Headaches During Your Period
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham
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.
Why Do 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.
TCM Patterns Behind Menstrual Headaches
Liver qi stagnation is 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. This pattern is worsened by stress and improved by gentle movement. It is 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. The pain is mild and aching rather than throbbing, and is 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, and dizziness, typically worse around ovulation and before the period.
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.
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 (Fengchi), LV 3 (Taichong), LI 4 (Hegu), and GB 34 (Yanglingquan).
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. I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan, adjusted to each patient's specific pattern.
To discuss menstrual headaches or migraines, contact me or book a consultation in Wokingham.
