Understanding Menstrual Migraine: When Hormones Trigger Headaches
By Canberra Headache Centre
For many women, migraine attacks seem to strike like clockwork — just before or during their period. This is known as Menstrual Migraine, a common but often under-recognised condition.
These headaches can be particularly severe, long-lasting, and resistant to usual treatments — but support is available at the Canberra Headache Centre where out expert team of physiotherapists can assess, diagnose and help treat headaches that may be driven by the menstrual cycle.
At Canberra Headache Centre, our expert physiotherapists work with people experiencing all types of headaches, including Tension-Type Headache. Using the Watson Headache® Approach, hands-on manual therapy, and a whole-body perspective, we help clients get to the root of their symptoms and find lasting relief.
What Is a Menstrual Migraine?
A menstrual migraine is a migraine attack linked to hormonal changes in the menstrual cycle. It typically occurs in the days just before or during menstruation, when oestrogen levels drop.
Symptoms are similar to migraine without aura:
• Throbbing or pulsating head pain
• Pain often on one side of the head
• Sensitivity to light, sound, or smell
• Nausea or vomiting
• Fatigue and difficulty concentrating
What Causes It?
The key driver is hormonal fluctuation, especially the sharp fall in oestrogen before menstruation. Other contributing factors include:
• Stress and poor sleep
• Skipped meals or dehydration
• Neck and jaw tension
• Underlying brainstem sensitivity in migraine-prone individuals
Common Triggers
- The menstrual cycle (hormonal shifts)
• Stress
• Lack of sleep
• Certain foods (e.g. alcohol, chocolate, processed foods)
How Is It Diagnosed?
Diagnosis is based on recognising the pattern:
• Migraines that reliably occur around the period
• A diary of symptoms can be especially useful
• Physical exam helps rule out other causes and identify contributing neck or musculoskeletal factors
At Canberra Headache Centre, we conduct a thorough physical examination, with particular attention to the upper cervical spine, posture, muscle patterns, and any contributing lifestyle or health factors.
We also help rule out other causes of headache and, when appropriate, work closely with your GP or neurologist for further investigation or management.
How Canberra Headache Centre Can Help
Our physiotherapists are specially trained in treating headache and migraine using a combination of hands-on techniques, education, and rehabilitation strategies.
Here’s how we approach Menstrual Migraine:
- Watson Headache® Approach
The Watson Headache® Approach is a world-renowned, evidence-informed method of examining and treating the upper cervical spine (top three neck joints), which has a powerful influence on headache-related brainstem sensitivity.
By gently identifying and treating dysfunctions in these joints, we can:
- Reduce referred pain to the head
- Desensitise the brainstem
- Address one of the key drivers of chronic headache
This approach is non-invasive, safe, and often highly effective — especially when other treatments haven’t worked.
- Manual Therapy and Postural Correction
We use a combination of:
- Joint mobilisation
- Soft tissue release
- Postural correction exercises
- Stretching and strengthening routines
to address musculoskeletal contributors to Menstrual Migraine. By improving neck and shoulder mechanics, we reduce strain on the headache-generating areas.
- Education and Lifestyle Advice
We believe that understanding your condition is one of the most powerful tools for recovery.
Our therapists will help you:
- Identify triggers and contributing factors
- Improve workstation ergonomics
- Develop stress management strategies
- Optimise sleep, hydration, and physical activity
Sometimes small changes in routine — like setting screen-time breaks or adjusting your pillow — can make a huge difference.
- Vestibular and Visual Considerations
While not a core feature of Menstrual Migraine, some people also experience symptoms like dizziness, visual strain, or imbalance — especially if the headache has become chronic. Our clinic can assess and treat these through vestibular rehabilitation, gaze retraining, or visual-motor exercises if needed.
- Collaborative Care
If we feel you need further medical input, we won’t hesitate to involve your GP, neurologist, or other allied health providers. Whether it’s medication management, imaging, or specialist referral, we’re committed to a team-based approach that keeps you at the centre.
Outlook
Menstrual Migraine can be highly disruptive, but with the right support many women experience:
• Shorter and less intense attacks
• Fewer days lost to migraine each month
• Better control with fewer medications
You don’t have to “just put up with it.” Effective strategies are available.
When to Seek Help
If you’re experiencing:
• Severe or frequent migraines around your period
• Attacks lasting several days or not responding to medication
• Headaches that significantly disrupt your work, family, or social life
• Increasing reliance on painkillers
… it’s time to seek professional support.