Does magnesium help with headaches during perimenopause?

Yes, magnesium is one of the most evidence-supported supplements for headache prevention, and the case for using it during perimenopause is particularly compelling. If you are dealing with new or worsening headaches as your hormones shift, magnesium is one of the first options worth discussing with your provider.

Headaches, including migraines, are extremely common during perimenopause. Estrogen fluctuations are a major migraine trigger for women who are susceptible. As estrogen levels become less stable during the perimenopausal transition, headache frequency can increase significantly. For some women who never had migraines before, they appear for the first time during this period. For women who already had migraines, they often worsen.

The clinical evidence for magnesium and migraines is stronger than for most supplements. A landmark study by Peikert et al. (1996) found that 600 mg of magnesium per day reduced migraine attack frequency by 41.6% over a 12-week period compared to placebo. That is a clinically meaningful reduction. A review by Boyle et al. (2017) also supported magnesium's role in reducing migraine severity and frequency. Based on this evidence, the American Headache Society and the American Academy of Neurology have both acknowledged magnesium as a reasonable option for migraine prevention, with a level of evidence that puts it on par with some pharmaceutical preventives.

Why does magnesium help with migraines? Several mechanisms have been proposed. Magnesium regulates serotonin receptors and nitric oxide production, both of which play roles in migraine initiation. Low magnesium levels are associated with cortical spreading depression, the wave of neural activity that is believed to underlie migraine aura. Magnesium also stabilizes NMDA receptors, reducing the kind of neural excitability that can trigger a headache cascade. Studies have found that people who suffer from migraines have significantly lower cerebrospinal fluid and red blood cell magnesium levels compared to people who do not, suggesting that deficiency is a real and measurable factor.

For hormone-related headaches specifically, magnesium may help in an additional way: by supporting the regulation of prostaglandin balance. Prostaglandins are signaling molecules involved in inflammation, and imbalances in prostaglandin production are associated with hormonal headaches. Magnesium may help moderate this pathway.

The form of magnesium matters for headache prevention. Magnesium glycinate is widely recommended because of its good absorption and low GI side effects. Some practitioners use magnesium oxide for this purpose because several of the clinical trials used that form, but magnesium oxide has much lower bioavailability. Magnesium citrate is an alternative with better absorption than oxide. If cost is a concern and you want to use a form closer to what was studied in trials, citrate is a reasonable middle ground.

Studies on magnesium for migraine prevention have used doses in the range of 400 to 600 mg per day. Talk to your healthcare provider about the right dose for your situation. Starting lower and increasing gradually is a sensible approach to minimize GI side effects while your body adjusts.

If your headaches are tied to your cycle, tracking their timing carefully can reveal the pattern. The PeriPlan app lets you log headache frequency and intensity alongside cycle phase and other symptoms, which makes it much easier to identify whether hormonal timing is driving your headaches and whether any intervention is changing the pattern.

Magnesium is generally very safe. The most common side effect at higher doses is loose stools or diarrhea. Magnesium glycinate is gentler on the digestive system than citrate or oxide. People with kidney disease should not supplement magnesium without medical supervision. If you take quinolone or tetracycline antibiotics, separate them from magnesium by at least two hours.

When to see a doctor: If you experience a sudden, severe headache that is unlike anything you have had before, a headache accompanied by vision changes, weakness, numbness, confusion, or difficulty speaking, or a headache following a head injury, seek medical care immediately. These can be signs of serious neurological events that require urgent evaluation. Additionally, if your headaches are frequent and disabling, your provider can discuss both preventive and acute treatment options beyond supplementation.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.