Like clockwork, a day or two before your period, the headache arrives. If that pattern sounds familiar, your hormones are very likely involved.

These are often called menstrual or hormonal migraines, and the trigger isn't high oestrogen, it's the sudden fall in oestrogen that happens in the late luteal phase, right before bleeding starts. The brain is sensitive to that drop, and for some women it sets off a migraine or a stubborn headache. It's the same reason migraines can flare in the unpredictable hormone swings of perimenopause, and why they sometimes ease in the steadier hormonal state of pregnancy or after menopause.

How to tell if yours are hormonal: track them for two or three cycles alongside your period. A clear clustering around the days before or during your bleed is the giveaway. (This tracking is also exactly what a doctor needs to see.)

What tends to help:

• Smoothing the drop. Because the trigger is a steep oestrogen fall, anything that keeps your system steady in that window helps. Some women benefit from specific timing of treatments around their period, which a doctor can advise on.
• The migraine basics, which matter more around your vulnerable days: regular sleep, regular meals (don't skip), hydration, managing stress, and easing back on known triggers like alcohol.
• Medical options. Standard migraine treatments work, and there are preventive and timed approaches for cyclical migraine. A doctor can tailor these.

One important safety note: if you have migraine with aura (visual disturbances, flashing lights, or other neurological symptoms before the headache), tell your doctor before using oestrogen-containing contraception or HRT, as the right choice depends on it.

You don't have to brace for an ambush every month. Once you can see the pattern, you can start to get ahead of it.

Common questions

Why do I get headaches before my period?

The sharp drop in oestrogen just before your period can trigger headaches and migraines in sensitive women.

Do hormonal migraines stop after menopause?

For many women they ease once hormones stabilise after menopause, though the perimenopausal years can be bumpy first.

Related reading: Your cycle, phase by phase · PMS or something more? · Take the free Hormone Quiz