Managing Menstrual Migraine

Should you suppose migraines timed to your menstrual cycle are simply one thing it’s a must to undergo by means of month after month, suppose once more.

“Menstrual migraine is a standard phenomenon and there are very helpful therapies to make this a extra comfy time,” says Huma U. Sheikh, MD, a headache specialist and CEO of New York Neurology Drugs.

How can I inform if it’s menstrual migraine?

In case your migraine begins anyplace from 2 days earlier than your interval to three days after, you could have menstrual migraine. However you can even get migraines at different occasions, like while you’re ovulating, Sheikh says.

Menstrual migraine assaults are usually extra extreme and last more. And also you’re usually extra delicate to gentle round this time than with different migraine assaults.

If there appears to be a connection between migraine assaults and your menstrual cycle, hormones are the possible trigger. “Utilizing a headache diary or app will be useful in figuring out if there’s a transparent sample,” Sheikh says.

Why do I get a migraine throughout my interval?

It’s all about hormones. “Through the course of a standard cycle, your estrogen ranges rise till about day 14 of your cycle,” says Steven A. Rabin, MD, a gynecologist in Burbank, CA. That’s while you begin to ovulate and make extra progesterone.

Round day 27 or 28, each hormones drop again all the way down to a standard stage. “The sudden drop of estrogen can set off a migraine headache for a lot of ladies,” Rabin says.

What helps with menstrual migraine?

There are many methods to handle and deal with your menstrual migraines. These embrace mini-preventive remedy, acute remedy, and hormonal remedy.

Mini-preventive remedy

You possibly can typically cease menstrual migraine assaults earlier than they begin or reduce how extreme they’re with prevention strategies.

“That is known as mini-prophylaxis or mini-prevention, or taking each day or common treatment across the time of your menstrual cycle,” Sheikh says.

One choice is taking nonsteroidal anti-inflammatory medication (NSAIDs) like ibuprofen, naproxen, or fenoprofen calcium (Nalfon) two occasions a day for 5-7 days. Do that 2-3 days earlier than your interval begins and all through.

Another choice is estrogen supplementation. You need to use a capsule, vaginal gel, or patch earlier than and through your interval to cease the pure estrogen dip that triggers migraine.

“We give sufferers a really low dose of plant-derived pure estradiol,” Rabin says. It comes within the type of a prescription patch. Each month, you set the patch in your pores and skin about 1 day earlier than your migraine usually comes on.

“It’s necessary to trace your cycle and discover at the present time so you may get what I name the estrogen parachute, which prevents your estrogen ranges from falling off a cliff and triggering the migraine,” Rabin says. You put on it about 3-4 days, then take it off.

Different mini-prevention strategies embrace taking magnesium beginning on day 15 of your cycle and taking triptan treatment two occasions a day all through your interval.

Acute remedy

Should you’re in the course of a menstrual migraine assault, you possibly can take medication to ease the ache. It’s best for those who take it early.

Your physician could suggest a fast-acting triptan or selective serotonin receptor agonist. Most triptans are drugs. Some can be found as injections below the pores and skin or as nasal sprays and powder.

Choices embrace:

• Almotriptan (Axert)
• Eletriptan (Relpax)
• Frovatriptan (Frova)
• Naratriptan (Amerge)
• Rizatriptan (Maxalt)
• Sumatriptan (Imitrex, Tosymra)
• Zolmitriptan (Zomig)

Your physician may additionally recommend taking an NSAID with the triptan. Taking a multitreatment method could assist, too, Sheikh says. For instance, you are taking a ache reliever whereas additionally utilizing a heating pad to handle different interval signs.

CGRP (calcitonin gene-related peptide) antagonists are an alternative choice. CGRP is a molecule concerned in inflicting migraine ache. CGRP antagonists block the results of CGRP. They embrace rimegepant (Nurtec ODT) and ubrogepant (Ubrelvy).

Steady prevention

Should you’ve tried different strategies and so they don’t work, or in case your interval is irregular, your physician could suggest steady preventive remedy.

One sort of steady prevention is taking contraception drugs with out breaking for a month-to-month interval. As a substitute of taking a placebo capsule for 7 days, you retain taking energetic drugs. This retains your hormones from dropping and triggering migraine. It’s also possible to do that with a vaginal ring. After you are taking the ring out, put a brand new one in straight away as an alternative of ready till your interval is over.

Your physician could suggest treatment that adjustments hormone ranges, like leuprolide (Lupron). Or they could recommend utilizing the bottom doable dose of estrogen in your hormonal contraception.

Botox is an effective choice, too. It’s FDA permitted for migraine and works by blocking ache alerts within the nerves. It might probably take time to work, so chances are you’ll want multiple remedy. Your physician could prescribe this if different preventive therapies don’t work.

Neuromodulation therapies can be utilized throughout an assault or to forestall one. They ship alerts to your mind and nervous system utilizing electrical or magnetic waves or warmth to calm mind exercise. Some are transportable; others are surgically implanted.

What ought to I keep away from?

You possibly can handle your ache higher by avoiding triggers or issues that make you’re feeling worse. Attempt preserving a migraine diary to determine triggers and sensitivities. Alcohol, dehydration, and stress are widespread ones. Warmth and lightweight may additionally make you’re feeling worse.

Keep away from alcohol round your interval. Attempt to drink 1.5-2 liters of water every single day. When you have gentle sensitivity or warmth sensitivity, attempt staying in a cool, darkish room.

Can life-style selections assist menstrual migraine?

“Common train and a nutritious diet have been proven to scale back total menstrual signs and might help with migraine assaults,” Sheikh says. , constant sleep schedule may also assist. Attempt limiting espresso and vitality drinks in the event that they trigger issues along with your sleep.

Be taught to handle stress higher. Attempt leisure strategies. “Yoga and mindfulness could be a actually useful device to assist regulate your hormones and make this time simpler,” Sheikh says.

Which menstrual migraine remedy is true for me?

Your physician might help you determine which choices are finest for you. It could be a mix of methods, together with mini-prevention, acute remedy, and life-style adjustments. Or they could suggest steady contraception.

“You’ve gotten many helpful choices and most of them are protected,” Sheikh says. However everybody’s completely different and it is determined by many elements. “It’s necessary to take a person method,” she says.