What I (didn’t) learn about menstrual migraines from my trip to the ER
“Just stress less,” the doctor told me. I couldn’t help but let out a sigh. “jUsT sTReSs LeSs”???
I had been in the ER for a couple of hours now. Earlier in the evening, I was having a pounding migraine and started seeing white flashes that quickly blocked most of my vision. Concerned that I couldn't see, my friend immediately called an Uber to bring me to the hospital. I had always suffered from migraines, but senior year was proving to be no joke when it came to these intense headaches. Yes, it was true that I have been stressing a lot recently. I was trying to complete my requirements for my engineering and design degrees, was on the exec board for my dance teams, and was trying to figure out life after graduation (hint: Aavia), all at the same time. Most of my friends were going through similar crises—it was simply impossible to stress less.
When I arrived at the ER, I immediately had to take a few blood tests and a physical exam. The doctors were scrambling around me. “She could be having a stroke, let’s take her to see the neurologist. Does she need an MRI?” “She could have a blood clot in her eye, let’s see what the optometrist says.” I was passed around from one specialist to another, and soon it was 5am (my poor friend was waiting for me this whole time—bless her soul).
So, when the doctor came back to me with the results, I was expecting more than “just stress less.”
After my friend and I had a 6am post-ER breakfast at IHOP, I went back to my dorm room unsatisfied with the doctor’s advice. I had to take matters to my own hands. I immediately Googled “migraines”, which brought back these results:
“A migraine is a headache of varying intensity, often accompanied by nausea and sensitivity to light and sound. Migraine headaches are sometimes preceded by warning symptoms. Triggers include hormonal changes, certain foods and drinks, stress, and exercise.”
I knew then that I had to investigate what my personal “triggers” were. I started tracking diligently what foods and drinks I was consuming, my daily mood, and my exercise routines. I didn’t quite know what “hormonal changes” were at that point, so I dismissed it.
Little did I know that “hormonal changes” were, in fact, important, because the next day, I started my period. I brushed it off thinking that it was a streak of bad luck to be going to the ER and getting a period in the same week, but I marked it in my tracker regardless.
After getting my migraines a couple more times, I started to notice a pattern in my data. I tended to mark negative moods right before my period came every month, and guess what—I also tended to have migraines during that time. I felt that I had suddenly unlocked the code of my own body.
The key was in my menstrual cycle.
What are menstrual migraines?
I immediately went back to Google to see if there can be a relationship between menstrual cycles and migraines. To my surprise, I learned that 60% of people who menstruate suffer from what is called menstrual migraines.
I also had to learn that my cycle is more than my period. A typical cycle is complex and lasts 21-35 days. During your cycle, your ovarian hormones (estrogen & progesterone) are fluctuating, impacting other parts of your physical and mental health (learn more about the hormone cycle in Dr. Seif’s blog here). Menstrual migraines may partly be due to the drop in the hormone estrogen that happens before you menstruate.
I felt a flood of relief when I read this definition:
Menstrual-related migraine: This more common form can come with or without aura symptoms such as vision disturbances. You may experience migraine attacks at other times of the month, but it usually comes around the onset of or after your period. Premenstrual syndrome (PMS) symptoms such as bloating, breast tenderness, nausea, and mood changes may accompany menstrual migraine attacks.
It finally all made sense.
For me, the biggest key to treating my migraines was knowing when they were coming. I started paying more attention to where I was in my cycle. The week before I predicted my period would come, I would dim the lights in my room and do work away from my computer screen. I meditated and did breathing exercises. I made sure to frontload projects to the first half of my cycle, so I can take it easier a few days before my period. I bought some Ibuprofen just in case.
By paying more attention to my cycle, I was able to mitigate my migraines.
Other treatments that I researched but did not try include:
- Taking birth control pills: Some doctors recommend taking birth control that contains low amounts of estrogen or only progestin to help with migraines. You can also take continuous birth control to eliminate the drop in hormones during the placebo week, which can lower your chances of getting a migraine from the drop in estrogen.
- Taking supplements: Supplements such as magnesium are known to help with migraines.
- Taking triptans or ditans: These drugs block pain signals in your brain and can start to work as soon as 2 hours after you take them.
However, I do suggest talking to your doctor and flagging it as a menstrual migraine if you do notice that your migraines are related to your cycle.
Like most people, I was not aware of the effects my hormone cycle can have on the rest of my body. Prior to starting Aavia, I thought “hormonal changes” meant transitory times like puberty, pregnancy, and menopause, but we, as people with ovaries, are always experiencing hormone fluctuations. Because your reproductive system is part of a larger hormonal system in your body, what’s happening in your ovaries can impact other bodily functions, including your mood and migraines.
I am still baffled as to why the doctors in the ER didn’t ask me about my cycle, especially when menstrual migraines seem to affect so many people with ovaries. This is why I’m passionate about arming more people with knowledge about their hormone cycles, because the more I learn about them, the more I realize that so many aspects of our lives are connected to them.
While my personal story is about migraines, your story may lie in your mental health, skin health, sex drive, sleep, and athletic ability. What secrets are hidden in your cycle? Start tracking with Aavia today to find out.