Headache Awareness: Menstrual Migraines
Wednesday, May 28, 2008
JC Jones MA RN
Migraine headaches are not life threatening but can be so disabling you sometimes feel you are dwelling in a twilight state between life and death. The pain is so crippling you can not participate in your every day life. My first experience with migraine headaches was in high school. An intelligent and talented friend of mine, William, lost days of school at a time due to migraine headache pain. He described how light and noise bothered him - he had to hide the telephone under a pillow while confining himself to a dark room until the pain subsided. I winced at his description of suffering, never dreaming I too would fall prey to this malady - my weak spot. Prepubescent boys and girls experience migraines with the same prevalence. Women, however, are 3 times more likely than men to have migraine headaches.
Menstrually related migraine (MRM) are more severe, last longer and are less responsive to pain medication than other migraine headaches. MRM occur 2 days before to within 3 days of the start of menses in at least 2 out of 3 menstrual cycles as well as other times during a woman's cycle. Menstrual migraine (MM) occur 2 days before to within 3 days of the start of menses in at least 2 out of 3 menstrual cycles and at no other time of the month. 8% of all women have MRM, but 50% of women who report headaches have MRM (me too). The theory is that falling estrogen levels in the late luteal phase of a woman's cycle trigger migraines.
Treatment of MRM and MM is two pronged - treat the migraine itself once it starts and short-term prevention taken perimenstrually. The April 2008 issue of Neurology published the following recommendations as a result of evidence-based research:
- Perimenstrual short term prevention:
- transcutaneous estrogen 1.5 mg
- frovatriptan 2.5 mg twice daily,
- naratriptan 1 mg twice daily
- Treatment of acute MRM/MM:
- sumatriptan 50 and 100 mg
- mefenamic acid 500 mg
- rizatriptan 10 mg
Thank you AxisGrid for use of photo Last Night.
Labels: menstrual migraine, migraine
2 Comments:
At Wed May 28, 02:13:00 PM 2008,
Abigail said…
A Migraine attack itself may not be life threatening, but did you know that Migraines can cause strokes? Sometimes those strokes ARE life threatening. It's great to raise awareness. People also need to realize that Migraine is a genetic neurological disease, not "just a headache."
At Thu May 29, 12:02:00 PM 2008,
JC Jones MA RN said…
Hmm...Not sure what your source is for that information Abigail. The latest medical information that I have indicates that migraine with aura is a significant risk factor for cardiovascular disease and stroke. I have not seen any clinical evidence that migraine headaches cause stroke. If you have such information, please forward it to us. Any sign of stroke is certainly a life threatening medical emergency. Thank You. JC
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