Treating Menstrually Related Migraines

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As a woman with Migraine disease, there have been times during my menstrual cycle when my migraines have been difficult to treat. Many women I’ve spoken with have shared the impact menstrual migraine has had on their life with me. In fact, 50% -60% of women with migraine disease have menstrual migraine and may be disabled two to three days a month depending upon the severity. It is important to have an accurate diagnosis so we can get the correct treatment plan, learn about our particular type of menstrual migraine and learn how to cope with them. According to the International Headache Society’s International Classification of Headache Disorders, second edition (ICHD-II,) there are three different type of menstrual migraine: pure menstrual migraine without aura; menstrually-related migraine without aura; or non-menstrual migraine without aura.

Many women are able to manage their menstrual migraines with over-the-counter (OTC) medications, like NSAIDs (e.g. aspirin), acetaminophen, caffeine or a combination of these. When OTC medications aren’t enough or don’t work, there are prescription medications that may prove beneficial. These are also used for acute (short term) relief and include:

  • Triptans- abortive medications developed for migraine that stop the migrainous process. There are eight available;  Amerge, Axert, Frova, Imitrex, Maxalt, Relpax, Zomig, and Treximet
  • DHE (dihydroergotamine)

In addition to medication, complimentary therapies such as biofeedback, relaxation and acupuncture are helpful for some women. Being mindful of our migraine triggers is imperative as this may help manage the number of migraines we have at any point during the month, but especially during our menses. Some common migraine triggers in addition to fluctuating hormones include; getting dehydrated, an irregular sleep schedule, skipping meals and changes in the barometric weather. It’s great to be able to avoid the triggers we can, but unfortunately changes in the weather and fluctuating hormones cannot be avoided.

What things do you do for your menstrual migraines? Have you found anything helpful to treat them? We’d love to hear from you. And as always, if you feel you need help with your menstrual migraine, please talk it over with your doctor. It is important to be an active participant in our own health care. Become an informed, educated patient. You owe it to yourself.

This is for informational purposes only and not to be intended as medical advice.

Brands, Jan Lewis, M.D. “The Influence of Estrogen on Migraine: A Systematic Review.” The Journal of the American Medical Association.2006; 295 (15)1824-1830

Young, William B. ,M.D., FAHS, FAAN;  Stephen D. Silberstein, M.D., FACP; Stephanie J. Nahas, M.D.;   Michael J. Marmura, M.D. Jefferson Headache Manual: Demos Medical Publishing, 2011. 71-73. Print.





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