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Menstrual (Catamenial) Migraine

Menstrual (Catamenial) Migraine

  • April 29, 2021
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Approximately 50 percent of females suffering from migraines note that their attacks occur around menses. These patients may also have episodes of migraine headache in between menstrual period. But around 10 percent of women have migraines exclusively associated with the menstrual period.

Why migraine occurs during menstrual period?

Most of the research suggests a drop in estrogen level and the normal release of prostaglandin during the first 48 hours of menstruation is responsible for migraine. But the actual mechanism is not well known and may be more complex than just the hormonal role.

Treatment:

 Migraine or simple headache  during menstruation usually

responds to the administration of an NSAID. These drugs need to be started 3 days before the anticipated onset of the menstrual period;

Other commonly use drugs to abort migraine attacks such as oral sumatriptan (25 to 50 mg QID) and zolmitriptan (2.5 to 5 mg bid) are equally effective. 

In practice hormonal therapy is rarely necessary and may required in refractory cases.

Prevention:

Need to take special precautions to ab=void known migraine triggers such as sleep deprivation, alcohol, excessive caffeine consumption, or fasting during menstruation.

References:

Migraine; Menstruation, Pregnancy and Lactation

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