--- title: "Migraine and hormones" description: "How periods, pregnancy and menopause can affect migraine, why aura matters for contraception, and which symptoms need urgent help." url: "https://myruva.co/learn/migraine-and-hormones" language: "en-GB" topic: "Wellbeing" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 4 --- # Migraine and hormones How periods, pregnancy and menopause can affect migraine, why aura matters for contraception, and which symptoms need urgent help. *Written and reviewed by the Ruva team · Updated 2026-10-19 · Wellbeing* ## Key points - Migraine around a period can last longer and be worse than attacks at other times. - Migraine with aura affects whether combined hormonal contraception is suitable. - A headache diary can help a clinician look at patterns and triggers. - Sudden signs of a stroke need emergency help, even if they stop. Migraine attacks just before or during a period can last longer and be worse than attacks at other times. They’re often called menstrual migraines. A link with your periods is worth talking about, especially if attacks are disrupting your plans or getting hard to control. ## Hormones are part of the picture No one knows exactly how migraine and the menstrual cycle are linked. A fall in oestrogen and progesterone around the start of a period may trigger an attack. Many people who get migraine around their periods also get attacks at other times. Include both in a diary. Migraine can bring throbbing head pain, feeling or being sick, and sensitivity to light or sound. Some people also get an aura. This means warning signs such as flashing lights, zigzag lines or tingling. Describe what happens rather than assuming that any change in your vision is an aura. ## Aura changes the contraception conversation If you’ve ever had a migraine aura, tell whoever prescribes your contraception. The NHS lists it among conditions that can make the combined pill unsuitable. ACOG says combined hormonal contraception shouldn’t be used if you have migraine with aura. This includes the pill, patch and ring. This advice is about the risk of stroke. CDC guidance describes a higher risk of ischaemic stroke (a stroke caused by a blocked blood vessel) with the combined pill, and also with migraine aura. New headaches, or a big change in your headaches, also need checking. Ask your prescriber which other method would suit you. If you think you may have started getting aura while using a combined method, contact your prescriber soon for advice on what to do next. Ask how to stay protected from pregnancy while another method is arranged. Changes to prescribed contraception need a plan from a clinician. Sudden symptoms affecting your nerves or brain need the emergency response below. ## Pregnancy and menopause can change attacks Migraine sometimes gets better during pregnancy, and often gets better after menopause. But some people find migraine gets worse or starts around menopause. Talk to your clinician about a changing pattern, even if you think hormones explain it. Ask your doctor to review your migraine treatment if you’re pregnant or planning a pregnancy. If you’re breastfeeding, ask which medicines are suitable then too. A migraine attack during pregnancy or soon after birth needs urgent advice, even if you’ve had migraine before. ## What to put in a migraine diary Write down when the headache started, what was happening around then, and your period dates. Include attacks outside your period. A migraine diary can help you look at triggers and the link with bleeding. It gives you and your clinician a record to talk about. You might also note how the attack affected work or sleep, any changes to your vision or senses, and what treatment you used. A short description in your own words is enough to start. Ask the clinician what other details would help them look at the pattern. Treatment can include medicines for an attack, such as triptans or medicines for feeling sick, and medicines to help prevent attacks. Your pharmacist, GP or doctor can advise which suit you. Regular meals, drinking enough and sleep are among the habits the NHS suggests alongside treatment. ## When to get urgent help Call 999 now (UK), 911 (US), or your local emergency number for sudden drooping of the face, weakness in an arm or leg, or problems speaking, or a sudden, extremely painful headache. Call too for a headache with loss of vision, blurred or double vision, drowsiness, confusion, a seizure (fit), a very high temperature with a stiff neck, or after a recent head injury. Get help even if the stroke signs stop. Don’t wait to see how long the aura lasts. Don’t assume these symptoms are your usual migraine. Contact your maternity unit now (UK), your obstetric team (US), or your local maternity service elsewhere for a severe headache that won’t go away, changes to your eyesight, pain below the ribs, or sudden swelling of your face, hands or feet during pregnancy or after birth. In the UK, call NHS 111 now if you’ve recently given birth or can’t reach your maternity unit. Elsewhere, get urgent medical help now if maternity care isn’t available. Don’t wait until tomorrow. The emergency signs above come first. Ask for an urgent GP appointment or call NHS 111 in the UK, contact your doctor or urgent care in the US, or your local urgent care service elsewhere if an attack lasts longer than 72 hours, an aura lasts longer than 1 hour, or you have an attack during pregnancy or soon after birth. For migraine that’s getting worse or hard to control, or attacks that often come with your periods, book a GP appointment in the UK or see your doctor in the US or elsewhere. Bring your diary and the names of your medicines and contraception. ## When to get help - **Emergency:** Call 999 now (UK), 911 (US), or your local emergency number for sudden drooping of the face, weakness in an arm or leg, or problems speaking, or a sudden, extremely painful headache. Call too for a headache with loss of vision, blurred or double vision, drowsiness, confusion, a seizure (fit), a very high temperature with a stiff neck, or after a recent head injury. Get help even if the stroke signs stop. Don’t wait to see how long the aura lasts. - **Same day:** Contact your maternity unit now (UK), your obstetric team (US), or your local maternity service elsewhere for a severe headache that won’t go away, changes to your eyesight, pain below the ribs, or sudden swelling of your face, hands or feet during pregnancy or after birth. In the UK, call NHS 111 now if you’ve recently given birth or can’t reach your maternity unit. Elsewhere, get urgent medical help now if maternity care isn’t available. Don’t wait until tomorrow. - **Same day:** Ask for an urgent GP appointment or call NHS 111 (UK), contact your doctor or urgent care (US), or your local urgent care service elsewhere if a migraine attack lasts longer than 72 hours, an aura lasts longer than 1 hour, or you have a migraine attack while pregnant or soon after a birth. - **Book an appointment:** Book a GP appointment (UK) or see your doctor (US or elsewhere) for migraine that is getting worse, is hard to control, or often comes with your periods. Tell whoever prescribes your contraception if you’ve ever had aura. ## Where you live Services and advice differ between countries. - **UK:** NHS advice flags migraine with aura when checking whether the combined pill suits you. A migraine attack during pregnancy or soon after birth needs urgent advice. The emergency and maternity advice above comes first. - **US:** ACOG says combined hormonal contraception shouldn’t be used if you have migraine with aura. Talk to your prescriber about other options. Call 911 for sudden signs of a stroke. - **Elsewhere:** Elsewhere, ask your clinician about local contraception advice and how to get urgent care. Use your local emergency number for signs of a stroke. ## Sources 1. [Migraine](https://www.nhs.uk/conditions/migraine/), NHS 2. [Migraine](https://womenshealth.gov/a-z-topics/migraine), Office on Women's Health 3. [Combined Hormonal Birth Control: Pill, Patch, and Ring](https://www.acog.org/womens-health/faqs/combined-hormonal-birth-control-pill-patch-ring), American College of Obstetricians and Gynecologists 4. [Who can take the combined pill](https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/who-can-take-it/), NHS 5. [Appendix D: Classifications for Combined Hormonal Contraceptives](https://www.cdc.gov/contraception/hcp/usmec/combined-hormonal-contraceptives.html), Centers for Disease Control and Prevention 6. [Symptoms of a stroke](https://www.nhs.uk/conditions/stroke/symptoms/), NHS 7. [Meningitis](https://www.nhs.uk/conditions/meningitis/), NHS 8. [Pre-eclampsia](https://www.nhs.uk/conditions/pre-eclampsia/), NHS --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.