Caitlin Johnson, RD, CLT
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Menstrual Migraines Got You Down?

12/6/2016

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Recently I had a blog reader inquire about migraines that reoccur each month a day or two before the start of her next cycle. I used to get migraines 2-3 days before the end of each cycle too, so this question really hit home for me. These migraines are called menstrual migraines and often occur 2 days before the end of your cycle up through the first 3 days of your period. Because of the timing of these migraines, they can be difficult to treat and may not respond to the same medicines that other severe headaches and migraines respond to.
 
The cause of these migraines is likely one of the following reasons:  
 
The natural drop in magnesium towards the end of your monthly cycle. If this is the cause it can respond to administration of magnesium from the midpoint of your cycle (day 15 for most women) until the second day of your next period. I recommend a form of magnesium that is chelated like: magnesium glycinate, magnesium threonate or magnesium malate. You can start at 400 mg and gradually increase to between 800 and 1000 mg/ day. This can be administered before bedtime to help with relaxing and more sound sleep (magnesium has that effect). While administering magnesium monitor for changes in your stool consistency. Your bowel movements may become more frequent and more soft with magnesium intake. This is not concerning unless you begin having more than 3 bowel movements per day.
 
The natural drop in estrogen that takes place at the end of the cycle. A natural remedy is to take phytoestrogens in the 7-8 days leading up to your next cycle/period. You can try to add more estrogen rich foods like soy, take a supplement or use an estrogen cream or skin patch.
 
You can try adding both the magnesium and the phytoestrogens in the same cycle or try one remedy and if no relief is found within 3-4 cycles, try adding in the other. It may take 3-4 cycles for the migraines to respond.
 
Food! Women tend to crave certain foods in the days leading up to their period. Often times these are the only times they eat these foods or eat high quantities of these foods. Migraines can be triggered in response to the introduction of offending foods or (ENOUGH) of these offending foods [that is to say, it can be dose dependent, one bite may not trigger, but 10 just might].
 
If you only ever drink red wine or eat chocolate the few days leading up to your period, it could actually be that instead of the hormones or magnesium, and it just happens to be that your patterns match the hormonal shift. Below is a list of foods that tend to trigger migraines. There is some other advice in there too like sleeping and exercise (Surprise).
 
I always recommend tracking food, lifestyle patterns and symptoms leading up to your period to see if some months you get the headache and others you don't, then compare what may have been different in your diet, etc. 
 
Here is a list of foods that can trigger migraines:
 
Alcohol
MSG and high-glutamate foods/additives in all forms
All fermented foods including yogurt, sour cream and vinegar
All protein supplements
Chocolate
Artificial sweeteners
Avocado
Citrus
Banana
Onions
Dried fruit
Peanuts and all nuts
Aged cheeses
Processed meats
All leftover meats that are more than 36 hours old

The above list reduces some of the bigger sources of tyramine and histamine. During those days leading up to your period, your focus should be on simple foods that have been minimally processed. Additionally, I suggest you focus on regular sleep and hydration with at least a gallon of water per day.
 
As with many other conditions, migraine triggers “stack.” So, you may be able to have wine and cheese on a pleasant day in the early part of your cycle, but may find that wine and cheese while the barometer is dropping and your period is imminent crosses the pain threshold.

While not homeopathic, if you are open to Over The Counter medications pain relievers like Excedrin migraine or Aleve are best taken as soon as the pain starts. Taking Benadryl seems to enhance the effect of the NSAID and often brings faster relief. MANY migrainuers have a problem with histamine so Benadryl sometimes helps with that. Sometimes the pain is just too much and taking something to get rid of the pain as fast as possible is necessary. If you have to take something don’t kick yourself, just take it and look for the relief.

Often with a few extra pounds to lose hormones are affected. Adipose(fat) tissue play a role in hormone regulation. Sometimes even a small amount of change, namely 10-15 pounds can have great affect on hormones and through the cascade of change, can affect migraine occurrences.
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Be patient with yourself when these migraines happen, try laying in a cool dark room, relaxing, finding someone to rub your neck, a cool wet cloth on your forehead, and perhaps some peppermint essential oil to rub on your neck and temples. If you are having migraines throughout your cycle, it may be time to consider having your blood tested for food sensitivities. Your immune system creates chemicals that are pro-inflammatory (make more inflammation) in response to foods you are sensitive to. Eating these foods can trigger migraines, finding out which foods these may be can give you the knowledge and buy you freedom from these painful migraines.

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    Caitlin Johnson is a dietitian, wife, lover of ice cream, chef wannabe, California-girl, Christian, liver eating, "food-avore." 

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