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Review
. 2025 Dec;11(1):2468109.
doi: 10.1080/20565623.2025.2468109. Epub 2025 Mar 4.

Mechanistic approach and therapeutic strategies in menstrual and non-menstrual migraine

Tanya Mani  1 , Munira Murtaza  1 , Rukaiah Fatma Begum  2 , H Gayathri  1 , M Sumithra  1
Affiliations
Review

Mechanistic approach and therapeutic strategies in menstrual and non-menstrual migraine

Tanya Mani et al. Future Sci OA. 2025 Dec.

Abstract

Migraine is a common condition that can cause intense headaches, often on one side of the head, along with symptoms like nausea and sensitivity to light and sound. These headaches can be triggered by various factors, including stress, changes in hormones, sleep disturbances, diet, and even gut health. Migraines are more frequent in women, particularly those under 45, and this may be linked to hormones. After age 45, this difference between men and women becomes less noticeable. Women tend to experience migraines that are more severe and last longer than men, with menstrual migraines affecting about 22% of women during nearly half of their menstrual cycles, and 7.6% of women with migraines. Treatments for migraines include medications, lifestyle changes, and alternative therapies, all of which aim to address the different ways migraines can affect people. This review explores these aspects in detail.

Keywords: Menstrual migraine; female migraineurs; headache; hormonal fluctuations; non-menstrual migraine; oxidative stress.

Plain language summary

Migraines are intense, one-sided headaches often accompanied by nausea and sensitivity to light and sound. They can be triggered by various factors, including stress, hormonal changes, sleep issues, gut health, and certain foods. Migraines are more common in women, especially those under 45, likely due to hormonal influences. Women also tend to have more severe and longer-lasting migraines, and some experience migraines related to their menstrual cycles. Treatments include pain relief medications, lifestyle adjustments, and alternative therapies like acupuncture. Since migraine can show up in different ways, diagnosis and treatments are personalized to fit each person’s needs. This review discusses these aspects in detail.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Phases of migraine. The different phases of migraine; migraine is divided into four main phases, namely, Prodrome –which includes symptoms like constipation, mood swings, neck stiffness, persisting for a duration of 3 hours to several days, Aura - which includes symptoms like speech difficulty, pins and needle sensation, face numbness, persisting for 5 to 60 minutes, Headache - includes symptoms like pain on one side of the head, light sensitivity, Postdrome - nausea and vomiting persisting for 4 to 72 hours, which include symptoms like feeling drained, confused, sudden head movement may cause headaches again.
Figure 2.
Figure 2.
Different causes of migraine. The various causes of migraine which include hormonal imbalance, neurological and sensory mechanisms, sleep, gut microbes and diet, and genetic factors which are explained throughout the review.
Figure 3.
Figure 3.
Hormones playing a role in menstrual migraine. This figure shows the different genes like human Prostacyclin, Estrogen, Progesterone, Follicular Stimulating Hormone (FSH), Oxytocin, Prostaglandin and Luteinizing Hormone (LH) that plays a role in causing migraine.
Figure 4.
Figure 4.
Prevalence of migraine in different phases of menstruation. This figure explains the fluctuation in the frequency and amplitude of migraine with changes in the estrogen and progesterone levels in the different phases of migraine, namely; menstrual phase, follicular phase, ovulatory phase, and luteal phase. Migraine is generally at its peak in the menstrual phase in people having menstrual migraine.
Figure 5.
Figure 5.
Migraine–sleep correlation. Difference between the various anatomical structures of the brain involved in sleep and migraine.
See this image and copyright information in PMC

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