Menstrual Migraine Assessment Tool
Track migraine timing around menstrual-cycle days, compare attacks across cycles, and prepare a clinician discussion summary.
Compare migraine timing with menstrual-cycle days
Enter period start dates and migraine attack dates. The tool checks whether attacks fall in the days -2 through +3 window around bleeding day 1.
Period start dates
Use the first day of bleeding as day 1. Add up to three recent cycles.
Migraine attack dates
Add migraine/headache attacks from the same cycles. Detailed fields are optional.
Perimenstrual window
Day 1 is the first day of bleeding. The day before is -1; there is no day 0.
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Seek urgent medical attention for sudden severe headache, new weakness, confusion, fainting, fever with stiff neck, headache after injury, new neurological symptoms, or a very different headache pattern.
What is the Menstrual Migraine Assessment Tool?
MMAT helps you compare migraine attack dates with menstrual-cycle timing. It is designed to organize a diary-style pattern for clinician discussion, not to diagnose menstrual migraine.
What is the menstrual migraine window?
ICHD-3 uses day 1 plus or minus 2 days, meaning days -2 through +3 around the first day of menstruation. Day 1 is the first day of bleeding, the previous day is -1, and there is no day 0.
Pure menstrual vs menstrually related patterns
A possible pure menstrual pattern means attacks appear only around the menstrual window. A possible menstrually related pattern means attacks appear around the menstrual window and also at other times. A clinician should review your diary before any diagnosis or treatment decision.
Why tracking at least 3 cycles matters
ICHD-3 cycle-related migraine patterns rely on attacks occurring around menstruation in at least two out of three cycles. A three-cycle diary helps reduce guesswork and over-attribution.
What symptoms should you track?
Track attack date, severity, duration, aura, nausea, light or sound sensitivity, medication used, response after treatment, recurrence, and functional impact. Aura should be noted separately, especially before medication or hormonal contraception discussions.
How this connects with your migraine diary
This assessment is strongest when paired with regular diary entries. Use the tracker to log future attacks, medication response, and cycle timing over several months.
Frequently Asked Questions
Can this tool diagnose menstrual migraine?
No. This tool is informational only. A clinician can review your headache and cycle diary, symptoms, aura history, and medical context before making any diagnosis.
What is the menstrual migraine window?
ICHD-3 uses day 1 plus or minus 2 days, meaning days -2 through +3 around the first day of menstrual bleeding. The first day of bleeding is day 1, and there is no day 0.
Why does the tool ask for 3 cycles?
ICHD-3 menstrual migraine patterns are based on attacks occurring around menstruation in at least two out of three cycles. Tracking three cycles makes the pattern more reliable.
What is the difference between pure menstrual and menstrually related patterns?
A pure menstrual pattern means attacks appear only in the menstrual window. A menstrually related pattern means attacks appear in that window and also at other times. This tool only describes possible patterns.
Why does aura matter?
Aura should be tracked separately because treatment and hormonal contraception decisions can be different when aura is present. Discuss new, unusual, or prolonged aura with a clinician.
Should I change migraine medicine or hormones based on this result?
No. Do not start, stop, or change migraine medication, hormonal contraception, or hormone therapy without medical guidance.
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References
1. International Classification of Headache Disorders, 3rd edition. Pure menstrual migraine without aura. ICHD-3.
2. International Classification of Headache Disorders, 3rd edition. Menstrually related migraine without aura. ICHD-3.
3. American Migraine Foundation. Hormonal and Menstrual Migraine. Read AMF resource.
4. The Migraine Trust. Menstrual migraine. Read Migraine Trust guide.