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Menstrual Migraine

According to studies, the annual direct medical costs for patients and their migraine care were about $1 billion, with physician visits accounting for about 60 percent of these costs. Migraine incidence cost employers about $13 billion a year because of missed work days and impaired work function. Women who suffer severe episodes of migraine leading to bed rest result in an average of 5.6 bed-ridden days each, and a total of 68.9 million days of missed work in the U.S. annually.

Of the 21 million women estimated to be migraine sufferers in the US, approximately two-thirds experience “menstrual migraine,” a migraine headache occurring within a five-day window from two days before to two days after the menstrual period begins. While many women mistakenly associate these headaches as part of premenstrual syndrome (PMS), they are migraines and may be effectively treated or prevented. However, migraine headaches of this type are typically the most severe, longer in duration, more likely to be accompanied by nausea and vomiting, and least likely to respond to treatment.

While the exact causes of menstrual migraine are uncertain, evidence suggests the link between menstruation and migraine exists as a result of the drop in estrogen levels which normally occurs right before the period starts.

Restrictions in everyday activities were reported by 84 percent of women with menstrual migraine.

  • 81 percent were often unable to perform household chores.
  • 58 percent reported restricted family activities.
  • 55 percent were limited in their ability to participate in sports and work-related activities.
  • 45 percent reported work-related disability.

Despite the extensive debilitating effects of the condition, more than half of menstrual migraine sufferers may not correctly be diagnosed, and therefore may not be receiving adequate treatment. A significant need exists for physicians and women to understand how common menstrual migraine is, how it differs from other migraines and how its treatment options are unique.

In some women, taking low-dose birth control pills may reduce the frequency of menstrual migraine; however, some women may actually experience an increased effect when they try this treatment. Progestin-only birth control pills may also be helpful.

While there are numerous prescription and over-the-counter treatments for migraine, prevention is often the best bet. Try to identify any triggers for your migraines and avoid them. Practice healthy lifestyle habits such as getting adequate sleep and balanced nutrition. Keep a headache diary and bring this with you to consult a headache specialist who can review any medications you may have already tried and offer some new options. If your medication is not helping you despite taking it according to the instructions, speak with your physician about the possibility of taking a medicine prophylactically to prevent your migraines altogether.

Created: 9/20/2004  -  Donnica Moore, M.D.

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