Kortney Jones begin with a comprehensive evaluation that includes:

• A detailed menstrual and symptom diary

• Identification of migraine patterns and timing

• Review of hormone levels, if needed

• Assessment of sleep, nutrition, and lifestyle habits

• Discussion of past migraine treatments and what has or hasn’t worked

By identifying whether migraines are hormonal, we can tailor treatment more effectively.

Treatment Options

There are several ways to treat menstrual migraines, depending on their severity, timing, and how often they occur. At Complete Healthcare, we typically approach treatment in three phases:

1. Acute (Rescue) Treatment

Used when a migraine begins:

• Triptans (e.g., sumatriptan)

• NSAIDs (e.g., ibuprofen or naproxen)

• Anti-nausea medications, if needed

• Magnesium supplements, which can reduce pain intensity in some patients

2. Short-Term Prevention

For women with predictable migraines, treatment can begin a few days before the period and continue through the first few days of menstruation:

• Hormonal stabilization using low-dose estrogen patches or birth control

• NSAIDs, started two days before the period

• Triptans, taken as preventive therapy during this window

• Magnesium, 400 mg daily during the luteal phase

3. Long-Term Prevention

For women with frequent or severe migraines:

• Continuous birth control to prevent hormone fluctuations

• Low-dose antidepressants or anti-seizure medications

• Lifestyle optimization: consistent sleep, hydration, exercise, and nutrition

• Referral to neurology, if symptoms are resistant to typical treatments

Dr. Lorenzo and Kortney Jones will guide you through these options based on your individual medical history, goals, and response to treatment.

Hormonal Treatment Considerations

In some cases, menstrual migraines can be worsened by hormonal birth control, while in others, hormones help reduce them. At Complete Healthcare, we help you:

• Choose the right type and dose of estrogen

• Decide whether to try continuous or cyclical birth control

• Monitor your response to bioidentical hormone therapy, if appropriate

Finding the right balance is key. We adjust your care plan as needed for optimal symptom control.

When to Seek Help

You should schedule a visit with Complete Healthcare if:

• You experience migraines monthly or around your period

• Headaches are getting worse or lasting longer

• Over-the-counter medications no longer help

• You’re interested in hormone testing or treatment

• Migraines interfere with work, relationships, or daily life

You don’t have to suffer through the cycle each month. Effective treatments are available, and we’re here to help.

Expert Migraine and Hormone Care in Richland, WA

Menstrual migraines are more than just a headache—they are a real medical condition driven by hormonal shifts. At Complete Healthcare in Richland, WA, Dr. Richard Lorenzo and Kortney Jones, ARNP offer compassionate, thorough care for women navigating the complex overlap of hormones and neurological symptoms.

Our goal is to help you regain control, reduce pain, and improve your quality of life—one cycle at a time.

Schedule an Appointment

If you're dealing with monthly migraines or want to learn more about hormonal treatment options, Call 509-392-6700 to schedule your consultation today.

Richard Lorenzo, D.O.

Kortney Jones, ARNP

Complete Healthcare – Women’s Health and Wellness care in Richland, WA