Migraines and Menstruation

Nearly 70% of all migraine suffers are women and of those women more than half connect their migraine pain to their hormones, thus giving us menstrual migraines.  If your migraine headaches appear just prior to or following your period then you may have menstrual-related migraines (MRM).

What is MRM

Headaches, especially those in women have long been linked to hormones.  Most notably the fluctuation of estrogen levels in a women’s body during her monthly cycle or even pregnancy and breastfeeding.  MRM is divided into two separate categories premenstrual and menstrual.  Premenstrual migraines occur one to seven days prior to the start of your period.  Menstrual migraines begin may appear anywhere from the day before your cycle starts to for days after it begins.  Only 14% of women experience true menstrual migraines, as they can only appear during those specific days to be labeled that way.

Birth control pills and hormone replacement therapy, often used during menopause, have been recognized as migraine triggers in some women.  Adding to the connection of hormones and women with migraines, one study found that women taking birth control pills with a lower dosage of estrogen documented fewer headaches than those  not on the low dose.  Also, women taking birth control pills containing progesterone, documented little to no headaches.

In an effort to support your doctors in properly diagnosing your migraines, consider keeping a menstrual cycle calendar.  This will allow you to document the exact days of your cycle and headaches to better address the type of migraine you are experiencing.  You may also want to include information in your calendar regarding other menstrual related symptoms that you experience, such as cramps, mood swings, nausea, and sore breasts.  This information will be beneficial to your physician, as women who have MRM often experience dysmenorrheal, or excruciatingly painful menstrual cramping.

Treating MRM

There are a variety of treatment options available for MRM; however the use of non-steroidal anti-inflammatory drugs (NSAIDs) is the most popular choice.  The NSAIDs most often selected for MRM treatment are Advil, Motrin, Naprosyn, Relafen, and Orudis.  Doctors recommend starting your NSAID treatment 2-3 days prior to the start of your period and continuing through the end of your period.  This is simply a short-term preventative treatment option.  For those experiencing severe MRM and wishing to maintain their current birth control regime, doctors suggest starting NSAIDs on the 19^th day of your cycle and continuing through the start of the first day of the following cycle.

If the use of NSAIDs is not adequately meeting your pain relief needs, there are several prescription-strength pain relievers that your doctor may prescribe for you.  The most frequently used prescription medication for MRM treatment included:

• Small doses of ergotamine drugs
• Beta-blocker drugs
• Anticonvulsants
• Calcium channel blockers

The use of birth control pills may also be helpful in treating MRM for women that have not been able to find adequate relief through other methods.  When using the pill for migraine relief it might be helpful to try a low-estrogen pill or remove placebo days for most months by using a pill for such as Seasonale, where you only experience a menstrual cycle once every 3 months.  There are alternative treatment options and home remedies available if the use of medication isn’t your preferred method of pain relief.

• Ice – applying ice or a cold compress to your head and neck may alleviate pressure from your migraine.
• Relax – using relaxation exercise such as yoga, tai chi, Pilates, and breathing techniques can help to reduce your stress levels and
• Biofeedback therapy – this form of therapy works around the idea of learning to understand and control pain in the body.
• Acupuncture- the ancient Chinese medicine has shown tremendous success in reducing the frequency of migraines.  This technique does require multi-sessions.

If you are pregnant, breastfeeding or going through menopause the treatment of hormone related migraines will vary.  For obvious reasons, pregnant and breastfeeding women need to closely monitor the intake of medication, as some may be passed along to the baby.   The key for menopausal women is to utilize the lowest dosage of estrogen hormone replacement possible and to maintain use on a day-to-day basis.

Tags: children, children and migraines, migraine, migraine headache, migraine prevention, migraine treatment, pregnancy, women and migraines