Hormonal migraines and headaches are very common, but that does not mean they are a normal part of the menstrual cycle that you simply have to live with.
Many people feel wiped out for days before or during their period, and sometimes around ovulation too. When the pattern keeps repeating, it can be deeply frustrating to feel like the next attack is already on the way.
The good news is that the Chinese Medicine approach, including acupuncture and herbal medicine, offers a genuine pathway towards a better quality of life. These treatments have been refined and time-tested over countless generations, and acupuncture for headache and migraine has also been studied in modern clinical research, with encouraging evidence for both effectiveness and safety.
Because Chinese and Western medicine understand the body in different ways, they also approach diagnosis and treatment differently.
For many people, Chinese Medicine provides a useful complementary option when Western treatment has left them with questions or symptoms that feel unaddressed, or when they feel overlooked and as though they have no clear options left.
Hormonal migraines are thought to be driven mainly by drops in estrogen, especially in the days before menstruation, although some people also get attacks around ovulation for the same reason. These hormone shifts may influence serotonin, inflammation, and brain sensitivity, which can lower the threshold for headache or migraine to start.
Some people experience migraine every time estrogen levels fall, while others may be sensitised by the estrogen drop but need another factor such as stress, food sensitivity or exercise to trigger an episode.
For migraines related to menstruation, they typically happen from a couple of days beforehand to a few days into the bleeding phase.
The most common factors to consider in people with hormonal migraines relate to the “Liver” system and the “Blood” resources. These are special terms that have a distinct meaning in the Chinese medicine system.
The Liver is closely linked to movement, rhythm, and the smooth flow of energy through the body, which is why it is so often involved in symptoms that follow the menstrual cycle. It also plays a role in how the body directs its resources, adapts to stress, and restores itself through rest.
Blood, in this context, is the body’s nourishing and anchoring substance. It supports the head, calms the system, and provides the reserve the body draws on each month during menstruation. When Blood is depleted, or when it is not moving freely, the head is often one of the first places to feel it – with headache, migraine, dizziness, fatigue, or light sensitivity.
For many people with hormonal migraine, the underlying picture involves a mix of Liver Qi stagnation and Blood deficiency. In plain terms, that means the body may be dealing with both stuck flow and reduced reserves at the same time. Around menstruation, when demand increases, those imbalances can become more obvious and the head can suffer.
One way to understand this is that the body is trying to meet a recurring cyclical demand while also keeping enough in reserve for recovery and stability. If the flow is constrained, or if the reserves are low, migraine can be the result. That is why treatment often focuses on both easing tension and supporting nourishment, rather than looking at pain in isolation.
Hormonal migraines and headaches can show up in a few common patterns:
Menstrual migraine: Headaches or migraines that occur before, during, or just after a period.
Ovulation headaches: Migraines that flare around ovulation, when hormones shift mid-cycle.
Perimenopausal migraines: Migraines that become more frequent or less predictable during the menopause transition.
HRT-related migraines: Headaches that begin or worsen after starting hormone replacement therapy.
Contraception-related migraines: Migraines that change after starting or stopping the Pill, Mirena, or other hormonal contraceptives.
Postpartum headaches: Headaches or migraines that appear after birth, when hormones drop quickly and sleep is often disrupted.
When we treat hormonal migraine, we look at the whole picture: your constitution, long-term patterns, the timing of your menstrual cycle, and what is happening on the day you come in.
We also take into account stress, sleep, diet, medication use, and any side effects that may be adding pressure to the system.
All of this comes together in a Chinese medicine diagnosis that allows us to tailor treatment to you, rather than using a one-size-fits-all approach.
In many cases, Chinese herbal medicine is prescribed alongside acupuncture. Herbs can support nourishment, regulation, and symptom relief, and they also provide daily treatment between acupuncture sessions.
The aim is not only to settle the migraine once it has started, but to help shift the underlying pattern that is making hormonal migraine more likely.
Treatment usually unfolds over a course of sessions rather than in a single visit.
Many people notice early changes in sleep, tension, or cycle-related symptoms first, while migraine frequency and severity may take a little longer to shift. Because hormonal migraine is tied to the menstrual cycle, treatment often adjusts as the cycle changes, and progress is usually judged over a few cycles rather than a few days.
A practical rule of thumb is that the first phase of treatment is about stabilising symptoms and getting a clearer sense of your pattern, while the next phase is about building longer-term change. Some people improve within a few weeks, while others need a longer course depending on how long they have been dealing with migraines, how complex the pattern is, and whether other factors such as stress or medication are involved.
For more on how treatment courses work, see our main migraines page.
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Dr Lois Nethery (TCM) is a highly recommended AHPRA-registered Doctor of Traditional Chinese Medicine (TCM) with 20+ years of experience with migraine and headache natural treatment. She has created a unique migraine framework that addresses body, mind and spirit. Her system includes a range of effective and evidence-based complementary therapies such as acupuncture, gua sha, cupping, moxibustion, acupressure, dietary therapy, lifestyle therapy, meditation, EFT (tapping), light therapy, sound therapy and breath medicine. These are combined into a comprehensive system to address the sensitive nervous systems of people with migraine and chronic headaches.