Migraine
Headache Link To Menstruation Studied
New Research Provides
Therapy Hope
Migraines 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.
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 Uncommon
Dr. Raina Ernstoff,
an attending neurologist at William Beaumont Hospital in Royal
Oak, Mich., says that menstrual migraines are more common than
many women realize.
Many women have menstrual
migraines, but attribute them to other triggers, Dr. Ernstoff
says. However, she notes that if women are exposed to these
triggers when they are not in the premenstrual or menstrual
period, they may not get migraines.
Dr. MacGregor's study
included 155 women who had a history of migraines. None were
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.
"More than half of
patients who used frovatriptan 2.5 milligrams twice daily had
no menstruation-associated migraine," says study author Dr.
Stephen Silberstein, from Thomas Jefferson University in Philadelphia.
Managing
With and Without Medications
The researchers say
the medication was well-tolerated in this study, but Dr.
Ernstoff points out that frovatriptan, as with other triptan
medications, cannot be used in women with cardiovascular disease
or in those with uncontrolled hypertension.
Plus, she adds, if
headaches do not interfere with daily living, it is a
good idea to cut back on medications whenever possible.
"Women should talk
to their neurologists about other ways of dealing with migraine
symptoms, because there may be ways to reduce medications,"
she says.
Dr. MacGregor says
knowing when menstruation will occur can help women prevent
their migraines.
"We found that for
many women in our study, being able to predict menstruation
and hence migraine made them more able to prepare for menstrual
attacks, avoiding other triggers and treating early," she says.
Always consult your
physician for more information.
Online
Resources
(Our Organization
is not responsible for the content of Internet sites.)
American
Academy of Neurology
Centers
for Disease Control and Prevention (CDC)
HealthierUS.Gov
National
Institute of Neurological Disorders and Stroke
National
Institutes of Health (NIH)
National
Library of Medicine
National
Headache Foundation
National
Migraine Association
National
Women's Health Information Center
Office
of Research on Women's Health
US
Food and Drug Administration |
September 2004
Migraine
Headache Link To Menstruation Studied
Managing
With and Without Medications
Migraine
Headache Facts
Migraine
Headache Facts
According 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:
-
headache pain that is moderate
to severe and lasts for four hours to 72 hours, sometimes
longer
-
throbbing pain that can be
located on one side of the head; it can start on one side
and spread to the other side or be on both sides
-
nausea (an upset stomach)
-
-
sensitivity to light, sound,
or odors
-
pain becomes worse with movement
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:
-
exposure to bright lights
or loud noises
-
-
hormonal changes in women
-
-
some foods, such as chocolate
and some types of cheese
-
some food additives, such
as nitrites, nitrates, and monosodium glutamate (MSG)
-
some alcoholic beverages,
such as red wine
-
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. |
