In 2016, about 1.04 billion people had migraine, and the greatest burden of disability fell on women aged 15–49. Before puberty, boys and girls are affected about equally often, but afterwards migraine is two to three times more common in women. One leading hypothesis involves oestrogen withdrawal: in women with migraine, oestrogen levels fall faster before an attack than in women without it.
When attacks are most likely
In a Dutch study published in Cephalalgia in 2026, 563 women with migraine kept an electronic diary covering about 2,627 cycles in total. Around menstruation, the likelihood of an attack was about 1.67 times higher than in the luteal phase. The widespread belief that attacks increase after ovulation was not confirmed.
What this means for you
- For at least three months, note on which cycle days your attacks start.
- If attacks keep coming around your period, tell your doctor: there are preventive treatments.
- If you have migraine with aura, always talk to your doctor about hormonal contraception.
Sources
- GBD 2016 Headache Collaborators (2018). Global, regional, and national burden of migraine and tension-type headache, 1990–2016. The Lancet Neurology, 17(11), 954–976. doi:10.1016/S1474-4422(18)30322-3
- Gazerani P., Cairns B. E. (2020). Sex-specific pharmacotherapy for migraine: a narrative review. Frontiers in Neuroscience, 14. doi:10.3389/fnins.2020.00222
- van der Arend B. W. H., Bakker S., van Casteren D. S. et al. (2026). Migraine attack incidence in relation to the post-ovulatory estrogen decline: a prospective cohort study. Cephalalgia, 46(4). doi:10.1177/03331024261436415