Why do I have a headache before my period? I should pay attention to headaches during my period.

Many women experience headaches before their period. This pain may persist during or after their period. The most common cause is physiological reasons. Sometimes it may also cause vomiting and nausea. If this happens frequently, timely treatment is required.

1. Reasons

Why is the menstrual cycle related to headaches? Clinical studies have shown that this may be related to changes in the concentration of estradiol (a female hormone) in serum. Due to the physiological characteristics of women, the concentration of estradiol in serum decreases before and after menstruation, causing intracranial and extracranial blood vessels and uterine blood vessels to be more sensitive to certain factors such as serotonin and other substances, thereby causing changes in vascular tension and causing headaches in some patients who are sensitive to this. After menstruation, the concentration of estradiol in serum returns to normal and the patient's headaches can also be relieved. There is another possibility that estrogen (including estradiol) can stimulate the secretion of prolactin, thereby directly or indirectly stimulating the secretion of prostaglandins. Prostaglandins act on blood vessels, causing vascular contraction and dilation. This change also shows cyclical changes due to the influence of estrogen, thereby triggering headache attacks.

2. Clinical symptoms

Menstrual headaches are migraines that occur during menstruation. Migraine headaches are characterized by throbbing pain on one side of the head that lasts from a few minutes to an hour and gradually intensifies until nausea and vomiting occur, at which point the pain will begin to improve. The headache is relieved in a quiet, dark environment or after sleep. Neurological and mental dysfunction may occur before or during a headache. According to studies, migraine sufferers are more likely to suffer local brain damage, which can lead to stroke, than ordinary people. The more migraines they have, the larger the area of ​​the brain that is damaged.

The diagnosis is not difficult if there is a long history of recurrent headaches, normal intervening periods, a normal physical examination, and a family history of migraine. Ophthalmoplegia can be caused by aneurysms, and arteriovenous malformations can also be associated with migraines. A head CT scan or cerebral angiography should be performed to confirm the diagnosis. Complex migraine is often caused by organic disease and should be evaluated by neuroimaging. Occipital or temporal lobe tumors may also cause visual field defects or other visual symptoms in the early stages, but as the disease progresses, symptoms of increased intracranial pressure may eventually appear. Temporal arteritis should be excluded in elderly people with temporal-occipital headaches. The superficial temporal artery or occipital artery may become rope-like in thickness, with significantly weakened or absent pulsations, and characteristic multinucleated giant cell infiltration may be seen on arterial biopsy.