MENSTRUAL MIGRAINES

While many women do report their menstruation as a migraine trigger, there is a specific condition known as menstrual migraine. Menstrual migraines are most likely to occur in the two days leading up to a period and the first three days of a period. There is no reported aura with this type of migraine, however, it can often last much longer than other types. The two most accepted theories on the cause of menstrual migraines are:

• Withdrawal of estrogen as part of the normal menstrual cycle
• Normal release of prostaglandin during the first 48 hours of menstruation

Currently, there are no tests to confirm the diagnosis of menstrual migraines. The only way to accurately tell if you are suffering from menstrual migraines is to keep a migraine diary for at least 6 months, recording all migraine episodes and the days you menstruate. By doing this, you will be able to identify non-hormonal triggers that you may be able to avoid to prevent further episodes.

MENSTRUAL MIGRAINE FACTS

• Menstrual migraines most often occur two days before their period
• Migraine attacks in women usually begin with their first menstrual period, which is also called menarche
• Many times migraines improve in the last six months of pregnancy
• Use of oral contraceptives may change the frequency and severity of migraines
• Often migraines worsen in the postpartum period, immediately after a woman has given birth
• For many women, the migraines improve after menopause
• Typically, the first migraine with aura attack occurs between the ages of 12 and 13
• The first migraine without aura attack usually occurs between the ages of 14 and 17

HOW ARE MENSTRUAL MIGRAINES TREATED?

There are numerous treatment options for menstrual migraines, although none of these options are licensed to specifically treat them.
If you experience migraines and heavy periods, taking an anti-inflammatory painkiller such as mefenamic acid could help relieve your symptoms. Mefenamic acid is an effective migraine preventative and can be started 2 to 3 days before the expected start of your period. Naproxen can also be an effective treatment when taken once or twice daily around the time of menstruation. Oestrogen supplements are also commonly used to relieve migraine symptoms, but remember to discuss using estrogen with your doctor before using. Increasing your falling estrogen levels just before and during your period might help if your migraine occurs regularly before your period. Oestrogen can be taken in several forms such as skin patches or gel. If your periods are irregular, your physician may suggest other ways to maintain your estrogen levels such as an oral contraceptive pill.