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Menstrual Migraine.

Elizabeth Loder1

  • 1Headache and Pain Management Program, Spaulding Rehabilitation Hospital, 125 Nashua Street, Boston, MA 02114, USA. eloder@partners.org

Current Treatment Options in Neurology
|February 17, 2001
PubMed
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Menstrual migraine, linked to hormonal fluctuations, affects many women. Diagnosis requires tracking headache diaries, and while most treatments are effective, specific cases may benefit from pre-emptive or hormonal therapies.

Area of Science:

  • Neurology
  • Endocrinology
  • Women's Health

Background:

  • Menstruation is reported as a trigger for migraine in nearly half of women.
  • The significance of menstruation as a sole migraine trigger may be overestimated.
  • Menstrual migraine is often linked to abnormal central nervous system responses to hormonal shifts, not hormonal imbalances.

Purpose of the Study:

  • To clarify the role of menstruation in migraine triggers.
  • To outline diagnostic criteria for menstrual migraine.
  • To review current and potential treatment strategies for menstrual migraine.

Main Methods:

  • Diagnosis relies on prospectively maintained diaries correlating migraine attacks with menstrual cycles.
  • Evaluation of existing abortive and pre-emptive therapies.

Related Experiment Videos

  • Consideration of hormonal therapies for refractory cases.

    • Main Results:

    • Accurate diagnosis requires demonstrating a consistent temporal link between headaches and periods via diaries.
    • Standard abortive therapies are effective for most menstrual migraine cases.
    • Pre-emptive treatment can help predictable, cyclical headaches, but hormonal therapy evidence is limited.

    Conclusions:

    • Menstrual migraine is primarily due to CNS response to hormone fluctuations, not hormonal abnormalities.
    • Treatment choice depends on migraine frequency, predictability, patient factors, and cost.
    • Hormonal therapy for refractory cases lacks strong evidence; perimenstrual triptan use is not yet recommended.