Headache on the first day of your period

The hormone shift around menstruation can trigger migraine or a tension-type headache in some people. Migraine may bring throbbing pain, nausea, or sensitivity to light and sound; tension-type pain often feels like pressure. Poor sleep, missed meals, dehydration, stress, and caffeine changes can add to the discomfort.

A period-linked pattern is more likely when the headache starts at a similar point in several cycles and settles as the period progresses. A new pattern, a markedly different pain, or headache outside the menstrual cycle deserves a separate assessment.

Keep a cycle and headache diary: record the start of bleeding, pain location, severity, nausea, light sensitivity, sleep, meals, fluids, and medicines. Eat regular meals, drink fluids, rest in a quiet dim room, and try a cool pack on the forehead or neck.

A pharmacist or clinician can advise on a suitable pain reliever and timing. Check first if you are pregnant, have stomach ulcers, kidney disease, liver disease, asthma triggered by medicines, or take blood thinners. Follow the package directions and avoid frequent self-treatment without review.

Get emergency help for a sudden severe headache, fainting, confusion, new weakness or numbness, difficulty speaking, seizure, fever with a stiff neck, or new vision loss. Seek prompt care for repeated vomiting, a headache after head injury, or pain that is steadily worsening. Book a review if period headaches disrupt activities or are not controlled with your usual plan.

Does my pattern fit menstrual migraine or another headache type? Could my medicines or contraception affect it? What prevention plan should I use before the next period, and which symptoms would change the urgency?