Hormonal Migraines: The Essential Guide to Cycle-Related Headache Relief

Hormonal migraines, often referred to as menstrual migraines, are a daunting reality for many women. These debilitating headaches are closely linked to hormonal fluctuations, particularly around menstrual cycles. Unlike typical migraines, hormonal migraines are often more severe and can significantly impact daily life, work, and your ability to participate in many activities.

Understanding and managing these migraines holistically is crucial for long-term relief and improving your quality of life.

Understanding the Relationship Between Hormones and Migraines

Hormonal migraines occur primarily due to fluctuations in estrogen and progesterone levels. These hormones play a pivotal role in regulating various bodily functions, including pain perception and inflammation. During the menstrual cycle, the drop in estrogen levels can trigger migraines in susceptible women (1). 

But estrogen isn’t the only hormonal culprit behind migraines. Hormonal changes associated with pregnancy, menopause, and hormone replacement therapy can also influence migraine occurrence.

Key Hormones Involved:

  • Estrogen: Significant drops in estrogen levels can trigger migraines.
  • Progesterone: Fluctuations in progesterone can contribute to headache severity.
  • Serotonin: Hormonal changes can affect serotonin levels, influencing migraine activity.

Related: 7 Hormones All Women Should Know

Migraines During Ovulation or When a Period Starts

One of the most common times for women to experience hormonal migraines is during ovulation or at the start of a period. When a headache happens during ovulation, it’s typically linked to a surge in estrogen levels. When one occurs at the start of your period, it’s due to a drop in estrogen levels (2).

Fluctuations in other hormones, like serotonin, may also have an impact on headaches. During the luteal phase (after ovulation), where estrogen levels are low and progesterone levels are high, there is a decrease in serotonin levels, which may worsen headache pain (3).

menstrual cycle and estrogen

Managing Hormonal Migraines During Ovulation or When a Period Starts

  • Keep track of your menstrual cycle and ovulation using a tracking app or calendar.
  • Consider taking over-the-counter pain medication before ovulation or at the first sign of your period.
  • Practice self-care techniques such as hot compresses, relaxation exercises, and rest.

Listen: Say Goodbye to Migraines with Dr. Meg Hill

Migraines in Perimenopause

During perimenopause, progesterone generally declines first (and more rapidly) than estrogen. This means that relative estrogen dominance can occur, leading to increased migraine frequency and intensity. Unlike the menstrual cycle, fluctuations in hormone levels during perimenopause are more erratic, making it challenging to predict when migraines may occur (4). 

Managing Hormonal Migraines During Perimenopause

  • Keep track of your menstrual cycles and symptoms to determine patterns.
  • Consider using bio-identical hormone therapy to regulate hormone levels.
  • Manage stress through relaxation techniques such as meditation or yoga.
  • Maintain a healthy diet and exercise regularly.

Read: Perimenopause Signs & Symptoms + Tips to Find Relief

Pregnancy and Postpartum

Pregnancy is often associated with a decrease in migraines due to stable hormonal levels. However, some women may experience an increase in headaches during their first trimester due to changes in estrogen levels. On the other hand, postpartum migraines can be more severe and occur more frequently due to a sudden decrease in estrogen levels after giving birth (5). 

Managing Hormonal Migraines During Pregnancy and Postpartum

  • Consult with your healthcare provider about safe pain relief options during pregnancy.
  • Use natural remedies such as acupuncture or massage therapy to manage headaches.
  • Get enough rest and stay hydrated.


Estrogen plays a significant role in regulating serotonin levels (6). During menopause, when estrogen declines significantly, there is an increased risk of experiencing migraines. In fact, studies have shown that women who experience hormonal migraines during their reproductive years may have headaches worsen during this natural hormone shift (7).

Managing Hormonal Migraines During Menopause

  • Consider hormone replacement therapy to stabilize estrogen levels.
  • Incorporate relaxation techniques and stress management strategies into your daily routine.
  • Avoid triggers such as alcohol, caffeine, and certain foods. High histamine foods may be a trigger for some people.

Related: Navigating Night Sweats: Solving Sleep Problems During Menopause

Estrogen Dominance & Migraines

Estrogen excess can be a common cause for headaches and migraines in women of any age. Estrogen dominance is usually a result of two things: poor estrogen detox in the gut & liver, and environmental estrogens. Environmental estrogens are found in everyday products such as plastics, pesticides, and personal care products, and many women have significant exposure to these artificial estrogens (7). 

Managing Estrogen Dominance

Taking a Holistic Approach to Manage Hormonal Migraines

Managing hormonal migraines is not just about managing hormonal fluctuations. A holistic approach that includes addressing lifestyle factors such as diet, stress management, exercise, and environmental toxins can significantly improve migraine symptoms.

In addition to medication and hormonal treatments, there are several holistic approaches that can help manage hormonal migraines. These include:

  • Acupuncture: This traditional Chinese medicine practice involves inserting thin needles into specific points on the body to alleviate pain and promote overall health. Research shows acupuncture may reduce migraine severity, or even prevent them from happening (8).
  • Massage therapy: Regular massages can help reduce stress and tension in the body, which can contribute to migraine occurrence.
  • Herbal supplements: Herbs like black cohosh, feverfew, and butterbur have shown promise in managing migraines by balancing hormones and reducing inflammation (9).
  • Stress management techniques: Activities like yoga, meditation, and deep breathing exercises can help reduce stress and tension in the body, which can contribute to migraines.
  • Nutritional Therapy: A balanced diet rich in magnesium, omega-3 fatty acids, and phytoestrogens can help stabilize hormone levels and reduce migraine frequency.
  • Aromatherapy: Essential oils such as lavender, peppermint, and rosemary can provide relief from headache symptoms and promote relaxation.

Additional Tips for Managing Hormonal Migraines:

  • Practice good sleep hygiene and get enough rest.
  • Keep a headache diary to track triggers and patterns.
  • Try relaxation techniques such as aromatherapy or hot/cold therapy.
  • Consider cognitive-behavioral therapy (CBT) to help cope with migraine-related stress and anxiety.  

Overall, don’t be afraid to explore different treatment options and lifestyle changes until you find what works best for you. Remember, managing hormonal migraines is an ongoing process, but with patience and persistence, relief can be achieved. 

Eastern Medicine Techniques for Migraine Relief

Eastern medicine offers various techniques that can help manage hormonal migraines effectively. These practices focus on restoring balance to the body’s energy systems and addressing underlying imbalances.

Traditional Chinese Medicine (TCM):

  • Acupuncture: As mentioned earlier, acupuncture is a cornerstone of TCM for migraine relief. By stimulating specific points, it can help balance hormone levels and alleviate pain.
  • Herbal Medicine: TCM practitioners may recommend customized herbal formulas tailored to an individual’s unique constitution and hormonal profile.
  • Qi Gong and Tai Chi: These gentle exercises promote energy flow and relaxation, which can help reduce the frequency and intensity of migraines.


  • Dietary Adjustments: Ayurveda emphasizes eating according to one’s dosha (or body constitution) to maintain hormonal balance and prevent migraines.
  • Yoga and Meditation: Regular practice of yoga and meditation can reduce stress, improve hormonal balance, and enhance overall well-being.
  • Panchakarma: This detoxification process can help eliminate toxins from the body and balance hormones.

For women struggling with hormonal migraines, exploring these holistic and eastern medicine strategies can provide much-needed relief and improve quality of life. Remember, it’s essential to consult with healthcare professionals before starting any new treatment regimen.