Menstrual migraines are headaches triggered by hormonal fluctuations, especially the drop in estrogen levels right before or during menstruation. They usually happen one to two days before the periods start and last two to three days after the periods end. These migraines are often more intense and can last longer than other types of migraines. Some women experience migraines exclusively around their menstrual cycle, while others may have them at other times as well.

  1. Acute treatments are similar to other migraine sttacks.

• Triptans like sumatriptan or rizatriptan, taken at the onset of symptoms, are effective in relieving pain.

• Nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen can help alleviate pain.

• Gepants including Ubrogepant (Brand name: Ubrelvy), Rimegepant (Brand name: Nurtec ODT or Zavzpret for nasal spray),Atogepant (Brand name: Qulipta). They are a newer class of medications that can block CGRP and offer relief

Preventive treatments have be utilized for more severe cases.

Stabilizing estrogen levels with hormonal birth control or estrogen patches.
Magnesium has been shown to reduce the frequency of menstrual migraines.

The strategy, Mini-prophylaxis can be more affective in reducing the migraine attacks. Short-term use of medications (like NSAIDs or triptans or Repaints) a few days before and during the menstrual cycle to prevent migraines.

Managing triggers and stress, staying hydrated, and maintaining a consistent sleep schedule can also help prevent menstrual migraines.