In one word: hormones.

By Emily Shiffer
Getty Images/Science Photo Library

Even if you don't use a period tracker, you can probably tell when your time of the month is looming: Aside from cramps and bloating, getting your period can also wreak havoc on your skinenergy levels and diet (cravings are real). And for some women, headaches are part of the period fun too.

That's right: If you tend to suffer from headaches around your period, it isn't all in your head (get it?!); period headaches are based in real science and are pretty common, too. Here, docs explain the connection between hormones and headaches—and what you can do to keep period headaches under control.

What Causes Period Headaches?

Unsurprisingly, it's all about hormones. "Estrogen is the female hormone important in triggering headaches in women," says Kristina Rauenhorst, M.D., a gynecologist at Mayo Clinic Health System. "Headaches are thought to occur when levels of estrogen drop, which happens before the menstrual period starts each month."

Here's how it works: The drop in estrogen levels cause chemical changes to occur in the brain, resulting in dilation of the vessels in the brain. Some of the nerves in the head are also more sensitive during this time related to the drop in estrogen, explains Dr. Rauenhorst, meaning pain can be felt in a more intense way during this time.

And even if you're on a hormonal birth control pill, which levels out your hormones throughout the month, you *can* still experience period-related headaches while on an estrogen-containing BC if you miss any of your pills, or during the hormone-free interval during the last week of your birth control pack, adds Dr. Rauenhorst.

What About Period Migraines?

Unfortunately, some women experience even worse period headache symptoms, in the form of menstrual migraines. While they're also caused by the estrogen drop, they tend to occur in women who already have a history of migraines, says Oluwakemi M. Edokpayi, M.D., a gynecologist at Northwestern Medicine.

Menstrual migraines typically start just prior to or during your menstrual cycle, last longer than regular migraines, and the symptoms are more severe. "These types of migraines may or may not be associated with aura (a series of sensory disturbances that happen shortly before a migraine attack) and they typically are associated with nausea, vomiting, and sensitivity to light/ sound," says Dr. Edokpayi.

How to Prevent and Treat Period Headaches

"Unfortunately, since menstrual headaches are usually related to a decrease in estrogen and progesterone, there is nothing you can do to change the physiological aspect of what is happening in your body," says Dr. Edokpayi. However, there are steps you can take to manage period-related headaches.

"I usually encourage my patients to have a balanced diet, drink plenty of water, exercise, and find better ways to handle stressors in life (i.e. meditation) to try to decrease the severity of menstrual headaches," says Dr. Edokpayi.

And, if you aren't already taking a birth control pill, you may want to talk to your ob-gyn about starting, since again, the pill can help equalize those estrogen fluctuations that cause period headaches in the first place.

Taking a magnesium oxide supplement (400 mg daily) may also be able to help since some research shows they can be effective at preventing menstrual migraines, adds Dr. Rauenhorst. (Related: The Benefits of Magnesium and How to Get More of It In Your Diet)

If a period headache hits, you can manage pain by simply popping an Advil or Tylenol like you would with any other headache. "Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, and acetaminophen are helpful for treating period headaches in many women," says Dr. Rauenhorst. While NSAIDs alone are effective for some women, more intense menstrual migraines may require additional medication, such as triptans, which can help reverse the changes in your brain that caused your migraine and inhibit over-active pain nerves, adds Dr. Edokpayi.

The Bottom Line On Period Headaches

If you're concerned about your headaches, start to track their frequency and duration; it will help your doc determine an accurate diagnosis and find the right treatment options for you, Dr. Edokpayi says.

When is it time to make an appointment? "Patients should see their physician if headaches are becoming more severe or are affecting their day-to-day activities," says Dr. Edokpayi. "If you find yourself lying in bed in a darkened room during your menstrual cycle because your headaches are so debilitating, then it's time to see your doctor."

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