Menstrual Migraine Relief: the Role of Vitamin E

Why Menstrual Migraines Occur

Many women notice that migraine attacks worsen or cluster around their period. This pattern, known as menstrual migraine, is thought to be driven in part by hormonal fluctuations and increased prostaglandin activity in the uterus. Menstrual migraines are primarily triggered by the sharp drop in estrogen that occurs just before menstruation. Estrogen plays a stabilizing role in the brain’s neurotransmitter systems, especially serotonin, which influence vascular tone and pain sensitivity. When estrogen levels fall rapidly, it can increase neuronal excitability and alter blood vessel regulation, both of which contribute to migraine onset.

At the same time, prostaglandin levels rise in the uterus to initiate menstrual shedding. These compounds can enter systemic circulation and promote inflammation, vasodilation, and pain signaling, amplifying migraine symptoms. For some women, additional factors such as dehydration, poor sleep, and changes in magnesium or iron levels during menstruation can further sensitize the nervous system, increasing migraine frequency and severity.

Vitamin E and Menstrual Migraine: What the Research Shows

Because vitamin E has antioxidant and anti-prostaglandin effects, researchers have investigated whether it might help reduce menstrual migraine symptoms.

One of the key studies is titled “The effect of vitamin E on the treatment of menstrual migraine.” In this double-blind, placebo-controlled trial, 72 women with menstrual migraine were given either a placebo or 400 IU of vitamin E daily for five days (from two days before menstruation to three days afterward) over two menstrual cycles. After a washout month, they then crossed over to the other arm (placebo or vitamin E) for two more cycles.

The results showed statistically significant improvement in:

• Migraine pain severity

• Functional disability

• Associated symptoms such as photophobia, phonophobia, and nausea

Compared to placebo (p < 0.001 for pain/disability; p < 0.05 for associated symptoms).The authors concluded that vitamin E “is effective in relieving symptoms due to menstrual migraine.”

A broader review of migraine prophylaxis with vitamins also discusses how menstrual migraine is associated with elevated prostaglandin levels in the endometrium, which vitamin E might counteract via its anti-prostaglandin properties.

Proposed Mechanisms & Rationale

1. Anti-prostaglandin / anti-inflammatory effects: Menstruation is associated with elevated prostaglandins, which can promote vasodilation, inflammation, and pain signals. Vitamin E can inhibit prostaglandin synthesis, which might reduce the triggers for migraine in the perimenstrual window.

2. Antioxidant action: Oxidative stress is implicated in migraine pathophysiology. As an antioxidant, vitamin E might help quench reactive oxygen species and reduce oxidative damage in vascular and neural tissues.

3. Hormonal modulation: Some sources describe vitamin E acting as a mild progesterone antagonist, potentially modulating hormonal fluctuations that may trigger migraines.

How Physical Therapy Can Help

While hormone fluctuations are a primary driver of menstrual migraines, many individuals also experience migraines triggered by tension, posture, or neuromuscular imbalances in the neck, jaw, and upper back. At Stability In Wellness, we specialize in identifying and treating these root causes through evidence-based physical therapy techniques such as dry needling, myofascial release, postural retraining, neuromuscular re-education, and even oral myofunctional therapy. By improving cervical and jaw alignment, reducing muscular tension, and enhancing breathing and movement patterns, we help decrease the frequency and intensity of non-hormonal migraines. Our holistic approach empowers patients to restore balance in their nervous and musculoskeletal systems, supporting long-term relief and resilience.

The Clinical Recommendations for Managing Menstrual Migraine also mention this approach:

“A double-blind, placebo-controlled trial found that taking 400 IU of vitamin E daily for 5 days (from 2 days before menses to 3 days after) significantly reduced pain intensity and disability while also providing greater relief from associated symptoms compared with placebo.”

Disclaimer: this post is in no way medical advice. It is meant to serve as an educational tool. Be sure to consult with your physician prior to beginning any new supplementation regimen.

• Safety: Because vitamin E is fat-soluble, avoid very high doses long-term (especially >1,000 mg/day, or ~1,500 IU) except under medical supervision

• Caution: If you take blood thinners, or have bleeding disorders, you should consult with a physician before supplementing.

References

1. Ziaei, S., Kazemnejad, A., & Zare, S. (2009). The effect of vitamin E on the treatment of menstrual migraine: a double-blind, placebo-controlled, crossover study. BJOG: An International Journal of Obstetrics & Gynaecology, 116(9), 1228–1232. PubMed

2. Ghorbani, Z., Abtahi, S. M., Fereidan-Esfahani, M., Togha, M., & Rafiee, P. (2020). Vitamins and minerals in migraine prophylaxis: A review of the evidence. Pain Research & Treatment, Article ID 1–8. PMC

3. NeurologyLive. (2021). Vitamin E for menstrual migraine relief: mechanisms and clinical relevance. Retrieved from https://www.neurologylive.com/

4. The Clinical Recommendations for Managing Menstrual Migraine. (n.d.). Guideline summary. NeurologyLive. Retrieved from https://www.neurologylive.com/er relief from associated symptoms” compared with placebo.