Diagnosing and Treating Menstrual Migraines


Diagnosing and Treating Menstrual Migraines

What Is a Menstrual Migraine?

Women are three times more likely to suffer from migraines than men. Of these women, 60 percent experience menstrual migraines.

Menstruation has often been considered a migraine trigger, however recent studies have indicated a specific condition referred to as a ‘menstrual migraine’ which is associated with the falling levels of estrogen and the normal release of prostaglandin during a woman’s period.

Menstrual migraines are said to typically last longer than other types of migraines, and unlike other types of migraines, menstrual migraines do not feature an aura during the attack – though an aura may precede a menstrual migraine episode.

Diagnosing Menstrual Migraines

There are currently no formal tests available to diagnose a menstrual migraine. Because of this, the only accurate way to tell if you are experiencing menstrual migraines is to document your migraine attacks over the course of several months, along with the days you menstruate.

Using a journal to keep track of your migraines will not only help your doctor to diagnose you, but it will also help you identify any non-hormonal triggers that may be associated with your migraine attacks. Keeping note of what you eat and the length of your sleep cycle, for example, may provide useful insight into what may be causing your migraine attacks if a menstrual migraine isn’t the diagnosis.

Other useful information to include in your journal would be the duration of a migraine, the time of day a migraine attack occurs, the migraine symptoms you experience, and the weather.

Symptoms of Menstrual Migraines

Symptoms of a menstrual migraine are very similar to the symptoms of a regular migraine headache. Unlike other types of migraines, a woman suffering from a menstrual migraine will not have an aura during the attack but may have one preceding it. Some other menstrual migraine symptoms to look for include:

  • Pain – usually beginning on one side of the head and progressing to the full head as the migraine intensifies
  • Fatigue
  • Nausea
  • Vomiting
  • Sensitivity to bright lights and sounds
  • Difficulty articulating thoughts
  • Numbness in extremities

Menstrual Migraine Treatment Options

If your doctor diagnoses you with menstrual migraines after reviewing your journal, here are some possible treatment plans. Treatment for women with a menstrual migraine can vary from acute treatment to preventative and hormonal treatment.

Acute Treatment

Acute treatment generally consists of anti-inflammatory drugs (NSAIDs), dihydroergotamine (DHE), triptans, or a combination of aspirin, acetaminophen, and caffeine (ACC); however, many migraine sufferers find minimal relief with these treatment methods and may instead need to be treated with dihydroergotamine, analgesics, or corticosteroids.

Preventative Treatment

Those who experience frequent and severe attacks may be candidates for preventative migraine treatment methods. For sufferers who experience severe migraine attacks regularly and are already on preventative medication, their dosage may need to be increased prior to menstruation if menstrual migraines are a concern.

For sufferers who are not on preventative medication, short-term prophylaxis taken prior to menstruation can be effective.

Another way to help prevent migraines is by making some key changes to your lifestyle. Some of these changes include:

  • Going to sleep and waking up at the same time each day – Migraines love inconsistency. Try to keep a normal sleep schedule to ensure you’re well-rested.
  • Staying hydrated throughout the day – People with headaches tend to be much more vulnerable to the effects of dehydration, so keep a bottle of water with you at all times.
  • Monitoring what you eat – Chocolate, aged cheeses, smoked and cured meats, alcohol, caffeine, and wine are all said to be migraine triggers.
  • Exercising daily – Daily exercise, when done gently and in moderation, can be a huge release of stress for a lot of people; yoga, in particular, has shown to be beneficial to migraine sufferers. Avoid rigorous or spontaneous exercise, however, as this is a known migraine trigger.
  • Avoiding stress – Stress is one of the biggest lifestyle factors associated with migraines. Try meditation, cognitive behavior therapy, and other relaxation exercises to help reduce the stress in your life and give your brain a break.

Hormonal Therapy

Another possible alternative treatment to consider when treating menstrual migraines is hormonal therapy. Utilizing estrogen supplements to top up falling estrogen levels just before and during your period may be useful if you suffer from menstrual migraines.

If you have irregular periods, a doctor may suggest maintaining your estrogen levels at a more stable rate through the use of an oral contraceptive pill.

The Takeaway…

Menstrual migraines affect 60 percent of female migraine sufferers, but that doesn’t mean it has to control your life. If you think you suffer from menstrual migraines, track your symptoms and work with your doctor to come up with the best treatment plan for your lifestyle. In addition to medications and hormone supplements, small lifestyle changes can make a huge difference in the day-to-day life of a migraine sufferer.

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