Q and A: Herbs for Menstrual Migraines

Health professionals answer readers questions with suggestions for black cohosh, eleuthero, cayenne and general diet.

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In every issue of Herbs for Health, professionals from a variety of health-care fields will answer your questions about using medicinal herbs. Herbalist Chanchal Cabrera and medical doctor D. Paul Barney responded for this issue.


I suffer from severe migraines related to PMS (premenstrual syndrome) that last three days and nights. I have tried everything I can get my hands on as far as over-the-counter remedies for PMS and headaches. The only thing that helps migraines is valerian, but relief lasts only two to three hours. Is there anything you can recommend for PMS migraines? I do not have a problem treating headaches from other causes, but nothing seems to work for a migraine associated with PMS. Also, I cannot take anything with caffeine as it gives me a headache.
L. J. C.
Boulder, Colorado

I am not sure which over-the-counter remedies you have tried. Migraine head­aches are commonly associated with hormone fluctuations, and in your case an attempt to minimize those fluctuations should be attempted. Phytoestrogens may help, including black cohosh (Cimicifuga racemosa), eleu­thero (Eleutherococcus senticosus), fennel (Foeniculum vulgare), angelica root (Angelica archangelica), dong-quai (A. sinensis), lovage root (Levisticum officinale), licorice root (Glycyrrhiza glabra), red raspberry leaves (Rubus idaeus), evening primrose oil (Oeno­thera biennis), and chaste tree berry (Vitex agnus-castus).

Standardized preparations of feverfew (Tanacetum parthenium) taken daily also have been shown to decrease the incidence of migraines. And ginkgo (Ginkgo biloba), which stabilizes arteries, may also be useful.
—D. Paul Barney

Migraines are often associated with stress and diet, but hormonal imbalances can be a factor, too. Be sure your problem is not aggravated by unresolved stress or dietary triggers such as chocolate, cheese, coffee, oranges, sea­food, red wine, soft drinks, or refined sugars.

If the cause is specifically hormonal (migraines occurring at regular monthly intervals, regardless of stress or diet), then the best herb to use is chaste tree berry, which regulates the hormones produced by the pituitary gland. This, in turn, helps regulate estrogen and progesterone levels and balance the menstrual cycle. It is very effective in reducing or completely eliminating PMS discomforts but may need to be taken for up to six months to have lasting effects.

The pain of migraines is caused by irregular spasms of the cerebral blood vessels affecting the flow of blood to parts of the brain. Some people have “hot” migraines when the vessels dilate; they feel flushed and feverish, have throbbing or pulsatile headaches, and often crave cool drinks or ice packs. This type of migraine responds well to the cooling herb feverfew. Daily use for several months may equalize the circulation and dramatically reduce the frequency and severity of the headaches.

A “cold” migraine results when the blood vessels constrict and impair blood flow to the brain. People suffering from this type of migraine complain of chills, shivers, and a constrictive or viselike headache. They crave warm drinks and hot packs. Using feverfew for this type of ­migraine is counterproductive. Cayenne (Capsicum ­annuum) or other warming herbs are preferable.
—Chanchal Cabrera

D. Paul Barney is a family practice and emergency-room physician in Layton, Utah. He also is an adjunct professor at Weber State University and author of Clinical Applications of Herbal Medicine (Woodland Publishing, 1996).

Chanchal Cabrera, an herbalist and clinical aromatherapist, has been a member of the National Institute of Medical Herbalists since 1987. She is associate editor of Medical Herbalism newsletter and is a member of the advisory board in botanical medicine for Bastyr University in Seattle.

The information offered in “Q & A” is not intended to be a substitute for advice from your health-care provider.