Migraine before period

Migraine before a period is common for many people with menstrual-related migraine. Falling estrogen before menstruation is one factor clinicians consider.

These attacks can feel especially frustrating because they may arrive predictably even when sleep, meals, hydration, and stress routines are good. Predictability can still be useful: it gives you and your clinician a pattern to plan around.

What to track

Track attacks against your cycle for at least two to three cycles. Record attack date, symptoms, severity, medication timing, relief, bleeding start date, and whether nausea or aura occurs.

Also track sleep, skipped meals, caffeine changes, stress, and acute medication days. If several factors cluster before your period, hormone timing may be part of the picture but not the only factor.

What to ask your clinician

Ask whether your pattern fits menstrual migraine, whether timed acute treatment or prevention could help, and which medications are safe for your health history, pregnancy plans, and migraine aura status.

Why aura matters

If you have migraine with aura, tell your clinician before discussing hormonal contraception or hormone treatment. Aura can affect risk conversations, especially when other risk factors such as smoking, high blood pressure, or obesity are present.

When to seek urgent care

Seek urgent care for sudden severe headache, new weakness, new speech or vision symptoms, confusion, seizure, headache during pregnancy or soon after birth, or symptoms that are different from your usual migraine.

Sources

• Mayo Clinic: Migraine symptoms and causes
• American Migraine Foundation: Menstrual migraine treatment and prevention
• NHS: Migraine