What to know about headaches after your period

When you have your period, your body goes through some hormonal changes. These changes are necessary for your menstrual cycle but can cause some other effects, including headaches. They may even trigger a migraine episode if you commonly experience these.

Experiencing mild, infrequent headaches at the end of your period usually isn’t cause for concern. But if your headaches are severe, you might be experiencing a migraine attack, and you may consider speaking with a healthcare professional about how to manage this condition.

Sex and gender exist on spectrums. This article uses the terms “women,” “men,” or both when discussing people assigned female or male at birth to reflect language that appears in source materials. 

While gender is solely about how you identify yourself, independent of your physical body, you may need to consider how your personal circumstances will affect diagnosis, symptoms, and treatment. 

Causes of headaches after periods

Several factors can cause headaches and migraine during your menstrual cycle, but it is most commonly because of the changing levels of estrogen and serotonin. 

Estrogen and serotonin drop during your period, usually at the beginning, leading to a cascade of events that can trigger headaches and migraine. Here’s what the process looks like:

• Estrogen and serotonin drop.
• The blood vessels inside your head dilate.
• The trigeminal nerve that runs along the side of your face and temple becomes more sensitive to stimulation.
• Pain signals sent from inside your head stimulate the trigeminal nerve.
• Inflammation occurs at the site.

Although scientists are not sure exactly why, a 2019 study indicates low iron levels in your blood can also increase your chances of headaches and migraine. So, blood loss during your period may contribute to a headache or migraine.

Dehydration may be another cause. Dehydration alone may cause headaches, but it can also worsen your chances of developing headaches and migraine if you are dehydrated during or just before your period. This is especially true if you have symptoms that can lead to dehydration, such as:

• nausea
• vomiting
• decreased appetite

Migraine and menstruation

Migraine is more common in women, especially during their reproductive years. Menstrual-related headaches and migraine are widespread, and up to 41% of all women have migraine symptoms before they turn 50 years old.

Menstrual-related headaches are typically related to changes in estrogen levels.

Although migraine symptoms are most likely to occur right before or in the early stages of your period, everyone is different. Some people may have more severe headaches toward the end of their period.

Need a diagnosis or prescription quickly? Optum Perks offers personalized on-demand care in as little as 15 minutes. For $29, answer a few questions online and receive a diagnosis and treatment plan from a US-licensed healthcare professional. Get started here.

About hormone imbalances

Hormonal imbalances can cause headaches and migraine throughout your life. 

You may be particularly prone to migraine:

• at certain points of your menstrual cycles
• during pregnancy
• during menopause
• after the surgical removal of the ovaries

Oral contraceptives, or birth control pills, may also affect headaches and migraine. Birth control pills can sometimes help manage headaches, but in other situations, they may worsen them. Speak with a doctor or healthcare professional to establish the best treatment course for your circumstance.

Note that if you experience migraine with aura, which is a migraine accompanied by visual disturbances like seeing flashes of light or spots of color, doctors won’t prescribe combined oral contraceptive pills.

Other reasons

Hormonal fluctuations are a common cause of migraine and headaches after and during periods, but other reasons may include:

• weather and seasonal changes
• irregular or skipped meals
• bright or flashing lights
• sleep pattern changes
• sudden or loud noises
• heightened emotions
• certain medications
• motion sickness
• low blood sugar
• head trauma
• overexertion
• tobacco use
• a hangover
• depression
• anxiety
• stress

Talk with a doctor or healthcare professional if you don’t know what is causing your migraine episodes. They may suggest you keep a headache diary to track your symptoms and their timing. Once you establish your headache and migraine triggers, a doctor can help you make a treatment plan.

Treatment

If your headaches are related to your periods, a doctor may recommend birth control pills. If you already take birth control pills, your doctor may adjust the dosage or advise a different birth control option.

Note that if you experience migraine episodes with aura, doctors are unlikely to recommend combined oral contraceptives due to the risk of blood clots.

If birth control methods do not work for you or your migraine episodes are unrelated to your periods, your doctor may recommend or prescribe other medications when you feel one starting. These may include:

• triptans, such as
  • almotriptan
  • eletriptan
  • frovatriptan (Frova)
  • naratriptan (Amerge)
  • rizatriptan (Maxalt)
  • sumatriptan (Imitrex)
  • zolmitriptan (Zomig)
• NSAIDs, such as ibuprofen (Motrin and Advil)
• calcitonin gene-related peptide inhibitors, such as Ubrelvy
• ergot derivative (ergotamine tartrate and dihydroergotamine)

Talk with a doctor about which medications might best suit your needs.

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Preventive treatments

You may be able to prevent or reduce the incidence of migraine by: 

• identifying and avoiding your triggers whenever possible
• going to bed and waking up at the same time every day
• eating regular, balanced meals
• exercising regularly, where possible
• limiting caffeine and alcohol
• finding ways to manage your stress
• trying acupuncture, biofeedback, or relaxation techniques

A doctor may also recommend daily medications to prevent migraine episodes, including:

• antidepressant medications, like amitriptyline or venlafaxine
• antiseizure medications, like divalproex sodium (Depakote) or topiramate (Topamax)
• beta-blockers, like propranolol or timolol
• calcium channel blockers, like verapamil (Verelan)

When to contact a doctor

Talk with a doctor if you think you may have migraine. 

If you already have a migraine diagnosis, contact a doctor if:

• Your migraine episodes change.
• Your treatments are no longer working.
• Your migraine symptoms become worse when you lie down.
• You have side effects from the medication you are taking.
• You are taking birth control pills and have a migraine with aura, which is when you see bright flashes of light or spots before your eyes.

Summary

Migraine is more common in women. This is mainly due to how hormonal changes affect you during menstruation, pregnancy, and menopause.

Typically, migraine and headaches occur before or at the beginning of your period, but they can happen at any time during the cycle.

If you have migraine or think you do, you may want to talk with your doctor about the best treatments.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.