Abstract
More than half of women with migraine note an association of headache attacks and their menstrual cycles. Headaches associated with menses are often more severe and disabling than headaches that occur other times of the month. First-line therapies include acute agents used for migraine in general; however, for many women, these therapies provide incomplete relief. In these situations, treatment options include short-term perimenstrual prevention employing nonsteroidal anti-inflammatory medications, triptans, or hormone-containing preparations. Should these options not suffice, or if menstrual cycles are irregular, continuous prevention using hormonal therapies or standard anti-migraine prophylaxis should be considered.
Similar content being viewed by others
References
Lipton RB, Stewart WF, Diamond S et al (2001) Prevalence and burden of migraine in the United States; data from the American Migraine Study II. Headache 41:646–657
Stewart WF, Lipton RB, Chee E, Sawyer J, Silberstein SD (2000) Menstrual cycle and headache in a population sample of migraineurs. Neurology 55:1517–1523
Martin V (2004) Menstrual migraine: a review of prophylactic therapies. Curr Pain Headache Rep 8:229–237
Johannes CB, Linet MS, Stewart WF, Celentano DD, Lipton RB, Szklo M (1995) Relationship of headache to phase of the menstrual cycle among young women: a daily diary study. Neurology 45:1076–1082
Calhoun AH, Hutchinson S (2009) Hormonal therapies for menstrual migraine. Curr Pain Headache Rep 13:381–385
Ventik KG, MacGregor EA, Lundquist C et al (2010) Self-reported menstrual migraine in the general population. Pain 11:87–92
MacGregor EA, Hackshaw A (2004) Prevalence of migraine on each day of the natural menstrual cycle. Neurology 63:351–353
MacGregor EA (2012) Classification of perimenstrual headache: clinical relevance. Curr Pain Headache Rep 16:452–460
Somerville BW (1971) The role of progesterone in menstrual migraine. Neurology 21:853–859
Benedetto C, Allais G, Ciochetto D et al (1997) Pathophysiological aspects of menstrual migraine. Cephalalgia 17(suppl 20):32–34
MacGregor EA (2009) Menstrual migraine: therapeutic approaches. Ther Adv Neurol Disord 2:327–336
Couturier EG, Bombof MA, Neven AK et al (2003) Menstrual migraine in a representative Dutch population sample: prevalence, disability and treatment. Cephalalgia 23:302–308
Martin VT, Wernke S, Mandell K et al (2005) Defining the relationship between ovarian hormones and migraine headache. Headache 45:1190–1201
Sullivan E, Bushnell C (2010) Management of menstrual migraine: a review of current abortive and prophylactic therapies. Curr Pain Headache Rep 14:376–384
Vetvik KG, Russell MB (2011) Are menstrual and nonmenstrual migraine different? Curr Pain Headache Rep 15:339–342
Granella F, Sances G, Allais G et al (2004) Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centers. Cephalalgia 24:707–716
Headache Classification Committee of the International Headache Society (IHS) (2013) The international classification of headache disorders, 3rd edition (beta version). Cephalalgia 33:629–808
Loder E, Silberstein SD, Abu-Shakra S, Mueller L, Smith T (2004) Efficacy and tolerability of oral zolmitriptan in menstrually associated migraine: a randomized, prospective, parallel-group, double-blind, placebo-controlled study. Headache 44:120–130
Newman LC, Harper S, Jones BA, Campbell J (2009) Frovatriptan for acute treatment of migraine associated with menstruation: results from an open-label postmarketing surveillance study. J Womans Health 18:1265–1273
Allais G, Acuto G, Cabarrocas X, Esbri R, Benedetto C, Bussone G (2006) Efficacy and tolerability of almotriptan versus zolmitriptan for the acute treatment of menstrual migraine. Neurol Sci 27(Suppl. 2):S193–S197
Allais G, Bussone G, De Lorenzo C et al (2007) Naproxen sodium in short-term prophylaxis of pure menstrual migraine: pathophysiological and clinical considerations. Neurol Sci 28(Suppl 2):S225–S228
Sances G, Martignoni E, Fioroni L, Blandini F, Facchinetti F, Nappi G (1990) Naproxen sodium in menstrual migraine prophylaxis: a double-blind placebo controlled study. Headache 30:705–709
Newman LC, Lipton RB, Lay CL, Solomon S (1998) A pilot study of oral sumatriptan as intermittent prophylaxis of menstruation-related migraine. Neurology 51:307–309
Moschiano F, Allais G, Grazzi L, Usai S, Benedetto C, D’Amico D et al (2005) Naratriptan in the short-term prophylaxis of pure menstrual migraine. Neurol Sci 26(Suppl 2):s162–s166
Newman L, Mannix LK, Landy S, Silberstein S, Lipton RB, Putnam DG et al (2001) Naratriptan as short-term prophylaxis of menstrually associated migraine: a randomized, double-blind, placebo-controlled study. Headache 41:248–256
Allais G, Tullo V, Omboni S et al (2013) Frovatriptan vs other triptans in the treatment of menstrual migraine: pooled analysis of three double-blind, randomized, cross-over studies. J Headache Pain 14(Suppl 1):191
Hu Y, Guan X, Fan L et al (2013) Triptans in prevention of menstrual migraine: a systematic review with meta-analysis. J Headache Pain 14:7–15
Guidotti M, Mauri M, Barrila C, Guidotti F, Belloni C (2007) Frovatriptan vs. transdermal oestrogens or naproxen sodium for the prophylaxis of menstrual migraine. J Headache Pain 8:283–288
Tassorelli C, Greco R, Allena M et al (2012) Transdermal hormonal therapy in perimenstrual migraine: why, when and how? Curr Pain Headache Rep 16:467–473
Calhoun A (2004) A novel specific prophylaxis for menstrually-associated migraine. South Med J 97:819–822
Edelman A, Gallo MF, Nichols MD, Jensen JT, Schulz KF, Grimes DA (2006) Continuous versus cyclic use of combined oral contraceptives for contraception: systematic Cochrane review of randomized controlled trials. Hum Reprod 21:573–578
Sulak P, Willis S, Kuehl T, Coffee A, Clark J (2007) Headaches and oral contraceptives: impact of eliminating the standard 7-day placebo interval. Headache 47:27–37
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Newman, L.C., Yugrakh, M.S. Menstrual migraine: treatment options. Neurol Sci 35 (Suppl 1), 57–60 (2014). https://doi.org/10.1007/s10072-014-1743-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-014-1743-3