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Reader’s Mail: Tamoxifen Therapy for Hormonal Migraine?

Q. Has anyone ever considered tamoxifen therapy for hormonally-based migraine?

A. Very little data exist on the use of tamoxifen in patients with hormonally-mediated migraine such as menstrual migraine. Menstrual migraine is a headache that reproducibly occurs 2 days before to 3 days after the onset of menstrual bleeding in 2 out of 3 menstrual periods. There was one small trial with less than 10 patients that found tamoxifen could prevent these menstrual migraines when given shortly before their onset. However, there was no control group (patients that were given placebo), and therefore, no conclusions can be drawn.

There have been other isolated reports of patients whose headaches improved after treatment for breast cancer, which included tamoxifen along with other therapies. It was not clear if the tamoxifen improved the headaches or if the other treatments for breast cancer did so. Therefore, it is unknown if it works for hormonally-mediated headaches.

Vincent Martin, M.D.
Headache and Facial Pain Program
University of Cincinnati Neuroscience Institute
Cincinnati, OH

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