Menstrual Migraines and Women - What Works
December 7, 2007
Over 21 million American women suffer from Migraines- three times the number of men. Migraines often produce terrible, throbbing pain with nausea and sensitivity to light and sound. About 15% of suffers report an “aura” before an attack, including vision changes and the general sense of an oncoming headache. Recent evidence points to hormone levels, specifically estrogen, and a woman’s menstrual cycle. Menstrual migraines often occur a few days before- through the first three days of a woman’s cycle. Then, as a woman approaches menopause, headaches tend to increase in frequency and severity as hormones fluctuate before the ovaries finally shutdown, no longer producing eggs. Common migraine triggers encouraging onset within the menstrual cycle include alcohol consumption, bright lights, caffeine, cheese, chocolate, fasting, lack of sleep, MSG, orgasm, stress, sulfites, and weather changes.
Treatment Options
Fortunately, sufferers of menstrual migraines have several treatment options available. For acute-migraines, recommendations include taking a Triptan (i.e. Imitrex) with a nonsteroidal anti-inflammatory (eg.Ibuprofen, Naproxen) within one to two hours of onset. These two drugs, together, have been shown to greatly reduce symptoms, but should not be used more than twice per week as rebound headaches may occur. However, if headaches occur more frequently than twice a week, therapy aimed at prevention should be implemented.
Preventive Treatment
Prevention of menstrual migraines is often achieved by taking a longer-acting Triptan (e.g. Frova, Amerge) twice a day for five to six days starting three days prior to an expected attack. Additionally, low-dose monophasic (the same level of hormone throughout the whole month) combined-oral-contraceptives (containing both estrogen and progesterone) can also be effective at preventing migraines.
However, this form of medication is not recommended in women who have risks for stroke including a prior history of blood clots, history of migraines with aura, hypertension, high cholesterol, diabetes, smoking, or obesity. The transdermal patch (Ortho Evral) or the vaginal ring (Nuva Ring) have also been shown to help maintain steady estrogen levels. However, women on hormone therapy should be alerted to contact their health provider right away if they develop a worsening migraine or develop and aura.
Additional treatments include the use of beta-blockers, calcium channel blockers, tricyclic antidepressants, and anticonvulsants. Another FDA-approved treatment is the NTI-TSS (Nociceptive Trigeminal Inhibition Tension Suppression System) offered by dentists. This treatment reduces jaw-clenching during sleep, which can send signals to the brain causing migraine pain, sinus pain, and chronic headache. This method has shown a 77% reduction of migraine incidents in many sufferers. Several reports suggest that mineral supplementation with Magnesium, 360 mg daily, has been shown to effectively decrease pain with menstrual migraines.
Finally, acupuncture, massage, and chiropractic are alternative therapies that may help with migraine frequency and/or severity. A headache diary can chart changes in headache patterns to assess which treatment works the best. If several treatments have been tried, without success, you should be referred to a neurologist or headache specialist to rule-out other underlying conditions that may be causing your headaches. As always, consult your physician or nurse practitioner for any questions you have related to your health.
Other useful information available on web:
1. Irregular Menstruation - Ayurvediccure.com
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