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Lisa K. Mannix, MD, is the Medical Director for Headache Associates, in Cincinnati, Ohio (click here). She earned her medical degree at the University of Cincinnati College of Medicine, completed her internship and neurology residency at The Cleveland Clinic Foundation, and completed a Seymour Diamond Clinical fellowship in headache education. Dr. Mannix is certified in Neurology by the American Board of Psychiatry and Neurology, in Headache Medicine by the United Council for Neurologic Subspecialties and also has a Certificate of Added Qualifications from the National Board for Certification in Headache Management. She is also a member of the Board of Directors for the National Headache Foundation.

Menstrual Migraine is a Distinct and Treatable Condition

There are "everyday" migraines, and then there are menstrual migraine. For women in their reproductive years who may be at risk for migraines tied to their menstrual cycle, it is important to know the difference.

"Regular" migraines can be triggered by a range of factors such as stress, foods, dehydration or a change in the weather. Menstrual migraine, however, appears to be linked to the drop in estrogen levels that occur right before the start of a women's period. This monthly fluctuation in hormones can produce a migraine that is more severe, lasts longer and is more likely accompanied by nausea and vomiting than migraines that occur at other times of the month.

Some women assume that menstrual migraine pain is just a part of their period and don't realize that it is a specific medical condition that can be treated.

In fact, more than half of the women suffering from migraine do not receive an accurate diagnosis, even though approximately 60 percent of the nearly 21 million American women who suffer from migraines may actually be experiencing menstrual migraines.

So how do you know if your migraine is a menstrual migraine? Menstrual migraines occur regularly, during a window from two days before until three days after a woman's period, apparently triggered by a drop in estrogen levels. They can be more severe than other migraines and last longer. If your migraines typically occur during this window of vulnerability, you may suffer from menstrual migraines.

Acute treatments for migraine, which should be taken as soon as a headache starts, include prescription medications, over-the-counter combination analgesics, and nonsteroidal anti-inflammatory drugs (NSAIDS).

Acute treatments for migraine:

  • Triptans: FROVA®, IMITREX®, AMERGE®, ZOMIG®, MAXALT®, AXERT®, and RELPAX®; ergotamine-type medicines (CAFERGOT, MIGRANAL®)
  • Analgesics
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen

Due to menstrual migraine's likely link to changes in the estrogen cycle and its predictable recurrence, additional management strategies should be considered for menstrual migraines than for other types of migraines.

Knowing other causes for migraines can also help women avoid attacks. In addition to hormonal changes women should be weary of migraine triggers -- such as alcohol, stress, changes in routine and travel - especially at that time of the month.

To get the help you need, explain to your physician that your headaches appear as part of a monthly cycle and that they are timed to your period. To demonstrate your case, track your migraine days and menstruation on a calendar and then bring it to a doctor's appointment to show the cyclical and predictable nature of these headaches.

For more information on migraine, click here

Created: 4/19/2008  -  Donnica Moore, M.D.

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