Women's Health |
Migraine Headache Link To Menstruation StudiedNew Research Provides Therapy HopeMigraines can attack with a vengeance during a woman's menstruation, but taking medication before it begins may help stave off excruciating headaches, according to new studies reported in the medical journal Neurology. The first study sought to confirm the association between migraine and menstruation that many women already report to their physicians. The researchers found that, indeed, such an association does exist: Women are 2.5 times more likely to have a migraine during the first three days of menstruation, and they are more than three times as likely to report the migraine as severe. The second study looked for a way to relieve menstrual migraines. Researchers compared the preventative use of a migraine medication, frovatriptan, to a placebo (inactive substance). They found that by starting medication therapy two days before menstruation begins and continuing treatment for six days, the occurrence of menstrual migraines could be reduced by as much as 26 percent. "The treatment study gave all patients a double-strength dose of medication on day one of the six-day program. This unique and unconventional approach could have had an important influence on the success of the outcome," observed Dr. Ivan Login, a headache and migraine expert with the UVa Department of Neurology . "Further attention to this detail in future studies as well as trying to apply this new knowlledge in routine practice is warranted." Regarding the study linking menstruation with migraines, Dr. Anne MacGregor, director of clinical research at the City of London Migraine Clinic, says, "This is the first study to compare menstrual vs. non-menstrual attacks within individual women. It confirms what women themselves tell us, that it is the menstrual attacks that give them the most problems." Migraines with Menstruation Not UncommonDr. JoAnn Pinkerton, director of the UVa Women's Midlife Health Center, says that many women have headaches before or during their menstrual cycle. For those who suffer from menstrual migraines, the pain can be debilitating and interfere with work or pleasure. For non migraine headaches, taking a nonsteroidal agent such as ibuprofen or naproxyn before your period starts and routinely for 2-3 days may be enough. For those with migraines (more severe in intensity, may be associated with photophobia or sensitivity to light, or with nausea or vomiting), the good news is that there are specific migraine medicines which may decrease or relieve the headaches,allowing a return to function. Dr. MacGregor's study included 155 women who had a history of migraines. None were taking birth control pills or using hormone therapy. All of the women kept diary cards that contained information on each headache and its severity, as well as any medications taken, and where in her menstrual cycle a woman was. Data were gathered for 693 menstrual cycles. The researchers found that women were 2.1 times more likely to have a migraine in the two days before a period, and that number increased to 2.5 times more likely during the first three days of menstruation. Women were 3.4 times more likely to report that migraines that occurred during menstruation were severe. In the treatment study, 443 women with migraines were recruited from 36 centers across the US. They were randomly assigned to one of three groups during each of three menstrual cycles. One group took a placebo; one group took 2.5 milligrams of frovatriptan once daily; and the other took 2.5 milligrams of frovatriptan twice a day. All took the treatments for six days, beginning two days before the expected start of menstruation. Sixty-seven percent of the women taking the placebo reported having migraines, while only 52 percent of those taking frovatriptan reported migraines. The group taking frovatriptan twice a day had the best results, with only 41 percent experiencing a migraine. Managing With and Without Medications"For some women, taking birth control pills may worsen headaches; for others it may relieve them," notes Dr. Pinkerton. "For women who get headaches only during the placebo week of the pill, associated with hot flushes or sweats, a low dose estrogen patch worn during the placebo week may prevent the headaches. For other women, it is possible to take the birth control pill for three months continuously before taking a placebo week and having your period." Dr. Pinkerton also observes that "For women who get headaches during their periods, it is important to track them - how long do they last, how severe, what precipitates, what relieves them. And ask for help. There are different types of medicines available. You don’t have to suffer through a severe three day migraine without relief." Always consult your physician for more information. Online Resources(Our Organization is not responsible for the content of Internet sites.) Centers for Disease Control and Prevention (CDC) National Institute of Neurological Disorders and Stroke National Institutes of Health (NIH) National Women's Health Information Center |
September 2004Migraine Headache Link To Menstruation Studied Migraines with Menstruation Not UncommonManaging With and Without Medications Online ResourcesMigraine Headache FactsAccording to the Journal of the American Medical Association patient page on migraines, unless an individual has personally experienced a migraine headache, he or she does not realize how incapacitating the pain of a migraine can be. This pain can keep a person from functioning normally and performing daily activities. It is estimated that migraine headaches affect 28 million people in the US. Every individual is different and may experience some symptoms and not others, or in various combinations. Symptoms may include:
Some of the above symptoms can signal even more serious conditions, so always consult with your physician. Some possible "triggers" for those susceptible to migraine headaches are:
Migraine Auras Migraine aura refers to neurological disturbances that occur before the migraine headache begins. The neurological disturbances are usually visual, such as seeing flashing lights or experiencing small blind spots; less commonly ringing in the ears or feelings of numbness may occur. Not all people with migraine headaches experience auras. "Headache Diaries" A diary of when you have a headache may help you determine what may influence your headaches and could give you an idea of what "triggers" you may want to eliminate or avoid. A diary can also help you see how well your medication and lifestyle changes are working. Treating Migraine Headaches If you have severe headaches, it is important to see a doctor for evaluation and diagnosis. Medications may be used to relieve pain and restore function during attacks. Stress management strategies such as exercise, relaxation training, biofeedback, and avoiding triggers may also have a role in treatment. Always consult your physician for more information. |
