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I Suffer From Hormonal Headaches

Hormonal Migraine Treatment

Hormonal migraines or menstrual migraines are commonly ranked in the top 5 most disabling conditions for women in Sydney, NSW.

While hormonal migraines are usually referred to within the healthcare industry as menstrual migraine, they have a number of alternative names, such as hormonal headaches or period headaches. This is because this migraine headache condition predominantly affects females typically during their menstrual cycle

Menstrual migraine is similar to a normal migraine attack, which usually targets one side of the head or in some cases both sides. Symptoms are usually felt during the time of the menstrual cycle and typically last for approximately 3 days.

At the Sydney Headache and Migraine Clinic we utilise world-class techniques in assessing and treating this problem. Once menstrual migraine treatment commences we expect a significant improvement to occur rapidly, as is the case with 90% of our patients with this condition. We expect to observe this within the first 5 treatment consultations.

Ready to find relief from your headaches? Schedule your first consultation and start your journey towards a pain-free life.

Understanding Your Symptoms

Symptoms of Hormonal Headache / Menstrual Migraine

Symptoms are usually felt during the time of the menstrual cycle and typically last for approximately 3 days. 

Commonly associated symptoms of menstrual migraine include:

  • Moderate to severe pulsating or throbbing pain
  • Nausea and vomiting
  • Sensitivity to light, sound and smell

They may also experience visual disturbances such as dark or bright coloured spots in their sight, and in some cases temporary vision loss.

Vertigo pain

Understanding Your Headache

What is the cause of Hormonal Headaches / Menstrual Migraines?

Recent studies and research have found a common underlying cause for those suffering from hormonal headaches. Studies suggest that those with hormonal headaches all have a common dysfunction, which is a sensitised brainstem. This is a result of a dysfunction in the upper cervical spine where the brainstem is situated.

The brainstem filters any information that passes into the brain including hormonal fluctuations in the body. During the menstrual cycle, there is a normal drop in oestrogen level. This information gets passed through the brainstem. Due to the brainstem being affected and hypersensitive, it now incorrectly registers that there is a greater drop in oestrogen levels than normal, and thus alerts the body with pain transferred as a migraine into the head.

Hence research shows that if a female suffers from a sensitised brainstem, any normal hormonal changes are now heightened and alerted by the brain. What should be a normal hormonal biological event is now considered as a threat resulting in pain along the trigeminal nerve eliciting a migraine during the menstrual cycle.

About The Assessment Stage

What To Expect During The Assessment


1. Comprehensive and in-depth examination

We instigate an in-depth assessment to identify all possible related factors that could be causing your headaches or migraines. The upper cervical spine, in particular, is thoroughly examined to identify possible issues.



2. Ligamental stability and vertebral arterial tests

We undertake careful examination of neck ligaments and vertebral arteries, ensuring only the highest standards of patient safety and comfort.


3. Temporarily reproduce your headache and migraine symptoms

As a part of the treatment process, we apply gentle and selective stress to the upper cervical spine in order to reproduce headache symptoms, which subside after 20-30 seconds. This helps to identify and treat the cause of your headaches.

Hormonal Headache Theory

Types of Hormonal and Menstrual Migraines

Hormonal headaches can present in several forms, each influenced by changes in hormone levels during the menstrual cycle.

Pure Menstrual Migraine

Pure menstrual migraine is characterised by migraine attacks that occur only in close proximity to menstruation—specifically, from two days before to three days after the onset of a period (known as day 1 ± 2). These migraines do not appear at any other point in the menstrual cycle. For a formal diagnosis, this pattern must be consistent, occurring in at least two out of three consecutive cycles. While symptoms like intense, throbbing head pain, nausea, and sensitivity to light or sound are common, the defining feature is their strict timing around menstruation. This form of migraine is relatively uncommon but often more predictable due to its clear hormonal trigger.

Menstrually Related Migraine:

Menstrually related migraine also occurs during the day 1 ± 2 window of menstruation, but with additional migraine attacks happening at other times throughout the cycle. This makes it more prevalent and sometimes more difficult to diagnose without long-term symptom tracking. The migraine attacks may still follow a hormonal pattern but are also influenced by other triggers such as stress, poor sleep, or dietary factors. Diagnosis typically requires confirmation that menstrual migraines have occurred in at least two out of the last three cycles, with careful observation over time. These migraines can vary in presentation, sometimes involving aura or other neurological symptoms in addition to the classic throbbing pain.

Other Hormonal Headaches

Hormonal headaches can also occur due to other hormonal changes, such as during pregnancy, perimenopause, menopause, or while using hormonal birth control methods like birth control pills. Fluctuations in oestrogen levels are a key trigger. These headaches often mimic migraine headaches and may include severe pain, visual disturbances, and neck pain. Monitoring symptoms with a headache diary can help track patterns and identify hormonal links.

Understanding the type of hormonal headache experienced is essential for effective hormonal migraine treatment and menstrual migraine prevention strategies.

History of Hormonal Headache / Menstrual Migraine

Hormonal Headache was originally thought to be due to abnormal levels of hormones throughout the body. During a normal menstrual cycle, oestrogen levels in the body drop.

It was previously thought that the drop in oestrogen levels was the cause of hormonal headaches. This was proven false, as several studies have found that the drop in oestrogen levels did not significantly differ from those with hormonal headaches, than those without this condition.

Leading experts in this field have found that there is in fact no hormonal abnormalities to trigger hormonal headaches.

Traditional Approaches to Hormonal Migraine Treatment

Traditional strategies for treating menstrual migraines often aim to manage symptoms rather than address potential underlying causes. Common approaches include the use of migraine medication, non-steroidal anti-inflammatory drugs (NSAIDs), and hormone replacement therapy (HRT). These options may provide temporary relief but can carry risks such as medication overuse or side effects linked to hormone therapies.

Many women are prescribed birth control pills or other methods to regulate hormone fluctuations in hopes of preventing period headaches. However, these treatments can sometimes lead to breakthrough bleeding or unintended hormonal side effects, especially in those with migraine with aura, where certain contraceptives may not be recommended.

Other options might include lifestyle adjustments, dietary changes, and tracking symptoms through a headache diary. While these can assist with identifying potential triggers, they often don’t resolve the core issue for those suffering from a sensitised brainstem.

While these treatments may offer relief for some, they may not work for everyone – particularly those whose migraines are linked to neural sensitisation rather than solely hormonal fluctuations. That’s why at Sydney Headache and Migraine Clinic™, our focus remains on comprehensive assessment and treatment targeting the brainstem, aiming to provide long-term relief without the reliance on medications or hormonal manipulation.

I’ve tried everything. What can be done to help my Hormonal Headaches?

Treating your Hormonal Headaches

You may have tried countless treatments, including natural remedies or medicated treatment. These often include Hormone Replacement Therapy (HRT) drugs, staying on the contraceptive pill to skip the menstrual cycle, or taking lots of natural supplements to try and stop these hormone headaches from developing. The question to ask yourself is, have you had your brainstem assessed to see whether or not the cause is coming from a sensitised brainstem?

At the Sydney Headache and Migraine Clinic, we utilise world-class techniques in assessing and treating this problem. A thorough examination of the upper cervical spine is initiated to determine the severity of your sensitised brainstem.

If the brainstem is identified as the likely cause of your hormonal headaches, treatment can begin immediately. Once treatment commences we expect a significant improvement to occur rapidly in 90% of our patients with hormonal headache. We expect to observe this within the first 5 treatment sessions.

Tools for managing migraines.