Headache and premenstrual syndrome: what to know

PMS symptoms appear in the days before menstruation and may include headache, mood changes, breast tenderness, bloating, or tiredness. A headache that repeatedly begins before bleeding and improves after the period starts may fit a menstrual pattern, although migraine and tension-type headache can also occur at this time. Tracking timing, sleep, meals, fluids, stress, bleeding, and other symptoms helps a clinician distinguish patterns and identify triggers.

Keep meals regular, drink enough fluid, protect your sleep routine, and use gentle movement if it feels comfortable. Rest in a quiet, dim room during a more intense episode. A pharmacist or clinician can advise whether an appropriate pain medicine is suitable for you, especially if you are pregnant, have another condition, or take other medicines. Record what you take and whether it helps; avoid using pain medicines more often than directed.

Arrange medical advice if headaches are new, becoming more frequent, disrupting daily life, or changing in character. Seek urgent care for a sudden severe headache, new weakness or numbness, trouble speaking, confusion, fainting, seizure, fever with a stiff neck, vision loss, or a severe headache after a head injury. Headache with very high blood pressure or during pregnancy also needs prompt assessment.

Could this pattern be PMS, migraine, or another type of headache? What should I record in a symptom diary? Which medicines are safe with my health conditions and current medicines? Could hormonal contraception affect the pattern?