This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.
Related guides: Migraine without aura, Migraine with aura, Chronic migraine.
What it is
Menstrual migraine is mainly set off by the natural fall in oestrogen before a period. Attacks happen in a window from 2 days before bleeding starts to the third day of the period, in at least 2 out of 3 cycles.
There are two kinds. In pure menstrual migraine, attacks happen only around periods. This is rare. In menstrually related migraine, which is much more common, attacks happen around periods and at other times too.
Period-related attacks tend to last longer, be more severe and come back the next day. They are usually without aura, even in women who get aura at other times. For some women the link only becomes clear in their late 30s or 40s.
Getting a diagnosis
There's no blood test. Hormone levels are usually normal: the issue is sensitivity to normal changes. Keep a diary of your attacks and your period days for at least 3 cycles and take it to your GP.
Treatment
Standard migraine treatment
GP or pharmacy
Painkillers, triptans and anti-sickness medicine taken early, and repeated if the attack comes back. These days count towards medication overuse limits.
Anti-inflammatories around your period
Prescription
Some women take an anti-inflammatory such as mefenamic acid or naproxen for a few days around their period, especially if periods are heavy or painful.
Short-term triptan prevention
Prescription
If your periods are regular, a doctor may suggest taking a longer-acting triptan, such as frovatriptan or naratriptan, for a few days around your period.
Hormonal options
GP or specialist
Taking the combined pill continuously (only if you don't have aura), a progestogen-only pill such as desogestrel, the injection, or a hormonal coil can help, depending on what drives your attacks. Oestrogen gel or patches around your period are sometimes used.
Perimenopause and menopause
Migraine often gets worse in the years leading up to the menopause, which can start up to 10 years before periods stop, because oestrogen levels swing more. For many women it eases a couple of years after periods stop, but not for everyone.
HRT isn't a migraine treatment, but if you need it, patches, gels or sprays through the skin are usually preferred because they give steadier hormone levels. Your doctor will usually start at a low dose.
Pregnancy
Most women with migraine without aura find it improves in pregnancy, especially from the second trimester. Aura is more likely to carry on, and can appear for the first time.
Many migraine medicines aren't suitable in pregnancy, so always check with your doctor or midwife. Paracetamol is usually the first choice. Topiramate, sodium valproate, CGRP medicines and gepants should be avoided, and ibuprofen should not be taken in the last trimester (from about 30 weeks). A new or unusual aura in pregnancy should always be checked.
When to get urgent help
Call 999 if you have
- a sudden, extremely bad headache that peaks within minutes
- weakness, numbness or a drooping face on one side, or slurred speech
- sudden loss of sight
- confusion, drowsiness or a seizure (fit)
- a high temperature with a stiff neck or a rash
- a headache after a head injury
Call NHS 111 if
- you are pregnant or have recently given birth and have a severe or unusual headache
- an attack lasts more than 3 days
- you have aura for the first time
See your GP if
- your attacks follow your periods and treatment isn't working
- migraine is getting worse around the menopause
- you're starting or changing contraception and have migraine with aura
Work and your workspace
Migraine can count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland) if it has a substantial, long-term effect on your everyday life. Conditions that come and go still count, and the law looks at how you would be without treatment. If it applies, your employer must make reasonable adjustments.
Adjustments that often help
- Flexibility to plan lighter work around your period
- Working from home on predictable bad days
- A quiet, dark place to rest
- Regular breaks, food and water
- Time off for appointments
A migraine-friendly workspace
- A chair with good lumbar and neck support
- A desk big enough to put your screen at arm's length
- Screen raised so the top is at eye level
- A flicker-free monitor with an anti-glare or blue-light filter
- Lighting without flicker or glare, and blinds to control daylight
Access to Work can pay towards equipment and support. Acas and Citizens Advice give free advice on your rights.
How The Beyond Pain Foundation can help
If NHS waits are too long, or the help you need is not available to you on the NHS, we may be able to fund:
- A private appointment with a headache specialist or a women's health doctor with migraine experience
- A private consultation to review hormonal treatment options
- Workspace equipment that reduces triggers on bad days, such as a supportive chair, a good monitor and screen filters
Every award depends on your situation and the funds we have that month. A letter from your doctor, a headache diary and a written quote all help your application.
Support and sources
The Migraine Trust
Information and support service
Information on every type of migraine, a free information and support service, and advice on treatment and work.
migrainetrust.orgNational Migraine Centre
Charity headache clinic
Specialist appointments in person and online, including routine appointments for a voluntary donation, plus free factsheets.
nationalmigrainecentre.org.ukNHS
Health information
Symptoms, treatment and when to get help with migraine and headache.
nhs.uk/conditions/migraineSources for this guide
Written in our own words from the sources above. Last reviewed: October 2026. Figures can differ between sources; where they do, we give the range.