A Menstrual migraine also called as Catamenial migraine is used to define both pure menstrual migraines and menstrual-related migraines. 50% of women, less than 35 years of age suffer from menstrual migraines which last for 3 days. The hormones estrogen (oestrogens) and progesterone display crucial roles in regulating the menstrual cycle and pregnancy and may also affect headache-related chemicals in the brain.
Estrogen is a collection of composites which are significant in the menstrual and reproductive cycles in women and progesterone is a natural steroid hormone included in the female menstrual cycle that stimulates the uterus to plan for pregnancy.
About 7-19% of women have migraines with or without aura only at the time of menstruation, these are termed as pure menstrual migraines. 35-51% of women have a menstrual-related migraine and is described to have an onset during a peri-menstrual period (2 days before to 3 days after the onset of menstruation) or may occur at other times of the menstrual cycle.
Menstrual migraine symptoms before the attack
• Nausea
• Mood changes
• Irritability
• Feeling light headed
• Restlessness and tiredness
• Bloating ( the body keeps too much water)
• Sleepiness
• Uterine pain or cramping and neck stiffness
• A Pounding headache on one side
• Fatigue
• Depression or euphoria (feeling happy)
• Excessive yawning
• Loss of appetite
• Talkativeness
• Diarrhea
Diagnosis for menstrual migraines
No tests are available to confirm the diagnosis of a menstrual migraine, the only way to diagnose is to keep a diary for at least 3 months recording both migraine attacks and days of menstruation. Take complete history and physical examination to rule out other causes of a headache.
Menstrual-related migraine attacks occur generally between 2 days before and 3 days after the start of menstruation in at least 2 out of 3 menstrual cycles in a row. Pure menstrual migraine and menstrually related migraine are migraines without aura.
The occurrence of menstrually related migraine without aura ranges from 35-51% of females with a migraine while that of pure menstrual migraine without aura varies from 7-18%. In 2012, a rare and exceptional case of a menstrual migraine with aura was reported.
Menstrual migraine causes
The particular causes of a menstrual migraine are not known, but there is a relation between the female hormones estrogen and progesterone fluctuation levels and the onset of a migraine attack. Estrogen and Progesterone levels rise and fall over women’s menstrual cycle and due to these variations, it will lead to migraines.
The changes in hormonal levels occur throughout the menstruation cycle, before and after. If a migraine occurs just prior to the onset of menstruation then it may be due to the natural drop in progesterone levels. A migraine may occur throughout menstruation itself when estrogen and progesterone are at their lowest.
It may also occur when a woman stops taking birth control pills or hormone pills in hormone replacement therapy. Generally, menstrual migraines occur in women who are subtle to hormonal variations.
Menstrual migraine treatment
Acute treatment of a menstrual migraine is similar to a migraine.There are several treatment options depending on symptoms of the menstrual cycle. For heavy and painful periods – NSAIDS help. If a migraine occurs just before menstrual cycle due to low levels of estrogen, then estrogen supplements can help taking 3 days before the 1st day of the menstrual period to complete menstruation.
Applying ice, stress management, acupuncture, biofeedback also helps. Triptans such as Frovatriptan, Ergotamines which are a kind of a drug made from a fungus called ergot, and estrogen transdermal patches, which are patches are worn on the skin that has estrogen in them which enter the body through the skin and then into the blood stream.
Top 5 treatments for a menstrual migraine
1. Magnesium supplements
A series of studies were conducted on women in which the researchers have compared between the migraineurs and non-migraineurs. About 50% women who suffer from migraines have magnesium deficiencies. The specialists discovered that women who are taking magnesium supplements had substantial relief. Magnesium helps ease the blood vessels that contract during a migraine attack.
For a migraine attack prevention, doctors recommend a daily dose of 400mg of magnesium supplement and for migraineurs, it is suggested to eat green vegetables, whole grains, beans, bananas, and seafood.
2. Stress reduction
Stress is one of the important migraine triggers. Stress can be due to job, family and any other responsibilities. If we adopt stress reducing method then our lifestyle changes can comfort symptoms of a menstrual migraine. To reduce migraine attacks meditation, deep breathing, yoga, biofeedback, aerobic exercises are suggested, and others like quitting smoking, developing the habit of regular sleep schedule, reducing the alcohol intake will be helpful.
In some studies, it is known that aerobic exercise may help to manage migraines. During a migraine, it is not suggested to do the exercise because it will worsen the symptoms.
3. Birth control pills
Many women who have irregular periods use hormonal birth control pills to normalize their menstrual cycles. The continuous use of birth control pills may work well for migraine sufferers because there will never be a decline in estrogen levels and that might precipitate a menstrual migraine.
As migraines are two types with aura and without aura. If a sufferer gets a menstrual migraine without aura taking birth control pills for pregnancy prevention can also recover migraine symptoms. But, if a sufferer has a menstrual migraine with aura it is recommended not to use birth control pills as the situation will be worse and if that happens, consult a specialist.
Not all women will have a positive experience, for some women taking birth control pills can improve migraines. But for others, the pills worsen the symptoms.
4. Avoid food triggers
Skipping breakfast can trigger a migraine. Keeping the journal or a diary to track diet and finding the symptoms will help to identify the foods that are migraine triggers. Eating meals at regular intervals will help to prevent the migraines. The migraine triggers vary from person to person. Some foods such as chocolate, monosodium glutamate (MSG), aged cheese, alcohol and red wine, processed meats, and caffeine can be avoided.
It is very simple and easy to identify what triggers a migraine and can be avoided instead of getting a migraine and dealing with the symptoms to treat it. For women, it is recommended to keep the track of their migraine triggers and avoid them in the week prior to the onset of a menstrual migraine.
Read more about Migraine and Food in the article Food Triggers
5. Pain relief medications
To treat the menstrual migraine doctors often recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil and Motrin, Naproxen (Aleve), Nalfon, Naprosyn, Relafen and Orudis, Triptans, Calcium channels or Beta blockers are the pain relieving medicines.
1 – 2 days before or seven days before the onset of the menses and menstrual headaches this medication can be taken and can continue for a total of two weeks.
Read more about Naproxen, Naprosyn,
NSAIDs should be taken with food and should be used for a limited period. Without discussing with the doctor, a person should not take them several times in a week and longer than few months. However, use of NSAIDs have some risks like an increase in gastrointestinal bleeding, ulcers, heart disease and stroke, kidney abnormality.
Even though pain relievers and other migraine medications will provide relief but also doctors caution that long- term and frequent use of the same medicine can end up bouncing back the headache pain once the effect of the medication is over which leads to taking another dose of medicine. To avoid the bouncing back of headaches doctors vary the treatments.
Triptans can relieve the pain, nausea and sensitivity to light that symbolizes migraines. Triptans and NSAIDs are the top remedies after the onset of menstrual migraines. They narrow blood vessels in the brain, which helps to reduce stretching and swelling.Triptans are started 2-3 days before the menses and continued for five days which are shown to be effective for menstrual migraines. The side effects of using Triptans include nausea, dizziness and muscle weakness
Read more about Triptans in the article Migraine-specific drugs
Beta blockers reduce the regularity, severity, and length of menstrual migraines and also may increase the effectiveness of symptom-relieving medicines used during migraine attacks. Doctors recommend to take these medicine daily or when the predictable period is approaching and causing a migraine.
Beta blockers drugs such as Propranolol, Inderal, and Toprol are used to treat high blood pressure by relaxing blood vessels which can also reduce the severity and regularity of migraines.
The side effects include low blood pressure, fatigue and weight gain, dizziness, lightheadedness, can also make asthma worse if anybody having asthma along with migraines.
Read more about Beta Blockers in the article Beta Blockers
Calcium channel blockers include drugs like Verapamil, Cardizem, and Procardia which can also help with migraine attacks by reducing the contraction of blood vessels. The side effects include edema (water retention), swelling and constipation.
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William says
I’m here to tell everyone who are suffering from migraine headache that there is a treatment for it, I was ones a migraine sufferers for over 13 years, I always had migraine headaches 2 to 3 times in a week to an extent i lost one of my eye site for days, it was really hell for me, i visited different doctor for the treatment but all were singing the same song of no treatment for migraine, and I have taken different types of drugs, i spent all my money in drugs and health care centres, but still there were no avail, and I keep on praying to God to heal me from migraine headaches, but one day i was online doing research on how i can get treated on my headache and i found a testimony on how someone was been treated from migraine headache by Dr muzack of Africa with natural herbal products, at first i couldn’t believe him, but i was dying in pain and now I have no option again than to gives this same man a trial but i never knew it’s going to be the end of my headache i has been living with for years, the God who has done this for me will be praised for ever, that was how i contacted Dr muzack and he was humble and very understanding man, the way he spoke politely with me, that was when I knew that my problems is over, that’s was how he sends the drugs which was made from herbal products over to me here in Canada, I took the drugs as I was directed to, it’s over 7 months now and haven’t feel any pain like headache and I’m even stronger than ever and it has no side effect. Feel free to contact him directly on his email address tradomedicalhealer@gmail.com or call; +2347037791346