Managing Menstrual Migraine

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If you deliberation migraines timed to your menstrual rhythm are conscionable thing you person to suffer done period aft month, deliberation again.

“Menstrual migraine is simply a communal arena and location are very useful treatments to make this a much comfortable time,” says Huma U. Sheikh, MD, a headache master and CEO of New York Neurology Medicine.

How tin I show if it’s menstrual migraine?

If your migraine starts anyplace from 2 days earlier your play to 3 days after, you person menstrual migraine. But you tin besides get migraines astatine different times, for illustration erstwhile you’re ovulating, Sheikh says.

Menstrual migraine attacks thin to beryllium much terrible and past longer. And you’re typically much delicate to ray astir this clip than pinch different migraine attacks.

If location seems to beryllium a relationship betwixt migraine attacks and your menstrual cycle, hormones are nan apt cause. “Using a headache diary aliases app tin beryllium adjuvant successful determining if there’s a clear pattern,” Sheikh says.

Why do I get a migraine during my period?

It’s each astir hormones. “During nan people of a normal cycle, your estrogen levels emergence until astir time 14 of your cycle,” says Steven A. Rabin, MD, a gynecologist successful Burbank, CA. That’s erstwhile you commencement to ovulate and make much progesterone.

Around time 27 aliases 28, some hormones driblet backmost down to a normal level. “The abrupt driblet of estrogen tin trigger a migraine headache for galore women,” Rabin says.

What helps pinch menstrual migraine?

There are tons of ways to negociate and dainty your menstrual migraines. These see mini-preventive treatment, acute treatment, and hormonal treatment.

Mini-preventive treatment

You tin sometimes extremity menstrual migraine attacks earlier they commencement aliases lessen really terrible they are pinch prevention techniques.

“This is called mini-prophylaxis aliases mini-prevention, aliases taking regular aliases regular medicine astir nan clip of your menstrual cycle,” Sheikh says.

One action is taking nonsteroidal anti-inflammatory narcotics (NSAIDs) for illustration ibuprofen, naproxen, aliases fenoprofen calcium (Nalfon) 2 times a time for 5-7 days. Do this 2-3 days earlier your play starts and throughout.

Another action is estrogen supplementation. You tin usage a pill, vaginal gel, aliases spot earlier and during your play to extremity nan earthy estrogen dip that triggers migraine.

“We springiness patients a very debased dose of plant-derived earthy estradiol,” Rabin says. It comes successful nan shape of a medicine patch. Every month, you put nan spot connected your tegument astir 1 time earlier your migraine typically comes on.

“It’s important to way your rhythm and find this time truthful you tin get what I telephone nan estrogen parachute, which prevents your estrogen levels from falling disconnected a cliff and triggering nan migraine,” Rabin says. You deterioration it astir 3-4 days, past return it off.

Other mini-prevention techniques see taking magnesium starting connected time 15 of your rhythm and taking triptan medicine 2 times a time passim your period.

Acute treatment

If you’re successful nan mediate of a menstrual migraine attack, you tin return medicine to easiness nan pain. It’s astir effective if you return it early.

Your expert whitethorn urge a fast-acting triptan aliases selective serotonin receptor agonist. Most triptans are pills. Some are disposable arsenic injections nether nan tegument aliases arsenic nasal sprays and powder.

Options include:

  • Almotriptan (Axert)
  • Eletriptan (Relpax)
  • Frovatriptan (Frova)
  • Naratriptan (Amerge)
  • Rizatriptan (Maxalt)
  • Sumatriptan (Imitrex, Tosymra)
  • Zolmitriptan (Zomig)

Your expert mightiness besides propose taking an NSAID pinch nan triptan. Taking a multitreatment attack whitethorn help, too, Sheikh says. For example, you return a symptom reliever while besides utilizing a heating pad to negociate different play symptoms.

CGRP (calcitonin gene-related peptide) antagonists are different option. CGRP is simply a molecule progressive successful causing migraine pain. CGRP antagonists artifact nan effects of CGRP. They see rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy).

Continuous prevention

If you’ve tried different methods and they don’t work, aliases if your play is irregular, your expert whitethorn urge continuous preventive treatment.

One type of continuous prevention is taking commencement power pills without breaking for a monthly period. Instead of taking a placebo pill for 7 days, you support taking progressive pills. This keeps your hormones from dropping and triggering migraine. You tin besides do this pinch a vaginal ring. After you return nan ringing out, put a caller 1 successful correct distant alternatively of waiting until your play is over.

Your expert whitethorn urge medicine that changes hormone levels, for illustration leuprolide (Lupron). Or they whitethorn propose utilizing nan lowest imaginable dose of estrogen successful your hormonal contraception.

Botox is simply a bully option, too. It’s FDA approved for migraine and useful by blocking symptom signals successful nan nerves. It tin return clip to work, truthful you whitethorn request much than 1 treatment. Your expert whitethorn prescribe this if different preventive treatments don’t work.

Neuromodulation treatments tin beryllium utilized during an onslaught aliases to forestall one. They nonstop signals to your encephalon and tense strategy utilizing electrical aliases magnetic waves aliases power to calm encephalon activity. Some are portable; others are surgically implanted.

What should I avoid?

You tin negociate your symptom amended by avoiding triggers aliases things that make you consciousness worse. Try keeping a migraine diary to place triggers and sensitivities. Alcohol, dehydration, and accent are communal ones. Heat and ray whitethorn besides make you consciousness worse.

Avoid intoxicant astir your period. Try to portion 1.5-2 liters of h2o each day. If you person ray sensitivity aliases power sensitivity, effort staying successful a cool, acheronian room.

Can manner choices thief menstrual migraine?

“Regular workout and a patient fare person been shown to trim wide menstrual symptoms and tin thief pinch migraine attacks,” Sheikh says. A good, accordant slumber schedule tin besides help. Try limiting java and power drinks if they origin problems pinch your sleep.

Learn to negociate accent better. Try relaxation techniques. “Yoga and mindfulness tin beryllium a really adjuvant instrumentality to thief modulate your hormones and make this clip easier,” Sheikh says.

Which menstrual migraine curen is correct for me?

Your expert tin thief you determine which options are champion for you. It whitethorn beryllium a operation of strategies, including mini-prevention, acute treatment, and manner changes. Or they whitethorn urge continuous commencement control.

“You person galore useful options and astir of them are safe,” Sheikh says. But everyone’s different and it depends connected galore factors. “It’s important to return an individual approach,” she says.

Photo Credit: Stockbyte / Getty Images

SOURCES: 

Steven A. Rabin, MD, gynecologist, Burbank, CA.

Huma U Sheikh, MD, New York Neurology Medicine.

American Migraine Foundation: “Menstrual Migraine Treatment,” "Botox for Migraine,” “Neuromodulation for migraine treatment: An overview,” "ORAL AND INTRANASAL TRIPTANS FOR MIGRAINE."

Cleveland Clinic: “Menstrual Migraines (Hormone Headaches).”

Johns Hopkins Medicine: “Headaches and Women: What Do Hormones Have to Do With It?”

American Migraine Foundation.

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