An OB/GYN explains causes of menstrual migraine headaches.

Migraine headaches can be caused by a woman’s period. These are referred to as menstrual migraines.

Though migraine headaches that come with a woman’s period can be painful and interfere with the day’s activities, they are nothing to become alarmed about.

For this article about migraine headaches related to menstruation, I asked Randy Fink, MD, Director of the Center of Excellence for Obstetrics & Gynecology in Miami, FL, if there was a way to prevent them.

Dr. Fink explains: “Some women suffer from menstrual migraine headaches. These headaches are thought to be caused by a drop in the normal hormone levels, leading to menstruation.

“When the brain realizes pregnancy has not occurred, it says, ‘Okay. Shut off the hormones, clean everything out, and let’s try again next month.’

“This is the signal to have a normal period. The falling off of the hormone level from normal is thought to be one cause of menstrual migraines. 

Therefore, one way of treating menstrual migraines is to use continuous birth control. By not letting the hormone levels drop (i.e., ‘skipping the period,’ menstrual migraines resolve in over 80% of women.”

What is the physiology behind why the drop in hormones causes these menstrual migraine headaches?

Dr. Fink explains: “Estrogen has many effects in the central nervous system. The serotonin system is one such place.

“A decline in the levels of estrogen (such as during the hormone free week of the birth control, or during the period week of a natural cycle) causes serotonin levels to fall. (This may be one mechanism for the mood changes associated with menses, or PMS.)

“Falling serotonin levels increase pain producing biochemicals; there is a release of calcitonin gene-related peptide and substance P from one of the cranial nerves, the trigeminal nerve. 

This leads to vasodilation of cranial vessels and sensitization of the portion of the nerve that supplies the meninges — the brain’s lining. 

Estrogen also affects other chemicals — magnesium, nitric oxide, prostaglandins — that alter nerve function and increase the sense of pain. There may also be a decrease in endogenous opioid activity.”

Another way to reduce migraine headaches that come with your period is to restrict the amount of sugar and processed foods in your diet, and to drink 6-8 glasses of water every day.

dr. finkCreating an environment where the very best of medicine and gentle gynecology are practiced and where patients come first has always been Dr. Fink’s goal.