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"Menstrual" migraine: towards a definition

E A MacGregor1

  • 1City of London Migraine Clinic and Department of Gynaecology, St Bartholomew's Hospital, London, UK.

Cephalalgia : an International Journal of Headache
|February 1, 1996
PubMed
Summary

Migraine attacks occurring exclusively around menstruation may be better termed "estrogen withdrawal" migraine. This proposed definition requires attacks to start within a specific window of the menstrual cycle.

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Area of Science:

  • Neurology
  • Gynecology
  • Endocrinology

Background:

  • The term "menstrual" migraine is imprecisely defined and frequently misused.
  • Existing definitions lack a clear link to specific pathophysiological mechanisms.

Purpose of the Study:

  • To critically review existing literature on menstrual migraine.
  • To propose a precise clinical definition for menstrual migraine.
  • To explore potential underlying mechanisms, specifically estrogen withdrawal.

Main Methods:

  • Comprehensive literature review of studies on menstrual migraine.
  • Clinical analysis of migraine timing within the menstrual cycle.
  • Evaluation of proposed definitions against known physiological patterns.

Main Results:

  • The term "menstrual" migraine lacks a universally accepted, precise definition.
  • A proposed definition restricts "menstrual" migraine to attacks occurring exclusively between days 1 and 3 of the menstrual cycle.
  • This timing aligns with the physiological mechanism of estrogen withdrawal.

Conclusions:

  • The term "menstrual" migraine should be redefined to encompass attacks exclusively linked to the perimenstrual period.
  • "Estrogen withdrawal" migraine may be a more accurate and mechanistically relevant term.
  • Further research is needed to validate this proposed definition and terminology.

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