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Menstrual Migraine
Menstrual migraine is more than "just a hormone headache". For many years when I ask a patient if they have headaches, they often say "No, just my normal monthly headache." Well that's another "myth about headaches"! Headaches are not normal no matter when they occur. Even if you have been told in the past that "there is no such thing as a menstrual migraine" or "everyone gets headaches like that", this is not true. These types of migraines are real. Period. (No pun intended!)
Hormone related migraine may occur outside those times but close to them or at midcycle. OK..so now what? You are a woman stuck with cycles for many years until you get to menopause and even then you
might have migraines with menopause.
There are several ways to "manipulate" things so to speak, during this time of the month. The table below lists some options that include both hormonal and non-hormonal considerations during the week of your cycle. Many women have gone on the newer 90-day birth control pills and thereby avoid a mentrual migraine for several months. Then when one does strike, it is more easily treated with different options. At times, depending on the severity of the headache, I will give a woman a higher dose of magnesium and or a steroid pak (medrol dose pak) for one week. We may also add in longer acting triptans such as Frova taken twice a day at the onset of menses for two days. This front loads you with a drug that will last for a few days and prevent the recurring headache that happens with a shorter acting triptan such as Imitrex.
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