What Causes Hormonal Headaches?

Written by Sarah Gleim, WebMD Editorial Contributor
Medically Reviewed by Zilpah Sheikh, MD on February 24, 2025
10 min read

Certain types of headaches are linked to changing levels of hormones in your body, including estrogen and progesterone.

Some people get menstrual migraines. These may happen anywhere from two days before their period to three days after it starts. But periods aren’t the only trigger for hormonal headaches. Anything that leads to changes in these hormone levels could trigger or worsen hormonal headaches.

How serious hormonal headaches are in both men and women depends on how much their hormone levels change.

Hormonal headaches are headaches, usually migraines, that are caused or worsened by changing levels of estrogen and progesterone. These hormones are involved in controlling menstrual cycles and pregnancy. But they also affect chemicals in your brain that affect pain sensations.

Among the causes of hormonal headaches are pregnancy, menopause, certain medications, and your period.

What are menstrual migraines? 

A type of hormonal headache, menstrual migraines are headaches that hit just before or during your period. You get them because levels of estrogen and progesterone drop just before your period begins.

Hormonal headaches are tied to higher levels of female hormones. Before puberty, boys get more headaches than girls, according to research focused on cisgender people (those who identify as the gender they were assigned at birth). After puberty, females are more likely to get headaches. This difference lasts until after menopause.

Women are about three times more likely than men to have migraines. About 60% say there’s a connection between their migraine headaches and their periods.

One small study found that men who got migraine headaches had higher levels of an estrogen called estradiol than men who didn’t have migraines.

Anyone who takes certain hormone medications, such as birth control pills or hormone replacement therapy, can get a hormonal headache.

In addition to your menstrual cycle, these things can cause hormonal headaches:

Birth control. Some hormonal forms of birth control, including the pill, make headaches worse for some people and lessen them for others. Three weeks out of every month, they keep the hormones in your body steady. When you take placebo pills or no pills at all during the week of your period, your estrogen levels plummet and your head can pound.

Perimenopause. In the years before menopause, estrogen levels go on a roller-coaster ride. You may have both tension headaches, which result from stress, and migraines during this time. Once you’re in menopause (you stop having periods for good), you’ll probably have fewer migraines. But tension headaches often get worse.

Hormone replacement therapy. The type of medicine some people take during menopause to control their hormones, or as part of gender-affirming care, can also set off headaches.

Oophorectomy. This is surgery to remove your ovaries, sometimes done along with a hysterectomy or with gender-affirming therapy. Removing the ovaries causes a drop in estrogen levels right away, which may lead to headaches.

Pregnancy. During the first trimester, estrogen levels rise quickly, then level out. Because of this, you may notice your migraines get better or go away after your third month of pregnancy.

Childbirth. Once you give birth, your estrogen levels drop. This can trigger headaches. So can the sleep disruptions and stress that come with caring for a newborn.

A hormonal migraine is much like any other type of migraine. Symptoms may include:

  • Aura before the headache (not everyone gets this)
  • Throbbing pain on one side of your head
  • Appetite changes (loss or increase)
  • Sensitivity to light, sound, and smells
  • Chills
  • Sweating
  • Pale skin
  • Sore or sensitive scalp
  • Belly pain
  • Blurry vision
  • Dizziness
  • Head pain
  • Peeing less
  • Lack of coordination
  • Cravings for chocolate, salt, or alcohol

Where are hormonal headaches located?

Hormonal headaches usually cause pain on one side of your head, such as your forehead. But you may also feel pain in other spots on your head or neck. The pain location and intensity vary for everybody.

To figure out what’s causing your headaches, your doctor will ask you about your symptoms, as well as when and how often you get headaches. They may do a physical exam and tests to rule out other conditions that could cause your symptoms.

No one test can diagnose migraines or hormonal headaches, so it can be hard to figure out exactly what’s causing them. Often, the cause of migraines and other headaches is a combination of things, such as hormones, stress, and sleep loss, among other triggers.

Keeping a headache diary might help you and your doctor figure out whether hormones are causing your headaches. You can track your symptoms, menstrual cycles, mood, and more. A pattern may emerge that gives you clues about whether your headaches are hormone-related.

Treatment for your headaches will depend on how serious they are, as well as your general health.

Hormonal headache treatments 

An over-the-counter nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen, may be enough to stop either a premenstrual syndrome (PMS) headache or a hormonal migraine. Your doctor can prescribe stronger NSAIDs. Many treat period cramps as well as headaches.

If you’re on hormonal birth control and prone to migraine headaches, switching to birth control containing low amounts of estrogen or only progestin may help.

If you’re having pregnancy-related headaches, talk to your doctor before you take any drugs. Many migraine medicines are bad for your baby. An over-the-counter pain reliever like acetaminophen should be safe, but ask your doctor first.

Many headache medications are safe while you’re nursing, including acetaminophen, ibuprofen, naproxen, and sumatriptan. But always check with your doctor before you take one.

If you think hormone therapy is making your headaches worse, your doctor may lower the dose, advise you to stop taking it, or change to a different type. An estrogen patch or vaginal ring may be a better option than pills. It keeps your estrogen level steady, lowering the chances of a migraine.

If you’re having surgery to remove your ovaries, your doctor can prescribe an estradiol patch to keep estrogen levels stable and prevent migraines. Or you could take a preventive migraine medication.

Menstrual migraine treatment

Your doctor may suggest the same therapies for menstrual migraines as for other types of migraines.

Abortive migraine medications

When it comes to medications, there are now better options for treating a menstrual migraine once it begins. Those classified as “rescue” medications (which stop headaches after they start), include:

  • NSAIDs, the most common treatment for menstrual migraines. You can also take these short-term to help prevent menstrual migraines. Start taking them two to three days before you get your period, and keep taking them until it ends.
  • Triptans or ditans, which start to work as soon as two hours after you take them. You may take both an NSAID and a triptan. If your periods are regular, you can also use triptans or ditans to prevent migraines. Start taking them a few days before your period, and continue for up to a week.
  • Ergotamine or dihydroergotamine drugs

Preventive medication for migraine

“Preventive” migraine medications are made to keep headaches from starting. You generally take these every day. Your doctor may recommend increasing the dose around the time of your period. They include:

  • Beta-blocker drugs
  • Anticonvulsant drugs
  • Calcium channel blockers
  • Some antidepressants

Certain birth control pills, estrogen patches, or vaginal rings may reduce how many menstrual migraines you have or make them less serious. But they don’t work for everyone. In some cases, they could worsen migraines.

Your doctor might tell you to stay on birth control for three to six months without taking any placebo pills. This will prevent you from having a period and may stop your headaches.

If you get migraines with auras, using birth control that contains estrogen and progesterone isn’t a safe option. It could make you more likely to have a stroke. Other reasons your doctor may not want you to take birth control for menstrual migraines:

  • A history of smoking
  • High blood pressure

If nothing else works for your menstrual migraines, your doctor may prescribe a drug called leuprolide acetate (Eligard, Lupron Depot). It drops the estrogen levels in your body, but it has side effects, so it’s often used as a last resort.

Migraine devices

Nerve stimulation devices may also help prevent or treat hormonal migraines. FDA-approved devices include:

  • Cefaly: A headband that sends electrical pulses through your forehead to stimulate a nerve linked with migraines
  • SpringTMS: A magnet that uses split-second pulses to interrupt the electrical activity that migraine brings
  • GammaCore: This handheld device sends mild electrical pulses to stimulate your vagus nerve and stop migraine pain
  • Nerivio: Uses conditioned pain modulation to stimulate your own body to release pain-relief signals (neurotransmitters)

Talk to your doctor about these options, especially supplements, which can affect the way other medications work:

Acupuncture 

This is an ancient Chinese practice that involves inserting needles along energy points in your body. It may lead to fewer tension headaches and could help prevent migraines.

Relaxation techniques 

These include progressive muscle relaxation, guided imagery, and breathing exercises. They can’t hurt, and some experts say they help with headaches. But there isn’t a lot of solid evidence.

Biofeedback 

Biofeedback may improve headaches by helping you monitor how your body responds to stress. It might help with both tension headaches and migraines. Doctors aren’t exactly sure why.

Massage therapy 

There’s some evidence that shows it can help ease migraines, but again, doctors aren’t exactly sure how it works.

Ice 

Hold a cold cloth or an ice pack to the painful area on your head or neck. Wrap the ice pack in a towel to protect your skin.

Butterbur 

An extract made from the rhizome or underground stem of this plant may lead to fewer, less serious migraines. Side effects may include belching and other mild tummy troubles. Choose supplements that are free of pyrrolizidine alkaloids, which can cause liver damage and cancer.

Coenzyme Q10 

This antioxidant, available as a supplement, may help prevent headaches.

Feverfew 

This herb may prevent migraines, but supplements can cause aches, pains, and mouth sores.

Limiting salt intake 

Eating too many salty foods could also lead to headaches. It’s wise to limit the amount of salt you eat around the time of your period.

Magnesium 

Low levels of this mineral can lead to headaches. Supplements may help. But they can give you diarrhea.

Riboflavin 

Also known as B2, this vitamin might help prevent migraines. It could also turn your pee an intense yellow.

How to make period headaches go away

Aside from preventive medications, certain healthy lifestyle changes may help keep hormonal headaches at bay. Aim for:

  • A consistent sleep schedule, in which you go to bed and get up at about the same time every day
  • Regular exercise (at least 30 minutes a day, three times a week)
  • Good hydration habits, such as drinking eight cups of water a day
  • Eating at regular times during the day and not skipping meals
  • Stress management, which could include relaxation techniques
  • Avoiding dietary triggers, such as alcohol and chocolate

If you have mild PMS headaches, you probably don’t need medical treatment. But if your hormonal headaches are very painful, frequent, or interfere with your life, consult your doctor.

Visit your doctor or a headache specialist if you’ve been living with hormonal migraines for a while and

  • Your migraine medication isn’t working.
  • You’re getting headaches more often.
  • Your migraine symptoms get worse.
  • Something else changes about your headaches, such as new symptoms or pain in a different location.

When to get emergency help

Call 911 or go to the emergency room if you have a sudden, very serious headache, especially if you also have any of these symptoms:

  • Trouble talking or understanding speech
  • Confusion
  • Sudden vision problems
  • Difficulty walking
  • Numbness or weakness on one side of your body
  • A stiff neck
  • High fever
  • Fainting

This type of headache could be a symptom of meningitis, encephalitis, or a stroke — serious conditions that need immediate medical attention.

Hormonal headaches are headaches you get during times when you have changing levels of the hormones in your body. They can be very painful and affect your quality of life. They mostly affect women, but anyone who takes certain hormone medications can get hormonal headaches. Keeping a headache diary can help you and your doctor figure out if hormones are the cause of your headaches, and find out the best way to treat them.

What role do hormones play in triggering headaches?

When you have major changes in your hormone levels, whether from your period or medications you take, it can trigger severe headaches. For example, period headaches are caused by changes in hormones like estrogen. 

What are the symptoms of hormonal headaches? 

Symptoms of a hormonal headache vary from person to person. Some of the most common ones include:

  • Throbbing pain on one side of the head
  • Nausea or vomiting
  • Sensitivity to light

Are there specific times during the menstrual cycle when headaches are more common?

Menstrual migraines can happen at any time during your period, but the most severe pain usually happens about three days before you start your cycle and can last through the few days of your menstrual cycle.