How Stopping My Periods Affected My Migraine Attacks

With my doctor’s support, I started taking GnRH analogues to stop my periods. My menstrual migraine attacks stopped altogether.

Like many who live with migraine, I’ve identified a number of triggers over the years: hot weather, stress, dehydration, hunger, oversleeping — even cheese!

As I grew up, migraine became even more chronic in tandem with the development of other health conditions like postural orthostatic tachycardia syndrome (POTS) and ulcerative colitis (UC).

One trigger became the worst and most glaringly obvious of them all: my menstrual cycle.

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Migraine and menstruation

More than half of women with migraine report a link between their periods and migraine. This is likely due to the hormonal changes experienced during different parts of the menstrual cycle.

The main culprit? The drop in estrogen that occurs just before your period starts. This drop also occurs just after ovulation, meaning that some people experience migraine attacks at both these times — myself included.

I experienced intense migraine episodes every month, both after I ovulated and 2 days before every period started. These migraine attacks were always my worst kind, not that any migraine is the good kind. The usual abortive medication I’d use for other migraine attacks, like pain relievers and triptans, couldn’t even take the edge off.

These types of migraine attacks are usually classified as “menstrual migraine.” This term describes migraine episodes triggered by the drop in estrogen before your period, defined by the time they occur: from 2 days before to 2 days into your period. 

They’re often more severe, more prolonged, and more difficult to get rid of compared to other attacks.

Looking for relief

The first thing I did was speak with my primary care practitioner. They advised me to take a different kind of triptan. Triptans are abortive medications that reduce migraine attacks by dampening down overactive, inflamed nerves and constricting blood vessels.

Most triptans have a very short half-life of around 2 to 4 hours. This means that their duration of action is short. 

This led me to overuse triptans, which are only meant to be used for 10 days of the month to prevent medication overuse headache. However, my menstrual and ovulation migraine attacks were lasting longer than that, and I was still experiencing other migraine episodes during the month. Sometimes I’d take triptans for 10 or 11 days to stop the agony.

Then I tried a triptan with a 26-hour half-life. It’s often prescribed specifically for menstrual migraine for this reason.

Unfortunately, it didn’t work.

However, I still use it over the shorter-acting triptans because I experience far fewer side effects from it, like drowsiness, chest tightness, and dizziness. 

Finding a new option

As well as living with chronic migraine and various other health issues, I also have premenstrual dysphoric disorder (PMDD).

PMDD is a more severe form of premenstrual syndrome, associated with an exaggerated response to hormonal fluctuations during the luteal phase, or the second half of the menstrual cycle.

Symptoms of PMDD are both physical and mental and can include:

• changes in mood
• feeling upset or tearful
• feeling suicidal
• feeling anxious
• feeling angry
• difficulty concentrating
• muscle and joint aches
• headaches
• bloating
• sleep issues

These became severely debilitating for me, in particular the body aches, suicidal thoughts, and headaches/migraine attacks I was experiencing during my luteal phase.

There are a variety of treatment options for PMDD. These include antidepressants, the combined birth control pill, pain relievers, and talk therapy.

Having gone through these treatments and realizing that they were either ineffective or incompatible for me, it was agreed that I’d try a GnRH analogue to target the hormonal triggers of migraine.

How GnRH analogues work

GnRH analogues are usually given in injection form every month or every 3 months.

They work by blocking the release of the gonadotropin releasing hormone (GnRH). This hormone is responsible for triggering the release of the luteinizing hormone (LH) and the follicle stimulating hormone (FSH), which signal to the ovaries to ovulate and create estrogen and progesterone.

When GnRH is blocked by an analogue, this process cannot occur and ovulation stops.

GnRH analogues come with a variety of side effects similar to experiencing menopause due to the constant low estrogen. The most concerning of these is a thinning of the bones. People who are given this drug need to take replacement hormones in the form of hormone replacement therapy (HRT) to ensure they have some estrogen in their bodies.

My experience

Deciding to trial a GnRH analogue wasn’t an easy decision. 

I went through all the other treatments, (including HRT regimens for PMDD) over the course of around 2 years before I decided to try it.

I knew I’d likely have to cope with menopausal type symptoms and that my fertility would also be impacted. While I have no particular plans to have children, this still felt strange. There’s a difference between making a decision because you want to and having that decision taken away from you.

Nevertheless, considering how badly both my PMDD and menstrual migraine were impacting my life, I knew it was in my best interest to give it a try.

I had my first GnRH analogue injection in April 2024. The analogues reportedly take up to 8 weeks to work, so I was aware that I might menstruate the first few months regardless.

However, 4 weeks came, and I didn’t have a period!

I’ve had the injection twice now, and I haven’t had a period since the first one.

How did it affect my migraine attacks?

At first, my migraine attacks were worse. This was something that concerned me, but in truth, I wasn’t completely surprised. After all, with each injection, a series of hormonal fluctuations occur that cause an initial surge and then a sudden drop in estrogen and progesterone.

I also experienced side effects involving low estrogen levels from the drug — namely, hot flashes. This is something I still experience even now.

But to me, it’s been worth it.

Migraine is a disease — a health condition with multiple triggers. Taking my periods away has been the equivalent of eliminating one major trigger.

Does that mean my migraine attacks are gone? Absolutely not. I still experience chronic migraine all the time. My other triggers still cause them to appear pretty easily. I still take triptans, and I’m still waiting to try preventive treatment for migraine, like Botox and CGRP inhibitors. 

However, my menstrual migraine episodes are gone.

There have been times I’ve forgotten to apply my estrogen HRT for a day or 2 (in a gel form) and suddenly been hit with an awful, excruciating migraine attack, only for me to realize what happened.

It just shows how a drop in estrogen can trigger migraine attacks for me.

What’s more? My PMDD is also gone, as long as I consistently take my HRT.

One of my biggest wins is that I haven’t experienced any suicidal thoughts since I’ve been on the GnRH analogue. I realized that last month and I feel very grateful.

The takeaway

Hormonal changes are extremely powerful and can impact people in different ways. For me, my PMDD and severe menstrual migraine episodes encouraged me to try a GnRH analogue to stop my periods. It’s a decision I don’t regret at all, and I hope to stay on this treatment as long as possible.

While the analogues didn’t take away my chronic migraine attacks, they eliminated the most excruciating of them.

From a mental health perspective, this drug may have just saved my life.

If you relate to my experience, it may be a good idea to talk with your doctor about exploring options like these.