All too often many women will have an odd response when asked if they have headaches. “No I don’t have headaches, just my normal monthly one.” Well I am here to tell you that headaches are not normal, monthly or otherwise. Headaches that occur monthly during the menstrual cycle are menstrual migraines.
Menstrual migraine is due to the increasing and decreasing levels of estrogen in the brain during this time. Women have up to five (!) estrogen receptor sites in the brain and with all of them busy binding and unbinding estrogen, well this creates one heck of a headache. Many female migraineurs say that this headache can be the worst headache they have ever had. Like other migraines the headache symptoms are pounding, throbbing pain, sensitivity to light and sound and nausea. Unlike other migraines the symptoms are all magnified to the point where the headache may be disabling. Not only is she nauseated, but vomiting may also occur.
Menstrual migraine is now taken seriously by the medical profession unlike years ago when most women were told “It’s all in your head”. No kidding. This type of migraine is now being studied with its own research and much is being learned, especially on how to manage these headaches.
OK, now what? Well there are some new options on how to manage these migraines.
1. First of all, like all migraines, lifestyle plays a role. If you smoke, cut it in half immediately. Nicotine excites the brain and makes headaches worse. The same goes for caffeine. Cut out the power caffeine drinks, Starbucks and other caffeinated sodas.
2. Next step. Get on vitamin supplements targeted for migraine. All studies have shown, that vitamin B2 400mg, feverfew herb and magnesium 400mg can reduce your headaches. New information seems to point towards increasing the magnesium to 600mg or 800 mg during the menstrual week to blunt the headache.
3. Medications such as low dose anti seizure drugs may help reduce the pain of the headache. You might have to be on the medication for a few months to get things under control, but generally this is not something you will have to take for the rest of your life. Again, new research points to increasing the dose slightly during the menstrual week to ease the headache and then reducing the regular level after the menses is over.
4. Hormones may treat migraines! Often times, if the OB/GYN is involved, a woman can go on one of the new 90 day cycling birth control pills. Having a period once every 90 days means a bad headache, but only every three months. Other women have tried low dose estrogen that is used for menopause, during the menstrual week. A slight increase in estrogen may ease the headache pain.
5. Using longer acting medications during the menstrual week might prevent the headache from coming back. One of the newer drugs for migraine, frovatriptan, has a long acting formula and can prevent the migraine from returning over and over during the menstrual week.
Discuss your options with your medical provider, and don’t give up. New options are coming to light every few months or so, so keep asking questions about what is new to manage your hormone headaches.
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