Progesterone and migraine: what to know

Migraine is a neurological condition that can cause head pain with nausea, vomiting, dizziness or sensitivity to light. Shifts in reproductive hormones, including progesterone, may change when attacks occur or how they feel. The same episode can also be influenced by missed meals, poor sleep, stress, dehydration, heat or illness.

A migraine pattern may include throbbing pain, worsening with routine activity, or a warning phase called aura. Vertigo and facial pain can occur with several conditions, so symptoms should be described rather than self-diagnosed. A new pattern deserves clinical review, especially after a medicine change.

At the first sign, rest somewhere quiet and dim, drink fluids, eat if you have missed a meal and follow your clinician's agreed migraine plan. Take prescribed acute treatment as directed; frequent use of pain medicine can itself make headaches harder to control. Keep a diary of progesterone timing, cycle stage, sleep, food, fluids, symptoms and any treatment used.

Speak with the prescriber before changing progesterone or starting a new hormonal product. A review can consider your migraine pattern, aura history, pregnancy plans and other medicines, then choose a safer plan for your circumstances.

Call emergency services for a sudden, extreme headache; new weakness or numbness; trouble speaking; confusion; seizure; loss of vision; or fainting. Seek urgent assessment for a severe first attack, repeated vomiting with inability to keep fluids down, fever with a stiff neck, or severe headache after head injury. During pregnancy or after childbirth, a severe or unusual headache also needs prompt review.

Could my attacks be linked to progesterone timing or another trigger? Do my symptoms suggest migraine with aura? Which treatments are suitable with my other medicines or pregnancy plans? What should I do if nausea or vomiting prevents me taking treatment?