March 2019, Episode 6: Migraines related to the menstrual cycle are usually more severe, of longer duration, and resistant to medications than migraines that occur at other times of the month. This week’s episode of Heads UP: the weekly podcast of the National Headache Foundation included a questionnaire to determine if you experience menstrual migraine, then discussed how we can treat/prevent the migraines that are bringing us down at that particular time of the month.
Menstrual migraine (MM) usually occurs somewhere in the 5-day timeframe around the start of your period (between two days before and two days after menstruation begins). MM is caused by falling estrogen levels and also the release of chemicals from the uterine lining into the bloodstream. Heavy periods, particularly around the time of menopause, are particularly triggering.
There are a number of approaches that can be taken to treat or prevent MM. Acute therapies like triptans, ergots, and anti-inflammatories can be effective if they are taken EARLY in the progression of MM.
Hormone treatment is usually very effective. The most common approach is to take birth control pills continuously (skipping the placebo pills) or to take the placebo pills only once every three months.
Another option is referred to as “mini-prophylaxis”. This is best for women whose menstrual cycles and MM are highly regular and predictable. In this approach, women only take their preventive migraine medications during the five-day window they normally develop a migraine triggered by their period.
Are some of your migraines triggered by your period? Take the MM quiz and discuss the results with your doctor. Treating the MM component of your migraine disease can bring about significant positive change in your life and your health.
