How to manage and prevent menstrual migraine?

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Your migraines are menstrual-related, as many women experience a significant worsening of symptoms in the days leading up to their period due to hormonal fluctuations, especially the drop in estrogen. These hormone‑triggered migraines tend to be more severe, longer-lasting, and less responsive to over‑the‑counter painkillers, which seems to be the case for you.

Preventive treatment is often necessary when migraines are frequent or disabling, like yours. Several options can help reduce or prevent these attacks:

1. Short‑term preventive medications: Some women benefit from taking triptans for a few days around the start of their period for predictable menstrual migraines.

2. Continuous preventive therapy: Daily medications may include: Beta blockers, certain antidepressants, and anti‑seizure drugs.

3. Monthly injection‑based treatments: If migraines occur more than four times per month or significantly impact quality of life, options include CGRP (calcitonin gene-related peptide) monoclonal antibodies such as Erenumab, Fremanezumab, or Galcanezumab. These are generally well-tolerated and can be very effective.

4. Hormonal options: Estrogen patches or contraceptives may be considered carefully if your migraines are closely tied to your cycle. These must be used cautiously and are not recommended if you experience migraines with aura due to increased stroke risk.

I suggest you consult a specialist, talk to them, and take the medications with their consent.

I hope that this answers your query.

Please follow up if you have any further questions.