ymmv but this is the myth that took me way too long to unlearn: that a hormonal attack is just a regular migraine that happens to land on your period, so whatever’s already working should just… work. it doesn’t work the same way, and the reason is boring and hormonal.
most attacks are triggered by whatever your usual stack is, stress, sleep, weather. the hormonal ones are driven by the estrogen drop right before your period, which is a sharper, faster hit than anything else on my trigger log. my CGRP preventive (ajovy) is dosed monthly and evens out my baseline fine, but it was never built to blunt a withdrawal that happens in a 2-3 day window.
so people (including past me) assume the preventive failed, when really it’s covering 90% of the month and just can’t reach that one sharp drop. practical part: if you’re reaching for your triptan 3-4x in that same window every single cycle, that’s not you being weak, that’s a mismatch between how the drug is dosed and how the trigger behaves, and it’s also exactly the setup for MOH creeping in. anyone else’s neuro actually name the hormonal window as its own thing, separate from your regular attack pattern, or did you have to piece that together yourself?