If you experience severe headaches around the time of your period, you could be suffering from menstrual migraines. But, you're not alone. Approximately 70 percent of migraine sufferers are female, and 60 to 70 percent report their migraines are related to their menstrual cycle.  

Migraines are extremely painful headaches that commonly occur on one side of the head.  They're frequently associated with light sensitivity, nausea and visual changes (aura).  They last from 4 to 72 hours and can be debilitating.  

According to the Association for Reproductive Health Professionals (AHRP), there are two types of menstrual migraines:  

1) Menstrual migraines, which usually attack during the days right before a period starts and

2) Menstrual-related migraines, which can occur additionally at other times of her cycle.

What causes menstrual migraines?

We used to think migraines were caused by constriction of blood vessels in the brain but newer research says migraines may be caused by changes in the trigeminal nerve, one of the body's major pain pathways. Environmental, genetic and hormonal factors may trigger the trigeminal system to release substances called neuropeptides that travel to your brain's outer covering and cause pain.

It's thought that menstrual migraines result from the drop in estrogen women experience right before their period starts.  Some women also complain of migraines attacking during other low-estrogen times of life like the first few months of pregnancy, use of hormonal contraception or during menopause.  

How can  menstrual migraines be treated?

The first treatment of choice are analgesics to control pain including over-the-counter medications like ibuprofen and other nonsteroidal antiinflammatories. The key to successful migraine prevention is in starting treatment several days before you expect your period.  This may prevent the trigeminal pathway from responding to hormonal triggers that cause migraines.  

Some women may be good candidates for continuous-use oral contraceptives.  Traditional hormonal contraception has three weeks of active hormones (including estrogen) followed by an inactive week (with no estrogen) that causes your period.  Continuous-use contraceptives eliminate that inactive week; therefore, you don't have an estrogen drop, don't have a period and don't get migraines.

Other treatments include medications like Triptans (including Imetrex) and Ergotamine (including Cafergot) to relieve pain, nausea, light sensitivity and other migraine symptoms.  Anti-nausea medications, opiates and other medications may also be prescribed.

Many women prevent their migraines by getting plenty of sleep, reducing caffeine, alcohol and stress, especially around their periods.  Some women find however, that caffeine helps reduce migraine severity.  Acupuncture, biofeedback, some herbal supplements and massage have also proven effective in relieving t frequency and severity of migraines.

Whether you choose a natural, hormonal or medical treatment plan to combat your menstrual migraines, it's important to remember that you're not alone and there are plenty of options.

Mayo Clinic - http://www.mayoclinic.com/health/migraine-headache/DS00120/DSECTION=causes

Cleveland Clinic  - http://www.cchs.net/health/health-info/docs/1800/1877.asp?index=8260

Association for Reproductive Health Professionals -http://www.arhp.org/Publications-and-Resources/Clinical-Fact-Sheets/women-and-migraine

Practice Bulletin #109, "Non-contraceptive Uses of Hormonal Contraception," is published in the January 2010 issue of Obstetrics & Gynecology. Other potential benefits of hormonal contraceptives include prevention of menstrual migraines