Look for a pattern
A diary that includes the menstrual cycle can help identify whether attacks cluster around hormonal changes. Patterns can change through contraception, pregnancy, postpartum, perimenopause and menopause.
Why cycle tracking is more useful than memory
A single difficult period does not prove a menstrual migraine pattern. Recording migraine days alongside cycle timing over several months makes it easier to see whether attacks repeatedly cluster around the same hormonal window.
Perimenopause can make patterns less predictable
Hormonal fluctuation can become more variable through perimenopause, so a previously reliable monthly pattern may become less obvious. Tracking remains useful even when cycles become irregular.
Aura status matters in hormonal discussions
Tell a prescriber if you experience migraine with aura. Migraine type and other vascular risk factors can affect the discussion around oestrogen-containing contraception or hormone therapy.
Discuss treatment with a clinician
Treatment choices depend on migraine type, aura status, other health risks and reproductive plans. Hormonal treatment is not appropriate for everyone.
Understanding menstrual and hormonally influenced migraine
This page explains the recognised pattern associated with menstrual and hormonally influenced migraine and where it sits among migraine and headache disorders. Headache conditions can overlap, and the same person can experience more than one headache pattern.
How clinicians separate headache patterns
Diagnosis usually depends on the history: frequency, duration, pain features, associated symptoms, neurological symptoms, autonomic symptoms, medication use and examination. Imaging or other tests may be used when another cause needs to be considered; there is not one scan or blood test that proves migraine.
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