Menstrual migraine: an updated review on hormonal causes, prophylaxis and treatment

Abstract

Long-term daily preventive treatment should be considered for patients with MRM and those with severe PMM. Miniprophylaxis can be used in PMM rather than daily preventive treatment. When considering the use of short-term miniprophylaxis, sumatriptan, zolmitriptan, naratriptan, and frovatriptan have shown efficacy; however, frovatriptan appears to be the triptan of choice based on overall efficacy. Oral contraceptives may be considered if patients do not respond to or cannot tolerate typical migraine preventive medications. In patients with migraine with aura, oral contraceptives should be used with caution as this may add to the risk of stroke in this population.

Menstruation‐related headache in adolescents: Point prevalence and associated factors

“…The menstrual cycle is a sequence of interactions between the hypothalamus, ovary, and endometrium, involving alterations in hormone blood levels. The primary trigger of headache appears to be the decrease of estrogen level . The prevalence of menstruation‐related headache has been mainly investigated in adults, and the results were as high as 73% .…”

“…The primary trigger of headache appears to be the decrease of estrogen level. 6 The prevalence of menstruation-related headache has been mainly investigated in adults, and the results were as high as 73%. 7 Menstruation-related headache has rarely been studied in adolescents.…”

Systematic Review of Preventive and Acute Treatment of Menstrual Migraine

“…1 The International Headache Society has divided menstrual migraines into 2 different subtypes: menstrually related migraine, occurring without aura on or between days 22 to 13 of menstrual cycle, with additional attacks of migraine with or without aura at other times of the cycle; and pure menstrual migraine, which is migraine without aura that occurs only on or between days 22 to 13, with no attacks at any other time during the cycle. Approximately 50% of women carry an increased risk of developing migraines related to their menstrual cycle.…”

“…Approximately 50% of women carry an increased risk of developing migraines related to their menstrual cycle. 1 The International Headache Society has divided menstrual migraines into 2 different subtypes: menstrually related migraine, occurring without aura on or between days 22 to 13 of menstrual cycle, with additional attacks of migraine with or without aura at other times of the cycle; and pure menstrual migraine, which is migraine without aura that occurs only on or between days 22 to 13, with no attacks at any other time during the cycle. [2][3][4] Attacks of menstrual migraine are usually more debilitating, longer lasting, more prone to recurrence, and less responsive to acute treatment than nonmenstrual migraine attacks.…”

Menstrual Cycles: Who Cares? We All Should

“…We are also aware of the menstrual cyclicity of other symptoms of chronic diseases, such as catamenial epilepsy or menstrual migraines. 16,17 We need to continue to talk with our colleagues in other specialties to encourage them to consider the menstrual cycle when it comes to symptoms of chronic diseases that might have menstrual cyclicity, such as type 1 diabetes and asthma. 18,19 I'm working and teaching toward the day when all clinicians care about an event that happens monthly for half of their patients.…”