Reasons you get migraines before your menstrual cycle (and others don’t)

Migraines are more than just a headache; they are a debilitating neurological condition affecting millions of people worldwide. For some individuals, migraines become even more challenging to cope with due to their connection with the menstrual cycle.

Menstrual migraines, a specific subtype of migraines, occur in relation to the menstrual cycle. These migraines are often more intense and challenging to manage than regular migraines.

In this blog, we’ll delve into the world of menstrual migraines, exploring their causes and effective management strategies.

Role of Hormones

According to a population study, there is a 71% increase in the risk of migraine during the 2 days before menstruation. There is also a higher risk of migraine symptoms lasting longer when they occur 7-3 days before menstruation. [1]

Before menstruation, the ovaries stop producing oestrogen, which results in an overall large drop in the body’s oestrogen content. This also causes our serotonin to dip.

“oestrogens, are responsible for the synthesis and secretion of neuropeptides and neurotransmitters, including serotonin. When oestrogen levels fall, production of serotonin is reduced,” [3] – Dr Calhoun in Headache: The Journal of Head and Face Pain.

[2]

Understanding Serotonin and Its Regulation of the Brainstem

Serotonin, often referred to as the “feel-good” neurotransmitter, is not only responsible for regulating mood and emotions but also plays a crucial role in various physiological processes.

Serotonin acts as a natural pain inhibitor within the brainstem. It effectively ‘closes the pain gate’, allowing for better pain control.

Moreover, serotonin is involved in regulating sleep patterns, mood, appetite, and other bodily functions that intersect with migraine triggers.

Connecting the Dots: Serotonin’s Impact on Menstrual Migraines

When oestrogen levels drop before menstruation, it triggers a chain reaction that involves the brainstem’s serotonin pathways. This leads to increased sensitivity to pain signals, contributing to the throbbing, severe headaches associated with menstrual migraines.

So why is it that you get menstrual migraines and others don’t?

Several factors can contribute to the sensitivity of the brainstem to pain signals, which then leads to vulnerability to headaches and migraines. These factors vary among individuals.

However, Hormones are only part of the picture:

90% of women impacted by menstrual migraine also experience attacks at other points in time, meaning that it is not purely hormonal [1].

This means that there are other factors involved in the sensitisation of the brainstem, such as:

Inflammation

Inflammatory processes such as infections and autoimmune conditions such as gluten intolerance, irritable bowel syndrome, and polycystic ovarian syndrome can increase the production of histamines within the blood, which sensitise nerve pathways and lead to increased sensitivity to pain signals in the brainstem.

Sleep Disturbances

Poor sleep patterns or lack of sleep can affect pain modulation. Sleep disturbances can lead to increased sensitivity of the brainstem and heightened pain perception.

Cervical Spine Dysfunction

The cervical spine, comprising the first seven vertebrae in the neck, provides structural support for the head while allowing a wide range of motion. The first three vertebrae in this region are particularly significant due to their direct interaction with the brainstem.

Dysfunctional neck structures overload the brainstem with noxious information, leading to a state of sensitisation. This heightened sensitivity contributes to the worsening of headache or migraine symptoms.

Managing Menstrual Migraines

Menstrual migraines can be uncomfortable and may even stop you from doing the things you love. Fortunately, there are a number of things you can try to reduce their frequency and severity.

Lifestyle Modifications – Lifestyle changes like regular exercise and avoiding inflammatory foods such as gluten and refined sugars can help decrease your vulnerability to migraine.

Sleep Hygiene – Prioritising adequate sleep is crucial, as disruptions in sleep patterns can affect serotonin production.

Posture – Try sitting upright with your ears aligned with the shoulder and the shoulder aligned with the hip and avoid lifting with an outstretched neck. This can reduce your risk of cervical dysfunction particularly if most of your day is spent sitting at a desk or lifting from the floor.

Conclusion

Menstrual migraines can be a challenging aspect of a woman’s life, but with the right strategies, they can be effectively managed. It’s essential to work closely with a healthcare provider to identify triggers, develop a management plan, and explore treatment options. By understanding the underlying causes, tracking patterns, and making necessary lifestyle adjustments, women can gain better control over their menstrual migraines and improve their quality of life.

How Our Team Can Help

Our team understands that headaches are more than just a surface annoyance; they often stem from the intricate connection between your neck and brainstem. With a deep understanding of this connection, our skilled clinicians conduct thorough assessments to uncover the root causes of your headaches.

Through targeted manual therapy techniques, we address neck dysfunction, correct imbalances, and alleviate brainstem sensitivity – all while providing immediate feedback for real-time adjustments.

Step into a future where headaches no longer dictate your schedule. Let us help you unlock a life free from the grip of headaches.

References

1. “Review: Menstrual migraine: therapeutic approaches – SAGE Journals.”

2. “How does your mood change across your menstrual cycle? | Jennis.”

3. “Understanding Menstrual Migraine – Calhoun – 2018 – Headache.”

Jaw pain can affect far more than your jaw.

For many people, it shows up as a dull ache through the face, tightness around the temples, headaches, clicking when chewing, or a jaw that feels stiff or difficult to open. It may also come with teeth grinding at night, tension through the neck, or the sense that your jaw simply does not move the way it should.

These symptoms are often linked to TMD, also known as temporomandibular disorder. Many people call it “TMJ”, but that is actually the name of the joint itself. The temporomandibular joint, or TMJ, is the joint that connects your jaw to your skull. When that joint, and the muscles and nerves around it, are not functioning well, it can lead to ongoing pain and dysfunction.

At The Headache Clinic, we are experts in complex conditions involving the head, neck and jaw. That means we look deeper than the obvious symptom. If your jaw is painful, tight, clicking, locking, or contributing to headaches, we focus on finding the true driver of the problem and treating it with precision.

What is TMD?

Temporomandibular disorder (TMD) is a condition affecting the jaw joint and the muscles that control jaw movement. It can cause pain, stiffness, restricted movement, and a range of symptoms through the face, head and neck.

Because the jaw is used constantly for talking, chewing, swallowing and yawning, even mild dysfunction can become highly disruptive. For some people, symptoms come and go. For others, they become persistent and start to affect sleep, eating, concentration and quality of life.

Common symptoms of TMD:

TMD can present in different ways, but common symptoms include:

- Jaw pain or tenderness, often around the joint or muscles
- Clicking, popping, or grinding sounds with jaw movement
- Difficulty opening the mouth fully or reduced range
- Jaw locking, catching, or stiffness
- Pain when chewing, talking, or prolonged mouth use
- Facial pain or a sense of pressure
- Headaches, particularly through the temples
- Clenching or grinding of the teeth, especially at night
- Neck pain and increased muscular tension
- Pain around the ear or a feeling of tightness through the side of the face

In many cases, people do not initially realise their headaches or facial pain could be coming from the jaw.

Why does TMD happen?

TMD rarely has one single cause. More often, it develops because several factors combine over time and place ongoing strain on the jaw joint and surrounding muscles.

Common contributors include:

- Stress and tension
- Teeth clenching or grinding, also called bruxism
- Excessive gum chewing
- Previous jaw injury
- Joint irritation or arthritic change
- Muscle tension through the jaw, face and neck
- Poor coordination between the jaw and upper neck

This is why generic advice does not always work. A mouthguard may help protect the teeth. Resting the jaw may ease symptoms briefly. But if the underlying dysfunction is still there, the pain often returns.

Why jaw problems often trigger headaches

The jaw, head and upper neck are closely connected. When the jaw is not moving properly, the surrounding muscles often become tense and overworked. This can refer pain into the temples, cheeks, behind the eyes and into the head.

For some people, this creates a repeating cycle. The jaw becomes tight, headaches become more frequent, the neck stiffens, and clenching increases, especially during sleep or times of stress.

That is why effective treatment needs to look beyond the jaw alone.

Why TMD is often missed or poorly treated

TMD is common, yet it is often not treated in a truly specialised way.

Many people are told to avoid chewy foods, wear a splint, or do a few basic exercises. While those strategies can sometimes help, they may not resolve the deeper issue if the real problem involves joint restriction, muscle dysfunction, neural irritation, or an associated neck problem.

This is where a more skilled and targeted approach can make all the difference.

At The Headache Clinic, treating jaw disorders is not an afterthought. It is part of our niche with complex head, neck and facial conditions.

Our approach to TMJ and TMD treatment

We provide a expert hands-on physiotherapy approach for people experiencing jaw pain, clenching, grinding, restricted movement and jaw-related headaches.

Your treatment is tailored to the structures actually involved in your symptoms. Depending on your presentation, this may include:

- Targeted treatment to the jaw joint
- Hands-on therapy for the surrounding muscles
- Treatment of associated neck dysfunction
- Careful work around facial and neural tension
- Restoring normal jaw movement and control
- Reducing the cycle of stiffness, overactivity and clenching
- Our aim is not simply to help you cope.

Our goal is to improve how the jaw and surrounding system function, so you can get lasting relief and return to eating, speaking and moving comfortably.

Book now

Is clenching and grinding a sign of TMD?

It can be.

Clenching and grinding often place significant load on the jaw joint and the muscles around it. Over time, this can lead to soreness, restricted movement, facial tension, worn teeth and headaches, especially on waking.

For some people, clenching is the main driver. For others, it is part of a broader pattern involving the jaw, neck and nervous system. Either way, it is worth assessing properly rather than simply assuming a night guard will solve it.

When should you seek treatment for jaw pain?

ou should consider an assessment if you have:

- Persistent jaw pain or tightness
- Clicking or locking of the jaw
- Difficulty opening your mouth fully
- Pain when chewing
- Frequent headaches with facial or temple tension
- Teeth grinding or clenching at night
- Ongoing symptoms that are not improving

You do not need to wait until symptoms become severe. Early treatment can often prevent the problem becoming more entrenched.

Why patients choose The Headache Clinic

People come to us because they want more than temporary relief.

They want a clear explanation of what is going on, a clinician who understands the connection between the jaw, head and neck, and a treatment plan that is specific to them.

At The Headache Clinic, we combine clinical expertise with a careful, hands-on approach that is designed to uncover and address the true cause of your symptoms. For patients with TMD, that often means finally feeling understood after months or even years of frustration.

Book a TMJ assessment

If you are dealing with jaw pain, clicking, clenching, grinding, headaches or restricted jaw movement, we are here to help.

Book your assessment today and take the first step towards a more comfortable jaw, fewer headaches, and relief that lasts.

Book now

Reasons you get migraines before your menstrual cycle (and others don’t)

Reasons you get migraines before your menstrual cycle (and others don’t)

How Our Team Can Help

What is TMD?

Common symptoms of TMD:

Why does TMD happen?

Why jaw problems often trigger headaches

Why TMD is often missed or poorly treated

Our approach to TMJ and TMD treatment

Is clenching and grinding a sign of TMD?

When should you seek treatment for jaw pain?

Why patients choose The Headache Clinic

Book a TMJ assessment

Reasons you get migraines before your menstrual cycle (and others don’t)

Dealing With Concussion

When Colic and Reflux Take Over: Understanding Infantile Colic and How to Find Relief