1. Employ Over-the-Counter NSAIDs as the First Line of Treatment
If you get migraines just before or during your period, you probably have what are known as "menstrual migraines." These headaches are brought on by shifts in hormone levels. Most menstrual headaches are mild enough that they can be treated with over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). If you have moderate to severe menstrual migraines, however, preventative treatment with over-the-counter NSAIDS may be indicated. For this treatment, you start taking NSAIDs regularly 2 to 3 days before you begin to menstruate and throughout your period. This treatment is short enough to prevent the side effects of NSAID overuse, but it's best to consult your doctor before you start preventative treatment.
2. Preventative Prescription Medications
If your migraines do not respond to NSAID treatment, a doctor can also prescribe preventative medications. These medications include cardiovascular drugs like beta blockers and calcium channel blockers and anti-convulsant drugs. Ergots drugs, long used to treat all kinds of migraines, can also be used. Recent studies have shown that triptans, which were once thought to be only an abortive drug, can be used in preventative treatment, as well. To use these drugs for menstrual migraine prevention, they should be started just before menstruation and continued throughout your cycle.
3. Birth Control Pills: Treatment or Trigger
For some women on birth control pills, starting the placebo pill after 3 weeks of hormone pills can trigger a migraine. Changing how you take your birth control pill can mitigate this problem. Extended-cycle birth control pills use placebo pills only once every three months, which reduces your periods to just four times a year. These pills offer new hope to women who suffer from uncontrolled menstrual headaches by at least decreasing their frequency.
Because menstrual migraines are triggered by hormonal changes, using birth control pills with estrogen can actually cause migraine problems. Starting birth control pills for the first time can bring on headaches for some women. This is less true for those using low-estrogen pills and pills containing progesterone. With continued use, most women will get used to the pills, and the migraines will subside.
