Review, 2009
What medications work for migraines around the menstrual period?
Multiple medications have evidence of benefit: sumatriptan, mefenamic acid, and rizatriptan for acute treatment, and estrogen patches, frovatriptan, and naratriptan for prevention. Whether preventive treatment provides significant additional benefit beyond placebo is unclear.
What they did
This review examined research on menstrual migraine diagnosis and treatment, including medication trials and clinical guidelines.
What they found
Menstrual migraines can be pure (attacks only around menstruation) or menstrually related (attacks around menstruation plus at other times). Regular migraine treatments work equally well for both types. Grade B evidence supports sumatriptan 50-100 mg, mefenamic acid 500 mg, and rizatriptan 10 mg for acute treatment. Grade B evidence supports estrogen patches 1.5 mg, frovatriptan 2.5 mg twice daily, and naratriptan 1 mg twice daily for prevention. Extended-cycle oral contraceptives may help. Preventive mini-prophylaxis outcomes are positive but the benefit compared to placebo is unclear.
What it means for you
Several proven medications exist for menstrual migraines, but it is unclear whether prevention provides significant additional benefit. The main limitation is lack of clear guidance on when and for how long to use preventive medications.
50-100 mg
sumatriptan dose for acute treatment
1.5 mg
estrogen patch dose for prevention
About the study
- Original title
- Clinical aspects of perimenstrual headaches
- Authors
- Taylor FR
- Journal
- Current pain and headache reports
- Year
- 2009
- Study design
- Review
- Read the paper
- doi.org/10.1007/s11916-009-0015-z
Topics
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