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Periods can be annoying enough, even if we’re only talking about symptoms like cramping, bloating, and, of course, bleeding. But on top of that, many women find they also experience headaches at this time of the month, as well—adding yet another layer to an already less-than-pleasant few days.

If you’re one of those women, it may help to know that your recurring headaches aren’t just your imagination. Menstrual migraines and other types of headaches during (or before) your period are a real medical phenomenon, and experts say they’re actually quite common. Here’s what to know about this type of pain, and what you can do about it.

Why do I get period headaches?
Your hormones fluctuate throughout your monthly menstrual cycle, says James Woods, MD, a professor of obstetrics and gynecology at the University of Rochester. Just before your period begins—assuming you didn’t become pregnant after ovulation—your estrogen levels drop sharply.

Menstrual migraine treatment and prevention
Since period-related headaches are fueled by hormonal changes, it can help to prevent large fluctuations, explains Dr. Woods. “A birth control pill that levels out those hormones throughout the month ... can really help,” he says.

Some women will still get headaches during the placebo week of a 28-day pill regimen, Dr. Woods adds. If that happens, he says, doctors may recommend that patients skip the placebo week and start right in on a new pack of pills.

“You can do that for a couple years, and you effectively level the playing field across the whole month,” he says. “If there’s no change in hormones, you’re less likely to get those headaches.”