Menstrual Headaches: How we can help to manage the cause, not just the pain

Sen Health
12 minutes ago
3 min read

Many women experience headaches or migraines before or during their periods, often accompanied by fatigue, mood changes, or nausea. These “cyclical headaches” can affect daily life and overall well-being.

Why Menstrual Headaches Happen

The female menstrual cycle can generally be divided into four phases:

Phase	Timing	Notes / Icon
Menstrual phase 🩸	Day 1–5	Period bleeding occurs
Post-menstrual phase 🌿	After menstruation until ovulation	Blood flow calm, body in “low-temperature” phase
Ovulation phase 🥚	Mid-cycle	Egg release, body preparing for potential pregnancy
Pre-menstrual phase 🔥	After ovulation until the next period	Blood flow is more active, liver & heart may become fiery (eg, moodiness, poor sleep, hot sensation)

At different phases, the body’s balance and blood flow change, affecting ovulation, menstruation, and basal body temperature.

Basal temperature chart showing a woman's menstrual cycle vs temperature change

Low-temperature phase: blood flow is calmer and slower, leaning toward yin
High-temperature phase: blood flow is more active, leaning toward yang
Especially in the week before menstruation, liver and heart fire may rise. If combined with stress, late nights, or spicy and warming foods, then headaches, irritability, or insomnia may occur.

Two Commonly Seen Patterns of Menstrual Headache

Menstrual headaches can present in many ways, but two patterns are commonly seen:

1. Pre-Menstrual Headache: Liver-Fire Excess Type

Timing: 1–3 days before menstruation
Symptoms: migraines, throbbing headache, irritability, bitter taste in the mouth, chest and flank discomfort
Tongue & Pulse: red tongue, wiry pulse
Common Formulas: Chai Hu Shu Gan Tang, Dan Zhi Xiaoyao San
Pain Location: temples or around the ears, often exacerbated by stress and emotional tension

2. Post-Menstrual Headache: Qi & Blood Deficiency Type

Timing: 1–3 days after menstruation
Symptoms: dizziness, dull headache, blurred vision, dry eyes, fatigue
Tongue & Pulse: pale tongue, thin and weak pulse
Common Formulas: Ba Zhen Tang, Gui Pi Tang
Pain Location: top or back of the head, often exacerbated by movement or eye strain, and may be sensitive to wind.

⚠️ These are just two commonly seen patterns. Each woman may have a mixed constitution, and an individualised assessment helps determine the most suitable support.

Daily Strategies to Support Menstrual Headaches

Balancing blood and maintaining healthy lifestyle habits may help reduce the frequency of headaches.

General Recommendations

Keep a regular schedule and avoid late nights or overworking
Limit spicy, fried, or warming foods
Avoid prolonged sun exposure, drafts, or cold environments
Limit coffee and strong tea consumption
Address chronic issues such as allergies, constipation, or eye fatigue

One Week Before Menstruation

Drink calming teas, such as rose or tangerine peel tea
Ensure adequate sleep and rest
Engage in moderate exercise to support blood flow
During headaches, use a warm towel on the back of the neck and upper shoulders or massage the Fengchi (GB20) acupoint
Take magnesium before bed each night to help relax nerves and muscles, potentially reducing headache occurrence

How Traditional Chinese Medicine & Acupuncture May Support Menstrual Headaches

Through syndrome differentiation, TCM practitioners can provide personalised support:

Pre-menstrual: may help regulate the liver to support hormonal and emotional balance
Post-menstrual: may help rebuild blood and overall energy levels
Acupuncture and herbal therapy may help improve circulation and relax muscles, potentially easing tension-related headaches.

Menstrual headaches are not just caused by hormonal changes—they may reflect imbalances in blood and yin-yang. With TCM support and lifestyle care, women may move through each cycle more comfortably, helping manage headaches naturally.