An Overview Of Menstrual Headache


affect 70 percent of these women. A menstrual headache occurs either before, during or immediately after periods, or during ovulation. While, serotonin is the primary hormonal trigger of a headache, some researchers believe that migraine is an inherited disorder that somehow affects the way serotonin is metabolized. But, for women, it also matters how serotonin interacts with uniquely female hormones. Menstrual migraines are primarily caused by estrogen, the female sex hormone which specifically regulates the menstrual cycle fluctuations throughout the cycle. With change in levels of estrogen and progesterone, a woman will be more vulnerable to headaches. As oral contraceptives influence estrogen levels, women on birth control pills may also experience more menstrual migraines.
The Treatment Options For Menstrual Headache -
The medications used in the treatment of menstrual migraine are non-steroidal anti-inflammatory medications called as NSAIDs. The NSAIDS most often used for menstrual migraine include ketoprofen (Orudis), ibuprofen (Advil and Motrin), fenoprofen calcium (Nalfon), naproxen (Naprosyn) and nabumetone (Relafen).
Therapy with the NSAID must start 2 to 3 days before the onset of the menstrual flow (menses) and should be continued through the flow. As the therapy is of short duration, the risk of gastrointestinal side effects is limited. For patients who have severe menstrual migraine or who want to continue taking birth control pills, physicians recommend taking a NSAID, starting on the l9th day of the cycle and then continuing it through the second day of the next cycle.
Other medications for menstrual headache can include:
a. Small amount of ergotamine (including Bellergal-S) or a similar compound, methylergonovine maleate (for example, Methergine)
b. Beta blocker drugs like propranolol
c. Anticonvulsants like valporate
d. Calcium channel blockers like veraperamil
These drugs should also be started 2 to 3 days pre-menses, and should be continued throughout the menstrual flow. As fluid retention is often associated with menses, diuretics have been used for preventing menstrual migraine. Some physicians also recommend that patients follow a salt-restricted diet immediately before the start of menses. Lupron is a medication that affects hormone levels and is used as the last option, when all other treatment methods have been tried and have failed.

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