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Migraine, Estrogen and Menstruation

Posted on May 20, 2015

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(HealthNewsDigest.com) – MOUNT ROYAL, NJ (May 20, 2015) – A series of articles to help women with migraine better understand the interaction between hormones and migraine attacks – and treatment strategies for minimizing the effects of these attacks — is now posted on the American Migraine Foundation’s website at: www.americanmigrainefoundation.org/resources-and-links/spotlight-on-women-and-migraine/.

The articles were developed in cooperation with Sheena Aurora, MD, FAHS,Clinical Associate Professor, Neurology & Neurological Sciences at Stanford University School of Medicine and American Headache Society board member, and Foundation Chair David W. Dodick, MD, FRCP (C), who is also Professor of Medicine at the Mayo Clinic School of Medicine.

In the first article, the headache specialists discuss the relationship between menstruation, estrogen levels and migraine attacks that some women experience.

“It’s long been known that for many women, there is a close connection between fluctuating levels of estrogen and migraine attacks,” says Dr. Dodick.  “It’s believed that cyclic changes in female sex hormones, particularly the premenstrual drop in estrogen levels, can trigger these attacks.  And, for some women, migraine attacks occur strictly during menstruation.”

If you have what is commonly called “menstrual migraine,” the attacks will occur within a five-day timeframe around your menstrual period, and in two out of every three menstrual cycles.  Women who experience pure menstrual migraine will not have migraine attacks at other times of the month.

“Some women get both menstrual and non-menstrual migraine attacks, however,” says Dr. Aurora.  “Unfortunately, for these women, their migraine attacks during menstruation are more severe, last longer, and respond less well to treatment compared with non-menstrual attacks.” 

Drs. Aurora and Dodick note that estrogen replacement therapy has been tried as a means to help control menstruation-related migraine attacks, but this approach has had mixed results.  Even oral birth control pills have an unpredictable effect on migraine attacks.  They can decrease migraine frequency, increase migraine frequency, or have no effect on migraine frequency.  “If you suffer from menstrual migraine, or any debilitating form of migraine, your first step should be to see a migraine specialist for an evaluation and treatment plan,” says Dr. Dodick.

Every woman who has menstrual migraine is different, and there are a number of different treatments her physician may try to help prevent or control her migraine attacks.  Treatment may include some of the same types of medications used with non-menstrual migraine.  In women with regular menstrual cycles, the preventive use of non-steroidal anti-inflammatory drugs (NSAIDS) or triptans around the time of menstruation may help.  

The American Migraine Foundation website (www.americanmigrainefoundation.org)  has a range of resources, including the “Spotlight” feature, where migraine sufferers and the public can turn for information about living with and managing many aspects of migraine. “Spotlight” changes topics on a regular basis throughout the year. In addition to the article discussed above, the current “Spotlight on Women and Migraine” includes an article on migraine and pregnancy, entitled “The Good News… And the Other Good News”; “Gender Bias… Is Anatomy Destiny,” which discusses the spike in migraine incidence in young women following the onset of puberty;  “Is There Anything Good About Menopause?”, which discusses the relationship between migraine, perimenopause and menopause; and “Headache Journal Toolboxes for Women and Migraine,” which links to a number of toolboxes, published in the American Headache Society journal Headache, which can help women better understand migraine and how to better manage and cope with migraine attacks.

ABOUT MIGRAINE: Some 36 million Americans live with migraine, more than have asthma and diabetes combined.  An estimated three to seven million Americans live with chronic migraine, a highly disabling neurological disorder. Migraine can be extremely disabling and costly, accounting for more than $20 billion in direct (e.g. doctor visits, medications) and indirect (e.g. missed work, lost productivity) expenses each year in the United States. 

ABOUT THE AMERICAN MIGRAINE FOUNDATION: The American Migraine Foundation is a non-profit foundation supported by the American Headache Society and generous donors dedicated to the advancement of migraine research. Its mission is to support innovative research that will lead to improvement in the lives of those who suffer from migraine and other disabling headaches.www.americanmigrainefoundation.org is the companion website to the American Headache Society (www.americanheadachesociety.org), the professional services organization for the world’s foremost clinicians and researchers working in migraine.

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