Menstrual migraines, also called “hormone headaches”, are a type of migraine headache that occur in response to changes in hormone levels during the menstrual cycle. For many migraine sufferers, a throbbing pain is felt only on one side of the head, often behind the eye or in the back of the head and neck, and generally last anywhere from a few hours to a few days. Migraine symptoms may include nausea, vomiting, and sensitivity to light and sound.
Migraines, in general, occur three times more frequently among women than men. Among these women menstrual migraines affects almost 60% of them. Hormones including estrogen and progesterone fluctuate throughout the course of a woman’s cycle to regulate her ovulation and menstruation. Menstrual migraines may occur before, during or immediately after a woman’s period, or during ovulation. Although they can occur at different times during the menstrual cycle, a woman will usually experience her menstrual migraine at the same phase each month. Serotonin, a neurotransmitter in the brain, is the primary hormonal trigger of all migraine headaches. Research suggests that for women with menstrual migraines, serotonin levels may be impacted by fluctuations in other female hormones, such as estrogen. Because oral contraceptives influence estrogen levels, women on birth control pills may also experience menstrual migraines.
Women with menstrual migraines are treated with “acute medications”. When attacks are very frequent, severe, or disabling, women may also benefit from use of a “prevention medication”. Doctors recommend a treatment based on the severity and frequency of headaches, and the past response to other treatments. If standard preventive measures are unsuccessful at controlling menstrual migraines, hormonal therapy may be indicated. This may involve the use of a supplemental estrogen taken prior to, and during menstruation. Another approach for women who take an estrogen/ progesterone oral contraceptive is to take it daily without the monthly break for 3 to 6 months. The reduction in menstrual periods provides a method of preventive treatment.
Dr. Piyush Ostwal
Neurology Specialist
Bahrain Specialist Hospital
Email: piyush.ostwal@bsh.com.bh