Severe Menstrual Migraines: When Headaches Lead to Nausea and Vomiting

During my menstrual period, I experience a day of severe headache that leads to vomiting?

Hello Doctor, I have been experiencing severe headaches during my menstrual period for about six months, which can lead to vomiting.
I have taken painkillers, but they only alleviate the pain slightly.
Any movement triggers nausea and vomiting.
Recently, I have also started feeling dizzy, nauseous, with an increased heart rate and shortness of breath when climbing stairs.
I had enlarged tonsils two years ago, and I'm not sure if this is related.
Could you please provide some insight? Thank you.

Tu Tu, 30~39 year old female. Ask Date: 2015/09/21

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the symptoms resemble those of a migraine, which typically lasts from 4 to 72 hours.
The characteristics of the headache include unilateral pain, which may feel throbbing or pulsating, often accompanied by nausea and vomiting, as well as sensitivity to light and sound.
Additionally, activities such as walking, climbing stairs, or moving the head can exacerbate the pain.
Many patients require analgesics or preventive medications to manage their condition.
Besides pharmacological treatment, lifestyle adjustments are also crucial.
This includes establishing good habits, maintaining a regular daily routine, ensuring adequate but not excessive sleep, avoiding overexertion, and practicing relaxation techniques.
Some individuals may have specific triggers, such as certain foods, alcohol, or drastic temperature changes, like repeatedly entering and exiting air-conditioned environments.
Avoiding these situations can help prevent migraines.
It is advisable to consult a neurologist for further evaluation and treatment.
Wishing you good health and happiness.

Reply Date: 2015/09/21

More Info

Severe menstrual migraines can be a debilitating condition that significantly impacts your quality of life. The symptoms you describe—intense headaches accompanied by nausea and vomiting—are characteristic of menstrual migraines, which are a type of migraine that occurs in relation to the menstrual cycle. These migraines are often triggered by hormonal fluctuations, particularly the drop in estrogen levels that occurs just before menstruation.

The fact that you experience vomiting and nausea along with your headaches suggests that you may be dealing with a more severe form of migraine known as "migraine with aura" or "complicated migraine." These types of migraines can lead to additional symptoms such as dizziness, light sensitivity, and even visual disturbances. The symptoms you mentioned, such as feeling dizzy when walking up stairs and experiencing rapid heart rate and shortness of breath, could also be related to the severity of your migraine attacks.

It’s important to note that while over-the-counter pain relievers can help alleviate some migraine symptoms, they may not be sufficient for severe cases. Medications specifically designed for migraines, such as triptans (e.g., sumatriptan), may be more effective. These medications work by constricting blood vessels and blocking pain pathways in the brain, providing relief from migraine symptoms.

Additionally, lifestyle modifications can play a crucial role in managing menstrual migraines. Keeping a headache diary can help you identify triggers, which may include certain foods, stress, lack of sleep, or hormonal changes. Regular exercise, adequate hydration, and a balanced diet can also contribute to reducing the frequency and severity of migraines.

Regarding your previous history of enlarged tonsils, while it may not be directly related to your migraines, any history of upper respiratory issues can contribute to overall health and may influence migraine triggers. If you have had recurrent throat infections or sleep apnea due to enlarged tonsils, it might be worth discussing with your healthcare provider, as these conditions can impact your overall well-being and potentially exacerbate migraine symptoms.

Given the severity of your symptoms, it is advisable to consult with a healthcare professional, preferably a neurologist or a headache specialist. They can conduct a thorough evaluation, which may include imaging studies such as an MRI or CT scan to rule out any other underlying conditions. They can also provide you with a tailored treatment plan that may include prescription medications, lifestyle changes, and possibly preventive treatments if your migraines are frequent.

In summary, menstrual migraines can lead to severe symptoms, including nausea and vomiting. It is essential to seek medical advice to explore effective treatment options and to manage your symptoms better. Keeping track of your symptoms and triggers can also be beneficial in finding the right approach to alleviate your migraine attacks.

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