Headaches during your period
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham
On this page
- Overview
- Why headaches occur during menstruation
- TCM patterns behind menstrual headaches
- Acupuncture for menstrual headaches
- Chinese herbal medicine
- Supplements with evidence
- Self-help and immediate relief
- Preventing menstrual headaches
- When to see a doctor
- Frequently asked questions
1. Headaches during your period
Menstrual headaches — headaches that reliably appear around the time of menstruation — affect a significant proportion of women and are one of the most disruptive cycle-related symptoms I treat. They can range from a dull frontal ache to a full migraine with visual disturbance and nausea, and they are almost entirely driven by hormonal changes in the days before and during the period. Traditional Chinese medicine provides a clear framework for understanding and treating them.
2. Why headaches occur during menstruation
The primary driver of menstrual headaches is the drop in oestrogen that occurs in the late luteal phase, just before menstruation begins. Oestrogen stimulates serotonin release and raises the pain threshold — so when it falls sharply, pain sensitivity increases. Prostaglandins released during menstruation also promote vasodilation and inflammation, both of which can trigger or worsen headaches. In women with true menstrual migraine, the low-oestrogen window between day −2 and day +3 of the cycle is the main trigger.
Additional contributors include:
- Magnesium deficiency — depleted by progesterone in the luteal phase
- Iron deficiency from heavy periods (see heavy menstrual bleeding)
- Dehydration
- Sleep disturbance in the late luteal phase
- Skipping meals (low blood sugar)
- Caffeine, alcohol or chocolate as triggers
- Stress — raises sympathetic tone and worsens vasoreactivity
3. TCM patterns behind menstrual headaches
Liver qi stagnation
The most common pattern. When Liver qi fails to flow smoothly, it accumulates and rises to the head, causing a throbbing or distending headache typically felt at the temples or sides of the head. Worsened by stress, improved by gentle movement. Often accompanied by irritability, premenstrual breast tenderness and clots in the menstrual blood.
Blood deficiency
Produces a dull, empty headache that often follows the period rather than preceding it, reflecting the blood loss of menstruation depleting an already low reserve. Mild and aching rather than throbbing, accompanied by pallor, fatigue and light menstrual flow.
Liver yang rising
Often rooted in Kidney yin deficiency. Produces a more severe headache or migraine with throbbing, heat, dizziness, typically worse around ovulation and before the period. Particularly common in perimenopause.
Blood stasis
Produces a fixed, stabbing headache that correlates closely with the period and improves once the flow is established. Clots and cramping are characteristic accompanying signs. Often coexists with endometriosis or adenomyosis.
4. Acupuncture for menstrual headaches
Acupuncture is highly effective for menstrual headaches and migraines. Research has shown it to be as effective as prophylactic migraine medication, with fewer side effects and longer-lasting benefit. I treat patients across the menstrual cycle — addressing the root pattern throughout the month rather than just at the time of the headache. Key points include GB 20 (Feng Chi), LV 3 (Tai Chong), LI 4 (He Gu) and GB 34 (Yang Ling Quan). Most patients see meaningful improvement within 3 cycles of consistent weekly treatment.
5. Chinese herbal medicine
For Liver qi stagnation headaches, Xiao Yao San or Chai Hu Shu Gan San are excellent starting points. For blood deficiency, Ba Zhen Tang nourishes both qi and blood. For Liver yang rising with Kidney yin deficiency, Tian Ma Gou Teng Yin is the classical formula. For blood stasis, formulas including Tao Hong Si Wu Tang move blood. I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan, individually tailored.
6. Supplements with evidence
- Magnesium glycinate (300–500 mg/day) — the strongest single-supplement evidence for menstrual migraine prevention
- Vitamin B2 (riboflavin, 400 mg/day) — evidence for migraine prevention generally
- CoQ10 (100–300 mg/day) — supports mitochondrial function in migraine prevention
- Vitamin D — deficiency worsens headaches; supplement to a level of 75–125 nmol/L
- Omega-3 (1,000+ mg combined EPA/DHA) — reduces inflammation
- Iron — if ferritin is below 50 ng/mL with heavy periods
- Feverfew or butterbur — herbal options for migraine prevention
7. Self-help and immediate relief
- Take NSAIDs early — ibuprofen or mefenamic acid taken at the first sign of premenstrual headache, ideally 1–2 days before the period starts
- Hydrate — 1.5–2 litres of water through the day
- Stable blood sugar — eat regularly; do not skip meals
- Reduce alcohol, caffeine, chocolate in the late luteal phase if these trigger your headaches
- Rest in a dark quiet room at the height of a migraine
- Acupressure on LI 4 (between thumb and index finger), LV 3 (top of foot between first and second toe) and GB 20 (base of skull)
- Cold compress on the forehead and back of neck
- Magnesium oil topically on the temples and neck
8. Preventing menstrual headaches
- Daily magnesium glycinate 300–400 mg
- Address iron and ferritin if low
- A consistent sleep schedule, 7–9 hours per night
- Regular moderate aerobic exercise
- Stress management — meditation, yoga, breathwork
- A course of acupuncture and Chinese herbal medicine over 3–6 cycles
- Identify and reduce dietary triggers (alcohol, caffeine, chocolate, MSG, aged cheese)
- Hormonal options if appropriate — some women benefit from a continuous combined pill that avoids the low-oestrogen window
9. When to see a doctor
See your GP urgently if you experience:
- The worst headache of your life, or sudden severe onset (thunderclap)
- Headache with fever, stiff neck, rash, confusion or vision loss
- New-onset headaches after the age of 50
- Persistent or worsening headaches over weeks
- Headache with focal neurological symptoms (weakness, speech change, persistent visual change)
10. Frequently asked questions
Why do I get headaches during my period?
The main driver is the sharp drop in oestrogen in the late luteal phase, which lowers serotonin and the pain threshold. Prostaglandin-driven inflammation and vasodilation during bleeding also contribute. Magnesium depletion, iron deficiency, dehydration, sleep disturbance and stress all worsen the picture.
How do I make period headaches go away?
Take NSAIDs (ibuprofen or mefenamic acid) at the first sign of symptoms, hydrate well, eat regular meals, and rest in a dark quiet room at the height of a migraine. Magnesium 300–500 mg, B2, CoQ10 and vitamin D help with prevention. Acupuncture is highly effective for both treatment and prevention.
Are period headaches normal?
Mild headaches around the period are common but not inevitable. Severe or disabling menstrual headaches, particularly with migraine features, are not normal and respond well to treatment. Persistent worsening headaches need GP assessment.
What is the difference between a tension headache and a menstrual migraine?
Tension headaches are dull, pressing, bilateral and steady. Menstrual migraines are throbbing, often one-sided, with light and sound sensitivity, nausea or vomiting, and typically last 4–72 hours. They cluster around the days before and during the period.
Can acupuncture relieve menstrual headaches?
Yes. Acupuncture has been shown in research to be as effective as prophylactic migraine medication for menstrual migraine, with fewer side effects. Most patients see meaningful improvement within 3 cycles of weekly treatment.
What is the best supplement for menstrual migraines?
Magnesium glycinate (300–500 mg/day) has the strongest evidence. Combined with vitamin B2 (400 mg/day) and CoQ10 (100–300 mg/day), the effect is amplified.
Related menstrual guides: period flu · period cravings · water retention before your period · period blood clots · period won’t stop / heavy bleeding · what to eat during your period
To discuss menstrual headaches or migraines, contact me or book a consultation at my Wokingham, Berkshire clinic.
