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Migraine: what the research says

141 studies on migraine in PMS and PMDD, each explained in plain English. 9 of them use the strongest designs: randomised trials and systematic reviews.

Survey study 43Review 23Study 22Randomised trial 18Cohort study 10Case report 8
Systematic review, 2023

What hormonal treatments have been tested for PMDD, menstrual migraine, and catamenial epilepsy?

Hormonal treatments have been tested 56 times for premenstrual mood disorder, 21 times for menstrual migraine, and 8 times for catamenial epilepsy. Combined oral contraceptives were a frequent focus.

Cohort study, 2022

Can women accurately tell if they have period-related migraines, or do they need to track them?

No. Women couldn't accurately tell if they had period migraines. Most needed to keep a daily headache diary for several cycles for accurate diagnosis.

Guideline, 2021

How should migraine be managed in women, particularly menstrual migraine?

This guideline covers migraine treatment approaches, noting that menstrual migraine, pregnancy, contraception, and hormone therapy are specific considerations. The abstract does not provide specific treatment details for menstrual migraine.

Randomised trial, 2016

Does telcagepant prevent migraines during the menstrual period?

Telcagepant did not reduce overall monthly migraine days. However, it did reduce headaches on the days it was taken around the period. It was generally safe.

Randomised trial, 2014

Does the combination of sumatriptan and naproxen sodium reduce menstrual symptoms and migraine?

Yes. The combination was better than placebo for tiredness, irritability, bloating, abdominal pain, and back pain, as well as migraine. However, women with severe period pain responded less well to migraine treatment.

Randomised trial, 2005

Does sumatriptan work for migraines around the menstrual cycle?

Yes, sumatriptan 100 mg gave headache relief to 67% of women for migraines during their menstrual window compared to 33% on placebo. Sumatriptan was well tolerated.

Randomised trial, 2005

Are triptans effective for menstrual migraine?

Yes. Triptans are effective for treating menstrual migraine both as a treatment taken when a migraine starts and as prevention taken regularly to stop migraines before they happen.

Review, 2004

How should doctors diagnose and treat PMS and PMDD?

Doctors can now diagnose these conditions using specific prospective symptom tracking and have several evidence-based treatments. Antidepressants that increase serotonin, especially when taken only during the luteal phase, work best for severe symptoms.

Survey study, 1994

How many different ways do researchers measure PMS in clinical trials?

Researchers use many different measurement tools across studies. 65 different questionnaires were found in 350 trials of PMS drugs, making it hard to compare whether treatments actually work.

Study, 2026

Does rimegepant help prevent migraines that happen around your period?

Yes, in this study rimegepant worked well. Women who took it around their period had fewer, shorter, and less severe migraines, and their quality of life improved. However, this was a small study without a comparison group.

Non-randomised trial, 2025

Do common migraine prevention drugs work as well for migraines around your period as other migraines?

No. Two preventive drugs, anti-CGRP antibodies and botulinum toxin, significantly reduced regular migraines but had limited effect on perimenstrual migraines (those around the time of your period). This suggests perimenstrual migraine may need different treatment.

Study, 2025

How can researchers better track hormone changes throughout the menstrual cycle?

Researchers created a new method called PACTS that better tracks how hormones change across your entire menstrual cycle, making patterns easier to spot and potentially improving diagnosis.

Cohort study, 2025

What causes migraine in female college students who have PMS?

Among college students with PMS, those with migraine have worse sleep quality and higher anxiety. Poor sleep and anxiety appear to predict migraine risk.

Randomised trial, 2023

Does the migraine drug ubrogepant work differently for period migraines than other migraines?

No. In 734 women, ubrogepant worked about the same whether the migraine happened around the period or at other times. This is reliable information from a large study of an approved drug.

Randomised trial, 2022

Does lasmiditan help with migraines around menstruation?

Lasmiditan 200 mg helped more women achieve migraine pain freedom compared to placebo. At 2 hours, 33.6% of women taking the 200 mg dose had pain relief.

Survey study, 2021

Are migraines around the period worse than migraines at other times?

Yes. Migraines during the menstrual window last much longer, come back more often, and are more intense than migraines at other times of the cycle.

Survey study, 2021

What is menstrual migraine and how common is it?

Menstrual migraine is migraine linked to menstruation more often than by chance. It affects 20-25% of women with migraines in the general population and 22-70% of people seen at headache clinics. These migraines cause more disability than non-menstrual migraines.

Review, 2019

How does the menstrual cycle affect migraine in women?

Hormone changes during the menstrual cycle affect migraine. Menstrual migraine has long attacks and is difficult to treat.

Survey study, 2015

Are neck problems linked to migraines during menstrual periods?

Yes. Women with perimenstrual migraines had more neck problems including reduced movement, tight muscles, and muscle tenderness. Tight muscles, reduced nerve flexibility, and upper spine stiffness were associated with notably higher migraine risk.

Review, 2013

What causes migraines linked to your period and how can they be treated?

Menstrual migraines are triggered by estrogen level changes during the menstrual cycle. They significantly affect quality of life and can be managed with preventive medications and hormonal birth control.

Randomised trial, 2013

Is frovatriptan better than other triptans for migraines caused by birth control?

In 35 women with birth control-induced menstrual migraines, frovatriptan was similar to other triptans for fast pain relief but significantly better at keeping pain away longer and preventing migraine return.

Case-control study, 2013

Are migraines linked to menstrual mood disorders and childhood sexual abuse?

Migraine with aura is much more common in women with menstrual mood disorders (11 out of 88 versus none out of 86 in controls), and women with both a mood disorder and childhood sexual abuse history have about 12 times higher risk. The study shows association but not cause.

Survey study, 2012

Is menstrual migraine a distinct type of migraine?

Yes. More than 50% of women with migraine report a link to menstruation, and research supports treating menstrual migraine as a distinct condition with its own diagnostic criteria rather than just one trigger.

Survey study, 2012

What treatments help menstrual migraine and PMS symptoms?

Several treatments have evidence including triptans, NSAIDs, magnesium, phytoestrogens, and certain birth control pills. More research is needed to compare treatments.

Review, 2012

Does estrogen therapy help migraines linked to the menstrual cycle?

Evidence shows estrogen fluctuations trigger these migraines. Stopping these changes through treatment or menopause may help or sometimes worsen symptoms, though we need more research to confirm this works in practice.

Review, 2012

Are triptans effective for migraines linked to the menstrual cycle?

Yes, triptans effectively relieve severe, disabling, and recurring migraines linked to the menstrual cycle. This review summarizes evidence-based recommendations for using them.

Randomised trial, 2011

Is frovatriptan as good as zolmitriptan for treating migraines tied to your period?

Both drugs provide similar quick pain relief within 2 hours, but frovatriptan had fewer migraines returning within 24 hours, providing better sustained relief.

Non-randomised trial, 2011

Does topiramate prevent migraines around the period?

Yes. Topiramate reduces how often perimenstrual migraines happen, but does not reduce how severe or long they are.

Randomised trial, 2011

Does an estradiol patch prevent migraines around your period?

The estradiol patch did not work better than placebo at preventing menstrual migraines in this 27-woman study. Both the patch and placebo reduced migraines compared to baseline, making it unclear whether the improvement came from the drug or the placebo effect.

Randomised trial, 2011

Does sumatriptan-naproxen help women with period migraines and period pain function better?

Yes, women given the combination drug reported higher satisfaction, better work productivity, and less functional disability compared to placebo at 24 hours.

Non-randomised trial, 2010

How accurate are different methods for diagnosing menstrual migraine?

Different diagnostic methods identified different women as having menstrual migraine. The strictest method found fewer cases than the standard method, and 20% of women who thought they had menstrual migraines were not diagnosed by either method.

Non-randomised trial, 2010

Are migraine attacks during the menstrual period worse than at other times?

Yes, migraine attacks during the menstrual period are more disabling, last longer, and are more likely to return within 24 hours compared to attacks at other times.

Case-control study, 2010

Are women with menstrual migraines more likely to be morning or evening people?

No. This study found no difference in whether women with menstrual migraines or healthy women prefer mornings or evenings.

Study, 2010

Are migraines around the menstrual cycle different from other migraines?

Yes. Menstrual migraines last longer, cause more disability, respond less well to treatment, and come back more often within 24 hours compared to other migraines.

Non-randomised trial, 2010

Does taking eletriptan around the time of menstruation prevent menstrual migraines?

Yes, for most women. Taking eletriptan around menstruation reduced migraine activity by 46% overall. About 53% of women had all three of their menstrual periods completely migraine-free during treatment.

Survey study, 2010

Do women with premenstrual asthma have more premenstrual symptoms overall?

Yes. Women whose asthma worsens before their period had greater increases in most premenstrual symptoms, especially belly and breast tension, compared to women without this pattern.

Review, 2009

Can hormonal treatments prevent migraines during menstruation?

The review suggests reducing estrogen fluctuations with hormonal treatments may help prevent migraines linked to menstruation, but more research is needed.

Survey study, 2008

Can a simple checklist help identify menstrual migraine?

Yes. A 3-question tool works well at identifying menstrual migraine in women at gynecology clinics.

Survey study, 2008

How common is menstrual migraine, and does pregnancy affect it?

Menstrual migraine is common among women with migraines, affecting 18% when counting only those with migraine exclusively during their period. In women who became pregnant, migraine usually improved.

Review, 2008

Are migraines linked to menstruation different from regular migraines?

Probably yes. Menstrually-related migraines are more severe and disabling than regular migraines, with worse pain intensity and poorer response to medication.

Study, 2008

What triggers migraine headaches in people?

Emotional stress (64%), sleep problems (81%), and the premenstrual period (53% reported hormonal triggers) are major migraine triggers. Many people also reported dietary triggers and smells as causes.

Study, 2004

Do migraine headaches change at different times of the menstrual cycle?

For women whose migraines are linked to their cycle, migraine attacks during or near menstruation last longer and are harder to treat than migraines at other times.

Review, 2003

Does bipolar disorder affect women differently than men?

Yes. Bipolar disorder often starts later in women, who experience more depressive episodes and rapid mood cycling. The postpartum period is high-risk for onset or recurrence.

Survey study, 2003

Does migraine risk change during menopause in women with PMS?

Yes. In women with PMS, migraine is highest in late perimenopause at 31% and lowest after menopause at 7%. Hormone levels also affect migraine risk.

Review, 2000

Do common diseases get worse before a woman's period?

Yes. A significant number of women with asthma, arthritis, migraine, diabetes, depression, or epilepsy report that their symptoms get worse before their period, though doctors do not yet fully understand why.

Review, 1998

How does the menstrual cycle affect other medical conditions?

Many medical conditions worsen at specific points in the menstrual cycle because of sudden changes in hormone levels. This includes migraines, epilepsy, asthma, arthritis, irritable bowel syndrome, and diabetes.

Case-control study, 1992

Do non-migraine headaches change across the menstrual cycle in women with PMS?

Yes. Women with PMS have significantly more non-migraine headaches during the perimenstrual phase (around their period) and more severe headaches than women without PMS.

Survey study, 2026

Do women with menstrual migraine have worse PMS and PMDD, and does coping strategy affect headache burden?

Yes. Women with menstrual migraine had significantly higher PMS severity and PMDD rates than women without menstrual migraine. Using awareness and acceptance coping strategies reduced headache impact on quality of life.

Case report, 2025

Can cluster headache happen before menstruation?

Yes. A 28-year-old woman had severe one-sided headaches starting only in the weeks before her period, which was initially mistaken for migraine. When treated with oxygen and verapamil, the headaches stopped.

Randomised trial, 2025

Can soy isoflavone supplements help with PMS and PMDD symptoms?

This paper describes theoretical mechanisms through which soy isoflavone supplements could help PMS and PMDD by affecting hormones, neurotransmitters, and inflammation. However, it presents only theoretical pathways, not results from actual human trials, so real-world effectiveness remains unknown.

Cohort study, 2025

Does migraine affect your ability to think clearly?

Women with migraine performed as well as healthy women on a memory task, but their brains showed lower activity in a deep brain region after an attack. Results are from a small group, so we should be cautious.

Randomised trial, 2025

Does rimegepant prevent migraines around your period?

Rimegepant prevented perimenstrual migraines in 85% of cycles with no side effects in this small study of 5 women, but we need larger studies to be confident in these results.

Study, 2025

Does a new way of tracking hormones in research align measurements better across different women?

Yes. The new PACTS method improves how well researchers can align estrogen measurements during the first part of the menstrual cycle, though it works similarly to traditional methods for progesterone during the second part.

Survey study, 2023

What menstrual symptoms do college students experience and what medicines do they use?

The abstract does not clearly report the study findings. It concludes PMS is treatable and that education and lifestyle counseling can help.

Non-randomised trial, 2023

Do anti-CGRP antibodies work the same for period-related migraines as other migraines?

Yes. Both period-related and non-period-related migraine days improved equally when treated with anti-CGRP antibodies.

Survey study, 2023

How common are migraines linked to the menstrual cycle in women with PMS?

About 10.7% of reproductive age women in Saudi Arabia experienced migraines tied to their menstrual cycle. Among all women with migraine, 57.9% had migraines linked to their menstrual cycle. These migraines significantly interfered with work and daily activities.

Survey study, 2023

Should doctors classify menstrual headaches based on how often they happen?

Yes. Headache frequency and purity (whether it happens only around menstruation) should both be considered because they affect how severe the headaches are and what type they are. High-frequency headaches are more severe and similar to migraine.

Survey study, 2022

Can psychological factors predict which women with migraines will have PMS?

Yes. Women with migraines who struggle with emotions and have low confidence are more likely to have PMS. However, these factors explain only 11% of PMS cases.

Interview study, 2021

Do women with migraines also tend to have premenstrual syndrome?

Yes. In gynecology clinics, 76% had PMS and 94% had headaches during their premenstrual phase. In neurology clinics, 79% had PMS and 79% of those with headaches also had PMS. Researchers concluded this is not coincidence.

Survey study, 2021

Are migraine headaches and PMS linked in medical students?

Yes. About 80% of women with PMS had headaches, and about 81.5% had migraines. Women with PMS had a 70% higher risk of menstrual migraine than women without PMS.