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Published on: June 2, 2014
Comparing Perimenstrual and Nonperimenstrual Migraine Attacks Using an e-Diary
Daphne S van Casteren1, Iris E Verhagen2, Britt W H van der Arend2
1From the Departments of Neurology (D.S.C., I.E.V., B.W.H.A., G.M.T.) and Medical Statistics (E.W.Z.), Leiden University Medical Center; and Division of Vascular Medicine and Pharmacology (D.S.C., I.E.V., B.W.H.A., A.M.V.D.B.), Erasmus University Medical Center, Rotterdam, the Netherlands. G.M.Terwindt@lumc.nl.
Perimenstrual migraine attacks in women are longer, more severe, and recur more often than non-perimenstrual attacks, increasing triptan use. This highlights the need for female-specific migraine prevention strategies.
Area of Science:
- Neurology
- Neuroscience
- Women's Health
Background:
- Female sex hormones significantly influence migraine pathophysiology.
- Perimenstrual migraine attacks may present differently than non-perimenstrual attacks, but previous research yielded conflicting results.
- Understanding these differences is crucial for effective migraine management in women.
Purpose of the Study:
- To compare the characteristics of perimenstrual versus non-perimenstrual migraine attacks in women.
- To assess the prevalence of premenstrual syndrome (PMS) in women with migraine.
- To identify specific needs for migraine treatment and prevention in women.
Main Methods:
- A prospective study involving 500 women with migraine using a headache e-diary.
- Comparison of perimenstrual and non-perimenstrual attack duration, intensity, accompanying symptoms, and medication use.
- Assessment of premenstrual syndrome (PMS) and subgroup analyses for menstrually related migraine (MRM) and hormonal contraceptive use.
Main Results:
- Perimenstrual migraine attacks were significantly longer (20.0 vs 16.1 hours), had higher recurrence risk (OR 2.4), increased triptan intake (OR 1.2), and greater intensity (OR 1.4).
- Women with perimenstrual attacks experienced more photophobia and phonophobia, and less aura.
- Differences were more pronounced in women with MRM and those using hormonal contraceptives; PMS prevalence did not differ between MRM and non-MRM groups.
Conclusions:
- Perimenstrual migraine attacks are associated with longer duration, higher recurrence, and increased acute medication use, particularly triptans.
- These findings underscore the potential for medication overuse and highlight the urgent need for developing female-specific prophylactic migraine treatments.
- Further research into hormonal influences on migraine pathophysiology is warranted.
