Review, 2007

What causes menstrual migraine and how is it treated?

Menstrual migraine is triggered by drops in estrogen and causes longer, more severe headaches than non-menstrual migraine. Initial treatment uses specific migraine medications, with hormone therapy as an option if that doesn't work.

Early or limited evidence Women with menstrual migraine (review)

What they did

Review of clinical features and treatment approaches for menstrual migraine.

What they found

Menstrual migraine has two forms: attacks only around menstruation, or attacks always around menstruation but also sometimes at other times. The main trigger is the drop in estrogen before menstruation. Menstrual migraines are longer, more intense, more disabling and more resistant to treatment than other migraines. Initial treatment uses triptans (specific migraine drugs). If that fails, short-term prevention around menstruation uses NSAIDs, triptans, or other medications. Hormone therapy using estrogen gel or extended-cycle birth control pills is an option for women not helped by other treatments.

What it means for you

Menstrual migraine requires distinct recognition and treatment strategies. Main limit: clinical review, not new research evidence.

About the study

Original title: Menstrual migraine: clinical and therapeutical aspects
Authors: Allais G, Castagnoli Gabellari I, De Lorenzo C et al.
Journal: Expert review of neurotherapeutics
Year: 2007
Study design: Review
What was tested: None
Read the paper: doi.org/10.1586/14737175.7.9.1105

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