Hormonal Ties of Menstrual Headaches
Health LibraryMenstrual Symptoms and Causes
Hormonal Ties of Menstrual Headaches


Menstrual headaches, particularly migraines, are a prevalent concern among individuals during their menstrual cycle. These headaches can significantly impact daily functioning and quality of life. In this article, we will delve into the causes of menstrual headaches and explore the intricate relationship between these headaches and hormonal fluctuations. Understanding these factors is crucial for effective management and relief of menstrual migraines. 

What Causes Menstrual Headaches?

Menstrual-related headaches are related to several important factors. Hormonal changes play a significant role in triggering menstrual headaches. The precise mechanism behind this connection is still being studied, but hormonal imbalances are believed to influence the sensitivity of the trigeminal nerve, a major player in migraine headaches.

In particular, estrogen is important, where serotonin and estrogen levels are directly related. During the late secretory phase of the menstrual cycle, when estrogen is low, the production of serotonin decreases, leading to increased level of a series of substances that are involved in the pathophysiology of general migraines and cause vasodilation of intracerebral vessels and sensory sensitization of the nerve. Around menstruation, the pain perception may be more sensitive than usual, which will more likely lead to headaches.

Besides, in the recent years, researchers are postulating new theories linking other hormones and estrogen in terms of the development of menstrual headache. For instance, some researchers are trying to prove that estrogen regulates Oxytocin (often referred to as the "love hormone"), which eventually lead to menstrual headache.

Except for hormones like estrogen, there are many other hormones that are thought to somehow contribute to menstrual headache/migraine, including:

  • Gonadotropins: Follicle-stimulating hormone (FSH) and luteinizing hormone (LH), known as gonadotropins, are involved in the regulation of the menstrual cycle. Fluctuations in these hormones, particularly during the premenstrual and menstrual phases, can contribute to the onset of headaches.
  • Cortisol: Cortisol, the primary stress hormone, may also impact menstrual headaches. During periods of high stress, cortisol levels can increase, potentially triggering or exacerbating headaches.
  • Melatonin: Melatonin is a hormone that regulates sleep-wake cycles. Disruptions in melatonin levels during the menstrual cycle, particularly during the premenstrual and menstrual phases, can affect sleep quality and potentially contribute to headaches.
  • Prostaglandins: The release of prostaglandins, hormone-like substances, during menstruation can contribute to headaches. Prostaglandins cause inflammation, pain, and blood vessel dilation. Increased levels of prostaglandins during the menstrual period may contribute to the development of menstrual headaches. 

While hormonal fluctuations play a significant role in menstrual headaches, certain triggers and lifestyle factors can exacerbate the frequency and intensity of these headaches. Common triggers include stress, lack of sleep, dietary factors (such as certain foods and caffeine), changes in weather, and hormonal medications.


Menstrual headaches, particularly migraines, can significantly impact the lives of individuals during their menstrual cycle. Hormonal fluctuations and lifestyle factors all contribute to the development of these headaches.

Understanding the complex relationship between menstrual headaches and hormones is essential for effective management and relief. By identifying the triggers, practicing stress management techniques, maintaining a healthy lifestyle, and seeking for professional guidance, you can develop strategies to alleviate the frequency and severity of menstrual headaches. It is important to consult healthcare professionals for accurate diagnosis, personalized treatment options, and comprehensive care to manage menstrual headaches and improve overall well-being.

  • Moy G, Gupta V. Menstrual-Related Headache. [Updated 2022 Oct 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
  • Bharadwaj, Vimala N., et al. "A new hypothesis linking oxytocin to menstrual migraine." Headache: The Journal of Head and Face Pain 61.7 (2021): 1051-1059.
  • Murray, Shona C., and Ken N. Muse. "Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and “add-back” therapy." Fertility and sterility 67.2 (1997): 390-393.
  • Martin V, Wernke S, Mandell K, Zoma W, Bean J, Pinney S, Liu J, Ramadan N, Rebar R. Medical oophorectomy with and without estrogen add-back therapy in the prevention of migraine headache. Headache. 2003 Apr;43(4):309-21.
  • Chazot, Guy, et al. "A chronobiological study of melatonin, cortisol growth hormone and prolactin secretion in cluster headache." Cephalalgia 4.4 (1984): 213-220. 
  • Horrobin, D. F. "Prostaglandins and migraine." Headache: The Journal of Head and Face Pain 17.3 (1977): 113-117.
2.What Causes Menstrual Headaches?