Menstrual migraine

  • Ana Recober
  • Lynne O. Geweke
Article

Abstract

Migraine is a common disorder that is disproportionately prevalent in women, especially during the reproductive years. Hormonal changes may play a role in the etiology of migraine, as many women note that their migraine attacks occur in temporal relationship with their menses. The Headache Classification Subcommittee of the International Headache Society has recently defined menstrual and menstrually related migraine. We review the most relevant and recent literature on menstrual migraine, with a special focus on pathophysiology and therapy. Although the pathogenesis of menstrual and menstrually related migraine is not well understood, estrogen withdrawal seems to play an important role as a trigger for menstrual migraine attacks. The therapeutic approach also may differ from the treatment of nonmenstrual migraine. Some patients do not require prophylaxis when they can abort their attacks effectively, whereas others may benefit from perimenstrual prophylaxis or standard migraine prophylaxis.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Loder E, Marcus DA: Migraine in Women. Hamilton, Ontario: Decker BC; 2004:102–111.Google Scholar
  2. 2.
    MacGregor EA: “Menstrual” migraine: towards a definition. Cephalalgia 1996, 16:11–21.PubMedCrossRefGoogle Scholar
  3. 3.
    Headache Classification Subcommittee of the International Headache Society (IHS). The International Classification of Headache Disorders (2nd edition). Cephalalgia 2004, 24(Suppl 1):9–160.Google Scholar
  4. 4.
    Couturier EG, Bomhof MA, Knuistingh Neven A, et al.: Menstrual migraine in a representative Dutch population sample: prevalence, disability and treatment. Cephalalgia 2003, 23:302–308.PubMedCrossRefGoogle Scholar
  5. 5.
    Dzoljic E, Sipetic S, Vlajinac H, et al.: Prevalence of menstrually related migraine and nonmigraine primary headache in female students of Belgrade University. Headache 2002, 42:185–193.PubMedCrossRefGoogle Scholar
  6. 6.
    Solbach P, Sargent J, Coyne L: Menstrual migraine headache: results of a controlled, experimental, outcome study of non-drug treatments. Headache 1984, 24:75–78.PubMedCrossRefGoogle Scholar
  7. 7.
    Somerville BW: The role of progesterone in menstrual migraine. Neurology 1971, 21:853–859.PubMedGoogle Scholar
  8. 8.
    Somerville BW: The role of estradiol in the etiology of menstrual migraine. Neurology 1972, 22:355–365.PubMedGoogle Scholar
  9. 9.
    Somerville BW: Estrogen-withdrawal migraine. I. Duration of exposure required and attempted prophylaxis by premenstrual estrogen administration. Neurology 1975, 25:239–244.PubMedGoogle Scholar
  10. 10.
    Welch KM, Darnley D, Simkins R: The role of estrogen in migraine: a review and hypothesis. Cephalalgia 1984, 4:227–236.PubMedCrossRefGoogle Scholar
  11. 11.
    Fioroni L, Martignoni E, Facchinetti F: Changes of neuroendocrine axes in patients with menstrual migraine. Cephalalgia 1995, 15:297–300.PubMedCrossRefGoogle Scholar
  12. 12.
    Fioroni L, D’Andrea G, Alecci M, et al.: Platelet serotonin pathway in menstrual migraine. Cephalalgia 1996, 16:427–430.PubMedCrossRefGoogle Scholar
  13. 13.
    Brun J, Claustrat B, Saddier P, et al.: Nocturnal melatonin excretion is decreased in patients with migraine without aura associated with menses. Cephalalgia 1995, 15:136–139.PubMedCrossRefGoogle Scholar
  14. 14.
    Murialdo G, Fonzi S, Costelli P, et al.: Urinary melatonin excretion throughout the ovarian cycle in menstrually related migraine. Cephalalgia 1994, 14:205–209.PubMedCrossRefGoogle Scholar
  15. 15.
    MacGregor EA: Oestrogen and attacks of migraine with and without aura. Lancet Neurol 2004, 3:354–361. This is a recent review of hormonal factors in menstrual migraine.PubMedCrossRefGoogle Scholar
  16. 16.
    Massiou H: Is menstrually associated migraine difficult to treat? Cephalalgia 1999, 19(Suppl 24):13–18.PubMedGoogle Scholar
  17. 17.
    Stewart WF, Lipton RB, Chee E, et al.: Menstrual cycle and headache in a population sample of migraineurs. Neurology 2000, 55:1517–1523.PubMedGoogle Scholar
  18. 18.
    Mattsson P: Hormonal factors in migraine: a population-based study of women aged 40 to 74 years. Headache 2003, 43:27–35.PubMedCrossRefGoogle Scholar
  19. 19.
    Facchinetti F, Neri I, Martignoni E, et al.: The association of menstrual migraine with the premenstrual syndrome. Cephalalgia 1993, 13:422–425.PubMedCrossRefGoogle Scholar
  20. 20.
    Gupta VK: Menstrual migraine is not pathogenetically related to premenstrual syndrome. Cephalalgia 1994, 14:411–412.PubMedCrossRefGoogle Scholar
  21. 21.
    Facchinetti F: The premenstrual syndrome belongs in the diagnostic criteria for menstrual migraine. Cephalalgia 1994, 14:413–414.PubMedCrossRefGoogle Scholar
  22. 22.
    Granella F, Sances G, Allais G, et al.: Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centres. Cephalalgia 2004, 24:707–716. This is a study comparing the differences in clinical features and response to abortive therapy of menstrual and non-menstrual migraine.PubMedCrossRefGoogle Scholar
  23. 23.
    MacGregor EA, Hackshaw A: Prevalence of migraine on each day of the natural menstrual cycle. Neurology 2004, 63:351–353.PubMedGoogle Scholar
  24. 24.
    Johannes CB, Linet MS, Stewart WF, et al.: Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology 1995, 45:1076–1082.PubMedGoogle Scholar
  25. 25.
    Silberstein SD, Armellino JJ, Hoffman HD, et al.: Treatment of menstruation-associated migraine with the nonprescription combination of acetaminophen, aspirin and caffeine: results from three randomized, placebo-controlled studies. Clin Ther 1999, 21:475–491.PubMedCrossRefGoogle Scholar
  26. 26.
    Loder E, Silberstein SD, Abu-Shakra S, et al.: Efficacy and tolerability of oral zolmitriptan in menstrually associated migraine: a randomized, prospective, parallel-group, double-blind, placebo-controlled study. Headache 2004, 44:120–130.PubMedCrossRefGoogle Scholar
  27. 27.
    Facchinetti F, Bonellie G, Kangasniemi P, and the Sumatriptan Menstrual Migraine Study Group: The efficacy and safety of subcutaneous sumatriptan in the acute treatment of menstrual migraine. Obstet Gynecol 1995, 86:911–916.PubMedCrossRefGoogle Scholar
  28. 28.
    Silberstein SD, Massiou H, Le Jeunne C, et al.: Rizatriptan in the treatment of menstrual migraine. Obstet Gynecol 2000, 96:237–242.PubMedCrossRefGoogle Scholar
  29. 29.
    Loder E: Menstrual migraine: timing is everything. Neurology 2004, 63:202–203.PubMedGoogle Scholar
  30. 30.
    Loder E: Prophylaxis of menstrual migraine with triptans: problems and possibilities. Neurology 2002, 59:1677–1681.PubMedGoogle Scholar
  31. 31.
    Silberstein SD, Elkind AH, Schreiber C, et al.: A randomized trial of frovatriptan for the intermittent prevention of menstrual migraine. Neurology 2004, 63:261–269.PubMedGoogle Scholar
  32. 32.
    Newman L, Mannix LK, Landy S, et al.: Naratriptan as short-term prophylaxis of menstrually associated migraine: a randomized, double-blind, placebo-controlled study. Headache 2001, 41:248–256.PubMedCrossRefGoogle Scholar
  33. 33.
    ChavanuKJ, O’Donnell DC: Hormonal interventions for menstrual migraines. Pharmacotherapy 2002, 22:1442–1457. This is a thorough review of the literature on hormonal therapy for menstrual migraine, with detailed tables comparing the studies discussed.CrossRefGoogle Scholar
  34. 34.
    Silberstein SD: The role of sex hormones in headache. Neurology 1992, 42(Suppl 2):37–42.PubMedGoogle Scholar
  35. 35.
    de Lignieres B, Vincens M, Mauvais-Jarvis P, et al.: Prevention of menstrual migraine by percutaneous oestradiol. BMJ 1986, 293:1540.PubMedCrossRefGoogle Scholar
  36. 36.
    Smits MG, Meer YG, Pfeil JP, et al.: Perimenstrual migraine: effect of Estraderm TTS (r) and the value of contingent negative variation and exteroceptive temporalis muscle suppression test. Headache 1993, 34:103–106.CrossRefGoogle Scholar
  37. 37.
    MacGregor A: Effects of oral and transdermal estrogen replacement on migraine. Cephalalgia 1999, 19:124–125.PubMedCrossRefGoogle Scholar
  38. 38.
    O’Dea JP, Davis EH: Tamoxifen in the treatment of menstrual migraine. Neurology 1990, 40:1470–1471.PubMedGoogle Scholar
  39. 39.
    Lichten EM, Bennett RS, WhittyAJ, et al.: Efficacy of danazol in the control of hormonal migraine. J Reprod Med 1991, 36:419–424.PubMedGoogle Scholar
  40. 40.
    Herzog AG: Continuous bromocriptine therapy in menstrual migraine. Neurology 1997, 48:101–102.PubMedGoogle Scholar
  41. 41.
    Murray SC, Muse KN: Effective treatment of severe menstrual migraine headaches with gonadotropin-releasing hormone agonist and “add-back” therapy. Fertil Steril 1997, 67:390–393.PubMedCrossRefGoogle Scholar
  42. 42.
    Martin V, Wernke S, Mandell K, et al.: Medical oophorectomy with and without estrogen add-back therapy in the prevention of migraine headache. Headache 2003, 43:309–321.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2005

Authors and Affiliations

  • Ana Recober
    • 1
  • Lynne O. Geweke
    • 1
  1. 1.Department of Neurology, Division of Head and Facial PainUniversity of Iowa Hospitals and ClinicsIowa CityUSA

Personalised recommendations