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Migraine: Menstrual Migraine

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Migraines: Menstrual

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Migraines and Women

Migraines occur far more frequently in women than in men. In fact, in adult women the rate of frequency is roughly fifteen to seventeen percent, whereas in men it is only about five percent. Twenty-five to thirty percent of all women in their 30s experience at least an occasional migraine.

Studies have concluded that estrogen withdrawal is a key factor in migraines related to menstrual cycles. Sixty to seventy percent of women who suffer from migraines have menstrual-related migraine. Menstrual migraines generally last longer than non-menstrual migraines and often are much more difficult to treat effectively.

Ten to fourteen percent of women with migraines have them only during menstruation. These types of headaches are known as ‘true menstrual migraine’.

Premenstrual migraine may in fact be part premenstrual syndrome (PMS), the menstrual related mood disorder. Symptoms of PMS include fatigue, irritability or depression, bloating and, yes, headache.

Two-thirds of women who suffered from pre-menopausal migraines find their condition improve with physiologic menopause. On the other hand, it has been found that surgical menopause worsens migraine conditions in two-thirds of cases.

Migraine attacks usually disappear during pregnancy. At the same time, however, some women report an initial onset of migraines during the first trimester of pregnancy, with the disappearance of their headaches after the third month of pregnancy.

Treatment options for menstrual migraine

When choosing to treat menstrual migraines with medication, the drugs used most often are non-steroidal anti-inflammatory medications (NSAIDs). The NSAIDS of choice in treating menstrual migraines are:

  • ketoprofen (Orudis)
  • ibuprofen (Advil and Motrin)
  • fenoprofen calcium (Nalfon)
  • naproxen (Naprosyn)
  • nabumetone (Relafen)

For best results when using NSAIDs to treat migraines, usage should be started two to three days before menstrual flow actually begins and the therapy should be continued throughout the period. Gastrointestinal side effects are generally not serious enough to be considered because the therapy takes place over such a short period, no pun intended.

For patients who suffer from more severe menstrual migraines or who desire to continue taking oral contraceptives, doctors also recommend taking a NSAID. This therapy should begin l9th day of your cycle and continue through the second day of the next cycle.

Some women have found anti-nausea medicine and pain relievers like aspirin, ibuprofen or acetaminophen sufficient enough to dull the pain. Others trust in analgesics or serotonin agonists such as Imitrex, Zomig, Amerge or Maxalt.

When using medications, it is extremely important to be aware of the dangers of avoiding a repetitive pattern of medication or overuse of medication as this can cause rebound headaches.

You might also consider using an estrogen skin patch. This treatment is utilized in the days leading up to your period and may either delay or actually prevent the onset of a menstrual migraine.

Some studies have found that daily doses of magnesium may help menstrual migraines in certain women. In addition, vitamin and herbal treatments have been found to be effective. The vitamin B2 when taken on a daily basis may reduce either the severity or the frequency of headaches, though research does not point to menstrual migraines in particular.

Even though two-thirds of women do report improvement in their migraine condition with the onset of natural menopause, two-thirds of women report a worsening with surgical menopause, therefore neither a hysterectomy nor an ovarian removal are recommended.

As always, you should consult your physician for a proper diagnosis before discontinuing or launching any kind of new treatment, including over-the-counter medication treatments.

Every woman has a unique health profile that includes aspects specific to their physiology and family history and that may preclude them from taking certain medications.

Some final tips

  • There enough different migraine triggers to fill a book and keeping track of them can be a full time job. It is highly recommended that you keep a trigger diary that includes a record of foods you eat, weather conditions, medications you have taken, stressful events, menstrual activity, etc.
  • Also of benefit, is developing a plan around your period. Reduce stress as much as possible by planning work and leisure commitments around your cycle so as to cut back on menstrual-related triggers as much as possible.

 

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