I often encounter female headache patients in the clinic, and the first thing they say is: “Doctor, I have a headache.” “What kind of headache? Where is it? What time of day do they occur?” “I have taken a lot of painkillers, but they are not effective. I can’t work when I have a headache, sometimes I can get relief from painkillers, sometimes I can’t get complete relief, and after taking them for a long time I had problems with my stomach.” At this point, I could basically tell that it was menstrual migraine. What is menstrual migraine? Menstrual migraine is the most common disorder of women during menstruation, and the pain is often unbearable. Migraine is divided into two types. Menstrual migraine is defined as migraine without aura, and the attack usually lasts for a long time, up to 4-5 days, which is comparable to the duration of menstruation. It can be divided into simple menstrual migraine without aura and menstrual-related migraine without aura. (1) Simple menstrual migraine without aura: Migraine attacks occur in menstruating women and meet the diagnostic criteria for migraine without aura. The headache attack should occur in at least 2 out of 3 menstrual cycles and only on day l±2 of menstruation, i.e., days -2 to +3 of the menstrual period, and not at other times of the menstrual cycle. (2) Menstrual-related migraine without aura: Occurs in menstruating women with headache attacks on menstrual day 1±2, i.e., days -2 to +3 of the menstrual period, and occurs in at least 2 of the 3 menstrual cycles and at other times of the menstrual cycle. In other words, these patients have both perimenstrual migraine and migraine at other times of the menstrual cycle. Epidemiological surveys show that in a survey of 163,186 people in 12,000 households in the United States, the cumulative incidence of migraine was 43% in women and 18% in men, and about 50% of female migraineurs had headache attacks that correlated with menstruation. The prevalence of migraine in Asia (excluding Korea and Hong Kong) ranged from l1.3% to 14.4% in women and 3.6% to 6.7% in men. In a population-based survey conducted by Couturier et al, a subjective review of respondents found that menstrual migraine was more painful, longer lasting, and less effective when treated with medication. In a study by MacGregor et al, 155 female headache clinic patients recorded headache diaries for a total of 693 menstrual cycles and found that the risk of migraine attacks began to increase during the first 5 days of menstruation, increased more than twofold on the day of menstruation and during the next 5 days, and the relative risk of severe migraine and migraine with nausea and vomiting was highest during the first 3 days of menstruation. Similar results were obtained in a study conducted by Granella et al. and Martin et al. also on headache clinic patients who kept a headache diary. In addition, treatment of menstrual migraine required a greater dose of medication for symptom relief than treatment of non-menstrual migraine, with lower rates of pain-free and prolonged pain-free medication application. The uncomfortable reactions to prolonged application of pain medication and the headaches that patients can expect cause many women to experience anxiety and restlessness during their menstrual cycle, and therefore, they want better treatment to completely resolve the distress caused by headaches. According to the literature, the etiology of menstrual migraine is closely related to the fluctuating levels of estrogen in the body; therefore, patients experience a natural decrease in headaches after menopause. However, the authors have observed in clinical practice (this is of course only empirical, no large sample of data) that there are also a significant number of older women who have been menopausal for several years who still have migraine attacks, and unlike when they were younger, their attack cycles are not regular. As a TCM practitioner in a Chinese medicine hospital, I often face such patients, and through clinical practice, I believe that such patients have a single TCM pathogenesis, mostly deficiency cold in the liver meridian, mostly with dysmenorrhea or had dysmenorrhea before, and no longer have dysmenorrhea after headache, therefore, the clinical use of products that warm the meridian and disperse cold can solve the patient’s pain and have the characteristic of not easy to recur. For patients, the most important regimen is: 1. abstain from cold food (including cold in temperature and cold in nature), especially during menstruation; 2. pay attention to the warmth of the abdomen and waist, especially pay attention to try not to wear low-waisted pants and umbilical cord clothing; 3. warmth in an air-conditioned environment is especially important; 4. a cup of strong ginger brown sugar water, or supermarket ginger brown sugar punch can be used daily during menstruation.