Premenstrual syndrome and migraine

Abstract

Premenstrual syndrome (PMS) includes a wide variety of physical, psychological, and cognitive symptoms that occur recurrently and cyclically during the luteal phase of the menstrual cycle and disappear soon after the onset of menstruation. Headache, often of migrainous type, is one of physical symptoms often reported in the diagnostic criteria for PMS. Menstrual migraine (MM) is a particular subtype of migraine occurring within the 2 days before and the 3 days after the onset of menses. According to this definition, therefore, some attacks of MM certainly occur in conjunction with the period of maximum exacerbation of PMS symptoms. The relationship between MM and PMS has been investigated through diary-based studies which have confirmed the possible correlation between these two conditions. In this paper we provide indications for the treatment of MM, making particular reference to those therapies that may be useful in the treatment of PMS symptoms. Even if triptans are the gold standard for the acute treatment, if symptomatic treatment is not sufficient one can resort to a short-term perimenstrual prophylaxis. Non-steroidal anti-inflammatory drugs have been demonstrated effective in MM prophylaxis. Among natural products there is some evidence of efficacy for magnesium, phytoestrogens, and ginkgolide B. Finally, also a combined oral contraceptive containing drospirenone, taken continuously for 168 days, has shown promising results.

Diet and nutraceutical interventions for headache management: A review of the evidence

“…In addition, headache practitioners should consider patient comorbidities, as some of the CAM therapies have been used in other circumstances and may therefore offer a twofold benefit. For example, patients with menstrual migraine and premenstrual syndrome may experience relief of both conditions with magnesium, phytoestrogens or ginkgolide B (129). In this way, clinicians need to weigh the 1128 Cephalalgia 36 (12) risks and benefits from the evidence, and consider individual patient characteristics and preferences when prescribing CAM, in the same manner as is currently the standard with pharmacological interventions.…”

No associations between five polymorphisms inCOMTgene and migraine

“…COMT contains the common functional polymorphism, a G‐to‐A transition at codon 158, which results in a valine‐to‐methionine substitution (Val158Met, rs4680). Individuals homozygous for the mutation Val158Met show the three‐ to four‐fold reduced COMT activity in peripheral red blood cells , liver , and brain . COMT polymorphisms have been implicated in the pathogenesis of neuropsychiatric disorders associated with dopamine, such as schizophrenia, bipolar affective disorder, and Parkinson's disease .…”

Magnesium in Women’s Health and Gynecology

“…Another open-label preliminary study found that modified-release magnesium 250 mg tablet was effective in improving PMS symptoms in affected women [29]. Additionally, magnesium was shown to have some efficacy in treating menstrual migraines that occur with PMS [30]. However, a case-control study that assessed mineral intake using questionnaires found that while nonheme iron, potassium, and zinc affected PMS risk, magnesium was unrelated to PMS [31].…”