Oh, the joys of being a woman! As if bloating, cramps, and mood swings weren’t enough, many of us get hit with splitting headaches like clockwork around our periods—or even during perimenopause. If you’re nodding along thinking, “Yep, that’s me,” you might be dealing with menstrual headaches, menstrual migraines, or perimenopausal headaches. But wait—aren’t those the same thing? Not quite! Let’s break it down and figure out what’s going on inside our heads (literally) each month (or phase of life!).
Menstrual Headaches: The Monthly Visitor You Didn’t Invite
Menstrual headaches are those dull, persistent head pains that show up before or during your period, usually thanks to a drop in oestrogen levels. It’s like your hormones are throwing a tantrum, and your head pays the price. These headaches are similar to tension headaches—think a steady ache rather than the all-out assault of a migraine. They often come with other delightful PMS symptoms like fatigue, bloating, and irritability.
Typical Symptoms of Menstrual Headaches:
- A dull, pressing pain (rather than throbbing)
- Pain usually on both sides of the head
- Mild to moderate intensity
- Can last a few hours to a couple of days
Menstrual Migraines: The Big Boss Battle
Now, menstrual migraines are a whole different beast. These are severe, throbbing headaches that typically hit before or during your period, triggered by—you guessed it—fluctuating hormone levels. Unlike regular migraines, which can strike at any time, menstrual migraines are directly tied to your cycle and can last much longer. They can sometimes run in families- your mum, aunties or sister may also experience these.
Symptoms of Menstrual Migraines:
- Intense, pulsating pain (usually on one side of the head)
- Nausea and even vomiting
- Sensitivity to light and sound
- Can last from hours to several days and leave you with that ‘hangover’ feeling.
- May come with aura (flashing lights, blind spots, tingling in hands or face)
Perimenopausal Headaches: When Hormones Go Haywire
If you thought hormonal headaches ended with your periods, think again! Perimenopause—the years leading up to menopause—can bring an onslaught of headaches, thanks to wildly fluctuating oestrogen levels. These headaches can mimic menstrual migraines or tension headaches, and they may become more frequent or severe as menopause approaches. These sorts of headaches and migraine are common in teenage girls- the perimenopause is almost a mirror image of adolescence and the highly fluctuating hormonal changes associated with it. If you struggled with headaches/migraine as a teenager- you may well be in for a rocky ride during the perimenopause also- sorry!!!
Symptoms of Perimenopausal Headaches:
- Can be tension-type (dull and persistent) or migraine-like (throbbing and severe)
- Often triggered by unpredictable hormone shifts, particularly big drops in oestrogen.
- May worsen with stress, poor sleep, or dehydration
- Can occur more frequently than menstrual headaches
How to Tell Which One You Have
A good rule of thumb? If your head just aches but you can still function (albeit grumpily), it’s likely a menstrual or perimenopausal headache. If you’re curled up in a dark room, unable to move without feeling like your skull might explode, it’s probably a menstrual migraine. Keeping a headache diary can help you track patterns and triggers, making it easier to pinpoint which type you’re dealing with, because the treatments can vary depending on exactly what’s going on. Better to go to your GP forearmed with lots of information from the get-go.
How to Deal with Them
If your head decides to wage war on you every month (or during perimenopause), here’s what might help:
For Menstrual & Perimenopausal Headaches:
- Over-the-counter painkillers like ibuprofen or paracetamol. Make sure you take the correct dose- taking a 600mg dose of ibuprofen as a one-off as soon as your symptoms start can be more effective than regularly under-dosing with 200-400mg. Check the pack for the strength of your pills- they usually come in 200 or 400mg tablets. Using ibuprofen in this way is also really effective for managing menstrual cramps and heavy bleeding.
- Staying hydrated (dehydration makes headaches worse)
- Managing stress with yoga, exercise or meditation
- Getting enough sleep (easier said than done, we know)
- Considering hormone therapy (speak to your GP if your headaches are severe). Replacing oestrogen using HRT can be a really effective treatment for perimenopausal headaches.
For Menstrual & Perimenopausal Migraines:
- Prescription migraine meds like triptans if they’re severe
- Magnesium supplements (some studies suggest they help)
- Avoiding trigger foods (think caffeine, chocolate, and alcohol)
- Hormonal birth control or HRT (can help regulate oestrogen levels)
When to See a Doctor
If your headaches or migraines are ruining your life every month (or becoming unbearable during perimenopause), don’t just suffer in silence. Chat with your GP, or book an appointment to see me, especially if they’re getting worse or lasting longer than usual. There are treatments out there that can help you reclaim your cycle (or transition into menopause) and feel more like yourself.
Final Thoughts
Hormonal headaches—whether from menstruation or perimenopause—might feel like yet another unfair part of womanhood, but understanding the difference can help you tackle them head-on (pun intended). Whether it’s tweaking your diet, adjusting your medication, or just drinking more water, small changes can make a big difference. So, next time your period (or perimenopause) rolls around, at least you’ll be armed with a plan—and maybe a hot water bottle and some emergency chocolate.
Have you found anything that helps with menstrual or perimenopausal headaches? Share your tips in the comments!
