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Menstrual migraine: a review of hormonal causes, prophylaxis and treatment

Avi Ashkenazi1, Stephen Silberstein

  • 1Thomas Jefferson University, Department of Neurology, Philadelphia, PA 19107, USA. avi.ashkenazi@jefferson.edu

Expert Opinion on Pharmacotherapy
|August 10, 2007
PubMed

Migraine in some women is associated with changes in sex hormone levels. Many women suffer from increased frequency of migraine around the time of menses. Menstrual migraine (MM) may be more severe than migraine that occurs at other times of the cycle. The pathogenesis of MM is probably related to declining estrogen levels after exposure to high levels of the hormone for several days. The acute treatment of MM is similar to that of non-menstrually-related attacks. 5-HT(1B/1D) agonists (triptans), ergots, NSAIDs, or combination analgesics may be used, although the response to some drugs may not be as robust as that of non-menstrual attacks. Women who suffer from frequent or debilitating MM attacks may benefit from perimenstrual prophylaxis that can be either hormonal or non-hormonal.

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